GOVERNMENT COLLEGE OF NURSING,

JODHPUR (RAJ.)

Subject- Nursing Education

Assignment on- Pain and Sensory Deprivation

SUBMITTED TO - SUBMITTED BY-

Mrs. SUMI MATHEW DIVYA SHARMA
NURSING LECTURER M.Sc. Nursing Pre. Year
GCON, Jodhpur BATCH-2020
GCON, Jodhpur

DATE OF SUBMISSION-
 PAIN
Definition of Pain :-

Pain is defined as unpleasant, subjective and emotional experience associated with

actual or potential tissue damage.( According to IASP: International association for the study
of pain)

Nature of Pain:-

• Pain is a complex set of multiple nuclei.

• Pain is subjective and highly individualized
• Pain cannot be objectively measured; only the client know whether pain is present and what
is the experience is like.
• Pain is fifth vital sign.

Physiology of Pain :-

Multidimensional experience includes 5 component

• Physiologic
• Behavioural
• Sensory
• Effective

(1)Physiologic dimension of Pain

The neural mechanism by which pain is perceived consist of four major steps

(1) Transduction
Transduction is process by which painful physical and chemical stimulus is
transformed into that can be carried (via transmission) to the central nervous system and
perceived as Pain.
Or
It is a conversation of a mechanical, thermal or chemical stimulus into a neuronal
action potential.
(2) Transmission

It is a movement of pain impulses from the site of transduction to the brain

Action potential continues from:

• Site of injury to spinal cord

• Spinal cord to brain stem and thalamus
• Thalamus to cortex for processing
(3) Perception

It occurs when pain is recognised, defined and responded to by the individual

experiencing the pain. It is the conscious experience of pain.

(4) Modulation ( Inhibition of pain transmission)

Pain modulation refers to the process by which the body alters a pain signal as it is
transmitted along the pain pathway. The neurones originating in the brain stem descend to
spinal cord and release substance that inhibit nociceptive impulses such as serotonin,
norepinephrine, gamma-Amino butyric acid and endogenous opioids that can inhibit pain
transmission.

(2) Sensory, Affective, Behavioural, Cognitive and Sociocultural

Dimensions of Pain:-

• Sensory components of pain is the recognition of the sensation as painful. Sensory

pain elements include patterns, area, intensity, and nature
• The affective component of pain refers to the emotional responses to the pain
experience, these affective response include anger, fear, depression, and anxiety.
• The behavioural components of pain refers to the observable actions used to express
or control pain . For example, facial expressions such as grimacing may reflect pain or
discomfort.
• The cognitive components of pain refers to belief, attitudes, memories, and meaning
attributed to pain.
• The sociocultural dimension is the effect of the patient's social and cultural background on
perception of and response to pain. It can influence beliefs about pain medications, treatment
 options, hospitalization, and the roles and responsibilities of both healthcare providers and the
patient.

Types of Pain

Pain can be described by its origin or cause and by its nature or description.

On The Basis Of Origin, Pain Can Be Classified As :

(1) Cutaneous Pain:-

This is caused by stimulating the cutaneous nerve endings in the skin and
results in in a well-organized “burning” or “ prickling”. Eg: Tangled hair pulled during
comb and produce stimulation in nerve endings which present on skin , cause a cutaneous
pain.

(2) Somatic or Deep Pain :-

This is non localized and originates in supporting structures such as tendons,

ligaments and nerves.

Deep pain is poorly localized, may produce nausea and in frequently

associated

Sweating and changes in blood pressure. Eg. Pain from lumbar disc is felt along the

Sciatic pain .

(3) Visceral or Splanchnic Pain:-

Visceral pain is a discomfort in the internal organs is less localized and more slowly
transmitted than cutaneous pain. Visceral pain is transmitted through sympathetic and
parasympathetic fibres of ANS with the pain referred to the body surface, often in site at a
distance..

On The Basis Of Nature, Pain Is Divided Into Two :

(1) Acute pain :-

Acute pain has a sudden onset, relatively short duration, mild to severe intensity, with
a steady decrease in intensity over a period of days to weeks.
 Or

Acute pain begins suddenly and usually sharp in quality. It severe as a warning
of disease or a threat to the body.

