划分疼痛的伤害性、参与性、情感性和指令性(HEED)维度。描述临床相关性。

IF 2.6 2区 医学 Q2 ANESTHESIOLOGY Pain physician Pub Date : 2024-09-01
James Giordano, John R Shook
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引用次数: 0

摘要

疼痛是有知觉的生物所面临的客观自然现实,这些生物拥有足够的认知能力和行动能力,能够理解疼痛的全部意义并付诸行动。主要用心理术语来定义疼痛,对于有自我意识的心理学和词汇来说是有意义的。疼痛作为动物的一种自然能力,其进化并不仅仅是为了与人类的语义和直觉相一致。关于疼痛的很多东西都是在可触及的、明确的意识层面之下运作的,疼痛作为一种感官感受,很可能在哺乳动物认知之前就已经出现了。疼痛不应被视为一种完全主观的简单感觉。它表现出质的差异、强度的不同、持续时间的波动、注意力的转移和/或捕获。疼痛的这些特征使它在影响行为的无数生理感受和情绪中处于意识的突出位置。疼痛的意义不能忽略疼痛的感觉,如果没有改变身体活动方向的迫切意义,疼痛就不会是疼痛。大多数疼痛都具有伤害性、参与性、情感性和指令性(即 - HEED)等特征。因此,疼痛进化为 HEED-ed。我们提出的操作性划分乍看之下似乎是生理学的,但它依赖于疼痛机体的生物-心理-社会现实,使其在理论上具有可还原性和可扩展性。对疼痛的这一界定要求疼痛发生的机体对疼痛加以关注,因此,那些声称要研究和治疗疼痛的人在伦理上也要关注疼痛。
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Delineating the Hurtful, Engaging, Emotive, and Directive (HEED) Dimensions of Pain. Characterization for Clinical Relevance.

Pain is an objective, natural reality among sentient creatures that possess cognition and mobility sufficient for apprehending and acting upon its full significance. Defining pain mostly in mental terms makes sense for self-conscious psychology and vocabulary. Pain as a natural capacity among animals did not evolve merely to be aligned with human semantics and intuitions. Much about pain operates beneath the level of accessible and explicit consciousness, and pain as a sensory feeling probably arose before mammalian cognition. Pain should not be viewed as just a simple sensation of utter subjectivity. It displays qualitative variance, degrees of intensity, fluctuating durations, and deflects and/or captures attention. These features of pain situate it prominently within awareness amidst the myriad physical feelings and emotions that influence behavior. The significance of pain cannot omit felt painfulness, and pain wouldn't be painful without its urgent significance for redirecting bodily activity. Most pain shares characteristics of being hurtful, engaging, emotive, and directive (i.e.,- HEED). So delineated, pain evolved to be HEED-ed. Our proposed operational delimitation at first glance appears to be physiological, but its reliance upon the bio-psychosocial actuality of the painient organism renders it inter-theoretically reducible and expandable. This delineation of pain necessitates its being HEED-ed by the organism in which it occurs; and hence ethically heeded by those who profess to study and treat it.

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来源期刊
Pain physician
Pain physician CLINICAL NEUROLOGY-CLINICAL NEUROLOGY
CiteScore
6.00
自引率
21.60%
发文量
234
期刊介绍: Pain Physician Journal is the official publication of the American Society of Interventional Pain Physicians (ASIPP). The open access journal is published 6 times a year. Pain Physician Journal is a peer-reviewed, multi-disciplinary, open access journal written by and directed to an audience of interventional pain physicians, clinicians and basic scientists with an interest in interventional pain management and pain medicine. Pain Physician Journal presents the latest studies, research, and information vital to those in the emerging specialty of interventional pain management – and critical to the people they serve.
期刊最新文献
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