The Differentiation Between Pain and Discomfort: A Concept Analysis of Discomfort

Background: Discomfort is a concept found in the literature, usually related to pain. Some sources do not distinguish between pain and discomfort. Others refer to different sources of discomfort, thereby leading to a lack of conceptual clarity. Aims: The objective of this paper was to present a concept analysis of discomfort. Full-text articles published between 1970 and 2016 in English were used to inform the concept analysis. Design: Articles were taken from CINAHL, Medline and PsycNET databases. Methods: A total of 7,406 articles and 120 abstracts were identified for evaluation. After initial review, 42 articles were further analyzed. Two reviewers independently evaluated the selected publications using the Walker and Avant approach to concept analysis. Results: Discomfort can be physical or psychological and is characterized by an unpleasant feeling resulting in a natural response of avoidance or reduction of the source of the discomfort. Pain is one of the causes for discomfort, but not every discomfort can be attributed to pain. It is identified by self-report or observation. Discomfort in noncommunicative patients is assessed and measured via behavioral expression, also used to describe pain and agitation, leading to discomfort being interpreted as pain in some conditions. Conclusions: A clarification of the concept of discomfort leads to a more accurate theoretical and operational definition. This clarification can help nurses to make more accurate nursing diagnoses and develop methods to measure discomfort in order to provide optimal quality of nursing care. (C) 2019 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.