Acute pain might be caused by many events of circumstances , including: surgical pain.
Traumatic pain , example broken bone, cut or burn.

Recurrent Acute Pain:-

It is repetitive painful episodes that recur over a prolonged period or throughout the
client's lifetime . Pain intervals alternate with painful episodes.

(2)Chronic pain

Chronic pain is defined as long term, persistent, nearly constant or recurrent pain
producing significant changes in the client's life. Chronic pain may last long after the
pathology is resolved.

Chronic Acute Pain

It occurs almost daily over a long period, months or years, and may never stop. Eg:
cancer pain.

Chronic Non Malignant Pain:-

It is also called chronic benign pain, occurs almost daily and lasts for at least 6
months, ranging from mild to severe intensity. Three critical characteristics of chronic Non
Malignant Pain is identified by Mc Caffery and Pasero.

• Caused by non-life threatening causes

• Not responsive to currently available pain relief methods
• May continue for the rest for the client’s life. Eg: Rheumatoid arthritis

Other Classifications

• Psychogenic pain.( Caused by psychological factors like depression and anxiety)

• Idiopathic pain.( Due to unknown cause )
• Nociceptive pain.( Caused by damage to body tissue )
• Neuropathic pain. ( Caused by damage or injury to the nerve)
• Deafferentation pain. ( Due to loss of sensory input into the CNS)
 Purpose of Pain

• Serves as a protective mechanism.

• Can be a diagnostic tool.

Theories of Pain

(1) The Specificity Theory :- ( Von Frey, 1895)

The theory was based on the assumption that pain was perceived following injury
because there was specific pain receptors transmit signal to a pain centre in the brain that
produces perception of pain .
(2) Pattern Theories:- ( John Paul Nafe, 1929)
This relate to the perception of pain to patterns of impulses in the nervous system
rather than to impulses in dedicated pain pathways. The pattern may be temporal ( in time) or
spatial ( the space). Pattern Theories may explain some chronic or recurrent pains which
occurs when there are nerve lesions.
(3) The Gate Control Theory:- ( Ronald Melzack and Patrick Wall, 1965)
• Psychologist Ronald Melzack and anatomist Patrick Wall proposed gate control theory for
pain in 1965 to explain the pain suppression.
• According to them, the pain stimuli transmitted by afferent pain fibbers are blocked by gate
mechanism at the posterior grey horn of spinal cord.

• The theory suggest nerve fibbers that contribute to pain transmission coverage at a site in the
dorsal horn of the spinal cord .
• This site is thought to act as a gating mechanism to determines which impulses will be
blocked and which will be transmitted to the thalamus.
• The image of gate is useful in teaching clients and their families about pain relief measures.
• If the gate is closed, the signal is stopped before it reaches the brain, where perception of pain
occurs.
• If gate is open, the signal will continue on through the spinothalamic track to the cortex and
the client will feel the pain.
• Where the gate is open or closed is influenced by impulses from peripheral nerves and nerve
signals that descend from the brain.
• If a person is anxious, the gate can be opened by signals sent from the room down to the
mechanism in the dorsal horn of the spinal cord.
• On the other hand, if the person has had positive experiences with pain control in the past, the
cognitive influences can send signal down to the gating mechanism and close it.

Factors Affecting the Pain Experience

• Age
• Previous pain experience
• Drug abuse
• Cultural norms

Phases Of Pain Experience

• The anticipation or fear of pain

• The sensation of pain .
• The aftermath of pain.( Aftermath :- a situation that is the result of an important or unpleasant
event)

Pain Assessment Tools:-

• Verbal analogue scale

• Visual analogue scale
• The faces scale

Factors to consider choosing a pain scale

• Age of patient
• Physical condition
• Level of consciousness
• Mental status
• Ability to communicate
(1) Numeric pain rating scale :-
• Ask the patient to rate the pain intensity on a scale of 0 (no pain) to 10 (the worst pain
imaginable)
• Some patients are unable to do this with only verbal instructions, but may be able to look at a
number scale and point to the number that describes the intensity of pain.

Fig. PAIN RATING SCALE...........

