George

Please do not work on this assignment at home. Wait until I give you instructions in class during my presentation on Thursday. Thank you.

**Memo 3 Example of a Comparison and Question Asking Memo** **April 4, 1997** **Brainstorming Memo About “The Pain** **Experience” and its Properties and Dimensions** Working from my personal experience, professional training, and the literature, I know that arthritis is certainly not the only cause of pain. One can also have pain from an injury, say a pulled muscle or a mild burn. Pain then can vary in “type” from “burning” to “sharp,” “dull,” and even “throbbing.” It can be described as “horrible,” “overwhelming,” “disruptive” or just an “irritant.” Pain is “percep- tual.” That means that if there happened to be an objective way to measure pain, two persons said to have the same objective pain would experience that pain differently because of who they are and what they bring with them to the pain experience. Some persons after surgery need lots of medication. Other persons need less. It’s because each person has a different “pain threshold” and different “reactions” to pain. Another point, the “pain experience” has a “trajectory” or course. The experience of pain does not begin with this pain but reaches back into the past, has a present, and enters into the next pain experience. Also this particular pain experience can vary being more or less intense over time. Thus, I now have some ideas for theoretical sampling such as looking for situations of temporary vs. chronic pain, intense pain versus more mild pain, and a pain history that includes relief from pain vs. a history unsatisfactory pain manage- ment. As I think about it, the pain experience is influenced by a combination of many factors such as intensity, duration, and whether or not it can be relieved partially, entirely, for good, or temporarily, as well as history. I recall a woman who had post-herpetic pain that never went away. She eventually died not from the pain per se but probably because she was worn down by it. Her history of looking for relief was a long one. In the end she just had to learn to live with the pain and decided that fighting it every day just was no longer feasible, getting at the meaning of pain and implications for daily life or biography. I can see that I have a lot of work to do to discover the relationships between pain and its properties, pain relief, and the pain experience. I also have a few questions that I would like to ask when I do that sampling. I should look at individuals with “chronic pain.” It is the property of chronicity that is driving me to collect data on persons, such as those with rheumatoid arthritics, herpetic pain, sickle cell anemia, and cancer. I should also look at those with “temporary” pain. Here it is the property of pain being “temporary” that is driving the data collection. I should go to persons with pain related to childbirth, surgery, or an injury to find temporary pain. Burns and amputations are both interesting areas because the pain may be “temporary” or “chronic” depending upon complications. Still another question is, what are the various patterns of the pain experience? Are there various patterns of experiencing pain that cross cut these various proper- ties? How is the meaning of pain derived? Does whether or not pain is expected

or not expected make a difference? Does the ability or probability to obtain relief make a difference? I mean, if one expects or believes that relief will come with treatment vs. the belief that there will be no relief despite treatment, does this make a difference in the experience? If pain is expected, what are the steps that are taken to prevent or lessen it? How do persons control their lives or activities to minimize pain? How do factors such as culture, age, gender, how long the pain has been going on, intensity, and efforts at relief affect the pain experience? (End of memo.)

Summary: The memo starts out positing that there is more than one way to look at pain that may appear to be the same. The type of pain can also vary in intensity and duration. The question becomes how than can these multiple variables be coded into a coherent organized document for research. How is it then that we go about creating sort of prescriptive methodologies to deal with the many faces of pain. Due to the number of variable present the answer must be mulitfaceted.