(2) Wong-Baker faces rating scale:-
• Can we use with young children ( some times as young as 3 years of age )
• Work well for many older children and adult as well as for those who speak a different
language.
• Explain that each face represents a person who may have no pain, some pain or much pain as
imaginable. Point to the appropriate face and say the appropriate description. E.g. “ This face
hurts just a little bit”
• Ask the patient to choose the face that best matches how she or he feels or how much they
hurt.
(3) Colour pain rating scale:-
• Ask the patient to point to the area on the scale that shows their level of pain from white (no
pain) to dark red ( worst possible pain)
• Obtain a number corresponding to the area where the patient points.

Pain management

(1) Goals is pain management therapy

• Decreased pain
• Decreased health care utilisation
• Decrease emergency room visits
• Improved functional status
• Increased ability to perform activities of daily living
Types of pain management
(1) Non pharmacological management
(2) Pharmacological management
(3) Others
➢ Non pharmacogical management:-
❖ Weight reduction
❖ Exercise
❖ Counselling
❖ Smoking cessation
❖ Massage, relaxation therapy
❖ Heat and cold application
➢ Pharmacological management
❖ Non opioids – E.g. Aspirin, Paracetamol
❖ Opioids – E.g. Codeine, morphine
❖ Adjuvant – E.g. muscle relaxant, antidepressants, antiepileptic.
➢ Choosing the appropriate analgesics
❖ Match severity of pain to the strength of the analgesics i.e. strong analgesic for severe pain
❖ The WHO developed 3 steps model guide analgesic choice depending on the severity of
patient’s pain.
➢ WHO management ladder
❖ Step 1
NSAIDS +/- adjuvant
❖ Step 2
NSAIDS + mild opioids +/- adjuvant
❖ Step 3
Strong opioids + NSAIDS +/- adjuvants
➢ Analgesics (Non opioids)
❖ There are three types of non opioids analgesics
▪ Salicylate
▪ Non-steroidal anti-inflammatory drugs
▪ Acetaminophen
❖ Use in full dose for the most part
❖ All have ceiling effect to their analgesia (a maximum dose past with no further analgesia can
be expected)
➢ Analgesics ( weak opioids)
Useful drugs
❖ Codeine and codeine combination product
❖ Oxycodone combination product
➢ Don’t use
❖ Dextropropoxyphene
➢ Analgesics ( strong opioids )
Useful drugs
❖ Morphine, hydromorphone, fentanyl, oxycodone, methadone
Don’t use
❖ Meperidine, anileridine, pentazocine
➢ Opioids Dosing
❖ Opioids analgesia is most effective when titrated to effect
❖ Effective dosage are highly variable between patient
❖ When use properly for analgesia addiction occurs in less than 1% of patients.
➢ Opioids side effects
❖ Constipation ( need proactive laxative use)
❖ Nausea/vomiting ( need antiemetic like metoclopramide)
❖ Urinary retention ( need of catheter )
❖ Itching/ rashes ( need of antihistamines like cetirizine)
❖ Respiratory depression ( may be need of ventilator )
❖ Neurotoxicity: Delirium, myoclonus seizures
❖ Dry mouth
➢ Adjuvant analgesics (Coanalgesics) :-
❖ Are medications that when added to primary analgesics, further improve pain control
❖ May themselves also be primary analgesics ( E.g. tricyclic antidepressants medications for
post therapeutic neuralgia )
❖ They can be added into the pain management plan at any steps in WHO ladder
➢ Adjuvants for neuropathic pain :-
❖ When pain is neuropathic there is good evidence for treating with adjuvant medication
rapidly
❖ E.g. : such as cyclic antidepressants, ( Amitriptyline, maprotiline) anticonvulsant,
(carbamazepine, valproic acid) local anaesthesia ( lidocaine)
➢ Surgical management/ other management
❖ Nerve blocks, epidural blocks and neurological procedures may be effective in pain
management
❖ Such procedure may be associated with return of pain after a number of months so that timing
of procedures may be important.
➢ Nursing management :-
Nurse role in caring for people in pain
1 In relation to the process in pain
❖ Assessor
❖ Preventor
❖ Strength lender and validator
❖ Support of patient's method of control
❖ Teacher of coping strategies
❖ Provide of specific pain therapies

2 In relation to other carers

❖ Advocate and educator

❖ Team member
❖ Team coordinator

3 In relationship to environment

❖ Planner, provider or controller of ambient temperature, noise etc .

➢ ASSESSMENT :-
Assessment of pain includes
❖ SUBJECTIVE
❖ OBJECTIVE
➢ Subjective :-
❖ A client’s pain threshold and pain tolerance level should be assessed. Pain threshold is the
intensity level where a person feels pain. It varies with each individual and with each type of
pain
❖ Assess location, onset and duration of the pain.
❖ Enquire about aggravating and alleviating factors and associated menifestations.
➢ Objective :-
❖ Objective data often presents a different picture depending on the type of pain the client is
experiencing
➢ Recording pain assessment findings
➢ NURISNG DIAGNOSIS
The two primary nursing diagnosis used to describe pain are ACUTE PAIN and CHRONIC
PAIN. Many diagnoses can be related to the client in pain depending on the effects of pain:
❖ Activity intolerance
❖ Anxiety
❖ Constipation
❖ Deficient knowledge
❖ Disturbed sleep pattern
❖ Disturbed body image
❖ Disturbed thought process
❖ Fatigue
❖ Fear
❖ Hopelessness
❖ Impaired social interaction
❖ Ineffective breathing pattern
❖ Ineffective individual coping
❖ Ineffective role performance
❖ Ineffective therapeutic regimen management
❖ Powerlessness
➢ PLANNING

When planning care, mutual gaol setting with the client experiencing pain is most important.
The nurse and client work together to develop realistic outcomes.

The general principles of management include

❖ Individualisation
❖ Prevention
❖ Utilisation of a multi disciplinary approach
➢ Individualisation
A variety of pain relief measures can be tried in many combinations. It is important to include
measures that the client believes will be effective. The cognitive component of pain
perception can have a powerful influence on the effectiveness of interventions. This may
mean including folk remedies or non scientific relief measures
➢ Use a preventive approach
Pain is much easier to control if it is treated before it gets severe. Interventions should be
implemented when pain is mild or when it is anticipated. E.g. :- medicate a client before a
painful dressing change or treatment rather than waiting for the pain occur.
➢ Use a multi disciplinary approach
Pain relief is a complex phenomenon requiring input from various members of the heath care
team. The nurse's role is pivotal (vitally important) in managing a client’s pain. The physician
also plays a key role, diagnosing and treating the medical cause of pain, which includes
prescribing appropriate medications. In complex cases, other professionals, such as physical
therapist, psychologist, social workers or chaplains may be needed.
OR
• The patient must also be believed
• Every patient deserves adequate pain management
• Treatment must be based on patient's goals.
• Treatment plan should use a combination of drug and nondrug therapies
• Multi disciplinary approach will be necessary to address all dimensions of pain
• All therapies must be evaluated to ensure that they are meeting the patient’s goals.
• Drug side effects must be prevented or managed
• Patient and family teaching should be a cornerstone to treatment plan .
➢ Conclusion

Nurses are often the first health care professionals to encounter the person in pain, so the
relationship patients and nurses can have an important part in the care of person with pain.
 SENSORY DEPRIVATION

Introduction :-

➢ Nature of sensory stimulation

➢ Normal sensory perception
❖ Reticular Activating System ( RAS)
❖ Input senses
➢ Characteristics of normal sensory perception
➢ Normal sensory patterns
❖ Sensory stasis
❖ Adaptation
➢ Sensory alterations
❖ Sensory overload
❖ Sensory deprivation
❖ Factors affecting sensory deprivation
▪ Environment
▪ Previous experience
▪ Culture
▪ Personality, life styles and habits
▪ Illness
▪ Medications
▪ Variations in stimulation
❖ Sensory deprivation in hospital settings
❖ Effects of sensory deprivation
▪ Perceptual Responses
▪ Cognitive Responses
▪ Emotional Responses
❖ Clinical signs of sensory perception
▪ Physical behaviours
▪ Emotional behaviours
▪ Changes in perception behaviour
▪ Changes in cognitive behaviour
❖ Impact of activities on daily livings
❖ Relaxation techniques
▪ Chamber test
▪ Flotation test
▪ Benefits of the therapy
▪ Side effects of the therapy
❖ Role of the nurse
▪ Nurse client interaction
❖ Theory application

❖ Journal abstract

❖ Summary

❖ Conclusion

❖ Bibliography
➢ Introduction:-
Sensory stimulation is a subject of interest to both biological and social sciences.
From conception to death, the human being uses sensory organs to learn about the
environment in which he lives. Stimulations of the sensory organs also promotes
development of these organs and contributes to overall well being of the individual.
Sensory stimulation programmes are one of the most common type of activities which
found in long term care facilities. Simply stated a sensory stimulation is a technique that
provides meaningful and common smells, movements, feels, sights, sound and tastes through
the stimulation of all six senses.
➢ Nature of sensory stimulation:-

o Sensory impulses : phenomenon of polarization and depolarisation through which the

abnormal activity of a fibre spreads through a nerve.
o Sensory neurones : Nerve cord carrying sensory stimuli to the brain
o Dendrite : cytoplasmic extension of a nerve cell
o Cell body : part of the nerve cell between the axon and the dendrites
o Axon: extension of neurones
o Motor neurone : nerve that produces muscular activity
o Motor end plate : muscular organ that becomes active in response to stimuli
o Myelin sheath : Envelope of phosphorated fats
o Receptors ( free nerve endings) : Receiver of nervous stimuli.
 For a person to revive data, FOUR conditions must be met. They are:-
o A STIMULUS : An agent, act or other influence capable of initiating a response by the
neurones by the nervous system must be prevented
o A RECEPTOR OR SENSORY ORGAN must receive the stimulus and convertor to a
nerve impulse .
o The NERVE IMPULSE must be conducted along a nervous pathway from the receptor or
sense organ to the brain.
o A PARTICULAR AREA in the brain must receive the impulse into a sensation.

The study of stimulation begins with nerve cells, NEURONE. The cell has a projection or
process called DENDRITES or DENDRONE, that carries an impulse to neurone. It has an
AXON which carries an impulse to CNS. Sensory nerves carry some impulses to area of the
brain where the individual becomes aware of the stimulation.

Perception than occurs with awareness

When impulses reaches consciousness, the individual becomes aware out side of the world
(E.g. : optic nerve carry message from the eye, Olfactory nerve carry from the nose so on)

The structure that receive stimuli is called RECEPTOR ( E.g. : eye is receptor of light waves
and muscle is the receptor of skeletal muscles)

Sensory perception involves the conscious organization and translation of the data or stimuli
into meaningful information . Sensory perception depends on the sensory receptors, reticular
activating system (RAS), and functioning nervous pathways to the brain. The RAS influences
awareness of stimuli, which are received the five senses : sight, hearing, touch, smell and
taste.

Reticular Activating System ( RAS)

It is responsible for bringing together information from the cerebellum and other parts of the
brain with the sense organs. The RAS is highly selective. For example, a parent my be
 awakened in the middle of the night at the slightest murmur of an infant in a bedroom down
the hall but may sleep through the loud traffic noises outside the bedroom window.
Destruction of RAS produces coma and an electroencephalograph pattern characteristics of
sleep.

Input of senses

Sensory functions begins with receptions of stimuli

❖ Externally the sensory receiving stimuli are:-

Vision, smell, taste , hearing and touch .
❖ Receptors organs are eyes, ear , olfactory receptors in the nose, taste buds on the tongue and
nerve endings in the skin and body tissues.
❖ Vision, hearing, smelling and tasted are termed, special senses.

Characteristics of normal sensory perception

❖ Normal vision is associated with visual acuity at or near 20/20, fill field of vision tricolour
vision ( red, green, blue)
❖ Normal hearing is associated with auditory acuity of sounds at an intensity of 0 to 25 dB, at
frequencies of 125 to 8000 cycles per second .
❖ Normal Taste involves the ability to discriminate sour, salty, sweet and bitter
❖ Normal Smell, involves the discrimination of primary odours, such as cainphoraceotrs,
musky, floral, peppermint , ethereal, pungent, and ptitrid
❖ Somatic senses, include discrimination of touch, pressure, vibration, position, tickling,
temperature and pain.

Normal sensory pattern

❖ Sensory stasis
Each person has his or her comfort zone. This comfort zone varies from person to person and
is the range at which a person perform at his or her peak. Sensor stasis is a state of optimum
arousal- not too much and not too little.
❖ Adaptation
Beyond the point of sensor stasis, sensory adaptation occurs. Sensory receptors adapt to
repeated stimulation by responding less and less. Lead time and after burn are two necessary
time periods crucial to helping a person deal with new stimuli.
▪ Lead time is the time each person needs to prepare for an event emotionally and physically.
▪ After burn is the time needed to think about, evaluate, and come to terms with activity after
its happens
❖ Sensory alterations
A change in environmental can be lead to MORE and LESS normal stimuli. When stimuli is
different from what is one used to it leads to sensory alterations. Hospitalized patient will
experience sensory alterations due to different stimuli loads.
Sensory alterations can result in either sensory overload or sensory deprivation.
Sensory overload

It occurs when a person is unable to process or manage the intensity and quantity of incoming
sensory stimuli. The person feel out of control and overwhelmed by the excessive input from
the environment. Routine activity health setting can contribute to sensory overload in clients.
These activities fall into three main categories
▪ Internal factor
▪ Information
▪ Environment

Internal factors :-

Such as thinking about surgery or the meaning of a medical diagnosis, can contribute
to anxiety and cognitive overload so that the person cannot process additional stimuli. Pain,
medication, lack of sleep, worry, and brain injury also can contribute to a person’s
vulnerability to sensory overload

Information:-

It is imparting information to a client may lead to sensory overload. Some examples

include teaching a client about a procedure, informing a client about a diagnosis, making
request of a client, or helping the client to solve a problem. Anxiety related to medical
diagnosis, prognosis and treatment can contribute to sensory overload. Lights and frequent
activity may cause sensory overload in premature neonate in the neonatal intensive unit.

Environment:-

The environment of healthcare agency provides a higher than usual amount of sensory
stimulation. A client newly admitted to the hospital, for example may have to cope with
 adjusting to a new roommate, having the television on more than usual, bright lights, paying
systems, meeting many staff members, having the bed move up and down at someone else
bidding, waiting for someone to answer the call light, uncontrolled pain, and having stranger
touch and not respect private body areas.

Sensory deprivation

Although sensory deprivation can be thought of as the opposite of sensory overload, they
share many elements. Sensory deprivation generally means a lessening or lack of meaningful
sensory stimuli, monotonous sensory input or an interference with processing of information.

Short-term sessions of sensory deprivation are described as relaxing and conductive to

medication however, extended or forced sensory deprivation can result in extreme anxiety,
hallucinations, bizarre thoughts and depression.

Factor affecting sensory deprivation

▪ Environment
Sensory stimuli in the environment affect sensory perception. For example, a teacher may not
notice the noise in a consistently noisy environment, such as the school cafeteria. But the
same teacher may perceive a loud television set very differently in his or her own home,
which is usually quiet.
▪ Previous Experience
It affects sensory perception in that people become more alert to stimuli that evoke a strong
response. For example , a person may drive to work by the same route each day, noticing
little along the way. A person may listen to the radio inattentively until a favourite song is
played , then listen to every word. A new experience, such as hospitalization, may cause a
client to perceive a barrage of threating new stimuli.
▪ Culture
1. An individual's culture often determines the amount of stimulation that a person considers
usual or normal.(E.g. : A child reared in big-city neighbourhood, where extended families
share responsibilities for all the children may be accustomed to more stimulation, than a child
reared in sub- urban of scattered single family.

2. In some culture's touching in comforting and in some it’s offensive.

3. Some patients find cultural symbols or religious symbols re assuring and their absence, a
source of anxiety

▪ Personality, lifestyle and Habits:-

It effects sensory perception. One person may enjoy a lifestyle surrounded by many people,
frequent changes, bright lights, and noise. Another person may prefer less contact with
crowds, less noise, and a slow paced routine. People with different lifestyles perceive stimuli
differently.
Cigarette smoking causes atrophy of taste buds, decreasing sensory perception of taste.
Chronic alcohol abuse may lead to peripheral neuropathy, a functional disorder of the
peripheral nervous system those results in sensory impairment.
▪ Illness :-
Certain illness affect sensory perception. Diabetes and hypertension cause changes in blood
vessels and nerves leading to visual deficit and decreased sensation of touch in extremities.
Cerebrovascular disorders impair blood flow to the brain, possibly blocking sensory
perception. Pain, fatigue and stress caused by illness also affect perception of stimuli.
▪ Medications :-
Some antibiotics, including streptomycin and gentamicin, can damage the auditory nerve,
impairing hearing. Central nervous system depressants, such as narcotic analgesics, decrease
awareness and impair perception of stimuli
▪ Variations in stimulation:-
If a person experiences more sensory stimulation than he or she is used so, then distress and
sensory overload may occurs
On the other hand, if a person experiences less than the usual stimulation, that person is
below his or her optimum state of arousal and may be at risk for sensory deprivation.
❖ Sensory deprivation in hospital settings
In the hospital such occurrence full into two general categories:
▪ Altered sensory reception:-
Occurs in such condition as spinal cord injury, brain damage, changes in receptor organs,
sleep deprivation, and chronic illness. The person does not receive adequate sensory input
because of an interference with the nervous system's ability to receive and process stimuli
▪ Deprived environments
 It can have negative effects on a person’s sensor stasis. A person who is immobilizer or
isolated for any reason is deprived of the usual amount of stimulation and may show
manifestations of sensory deprivation.
▪ Risk factors for sensory deprivation in the health care environment
o Private room
o Eyes bandaged
o Bed rest
o Sensory aid not available ( hearing aid, glasses )
o Isolation precautions
o Few visions
▪ Effects of sensory deprivation
(1) Perceptual responses
• Inaccurate perception of sights, sounds, tastes, smell and body position and equilibrium
• Mild to gross distortions ranging from day dreams to hallucinations
(2) Cognitive response
• Inability to control the direction of thought content
• Decreased attention span and ability to concentrate
• Difficulty with memory, problems solving and task performance
(3) Emotional responses
• Inappropriate emotional responses including apathy, anxiety, fear, anger, panic or depression
and rapid mood changes

❖ Clinical signs of sensory deprivation

✓ Physical behaviours
o Drowsiness
o Excessive yawning
✓ Escape behaviours
o Eating
o Exercising
o Sleeping
o Running away to escape the deprived environment
✓ Changes in perception behaviour
o Unusual body sensation
o Pre-occupation with somatic complaints ( Dry mouth, palpitations, difficulty breathing,
nausea ) and changes in body image, illusions and hallucinations
✓ Changes in cognitive behaviour
o Decreased attention span
o Inability to concentrate
o Decreased problem solving and task performance
❖ Impact on activities of daily living
▪ Sensory perception dysfunction may have effects on activities of daily livings (ADLs). Visual
deficits cause problems with self care activities as basic as dressing, toileting , and preparing
meals. Hearing deficits may restrict people from watching television, listening to the radio,
and answering the telephone. Safety hazards also exists for who are hearing impaired .
▪ People with taste and smell deficits may lose interest in eating
▪ These with sensory deficits involving touch are at risk for burns and injuries to the
extremities moving around outside the home may be impossible without special aids or help.
▪ May jobs are prohibited for people with sensory deficits, and driving may not be allowed
▪ The further restrictions the environment in which they may more about safety, making them
dependent on others. If the affected person is the major wage earner, a reductions in or loss of
income may occur .
❖ Relaxation techniques:-

Restricted Environment Stimulation Therapy( REST)

Sensory deprivation or restricted environmental stimulation therapy (REST), is a technique
by which sensory input ( sound, lights, smell etc.) is minimized. This practice encourage an
extremely deep level of relaxations.
o CHAMBER REST
In chamber REST, subjects lie on a bed in a completely dark and sound reducing ( on
average, 80 dB) room for up to 24 hours. Their movement is restricted by the experimental
instructions, but not by any mechanical restrains. Food, drink and toilet facilities are provided
in the room and are at the discretion of the tester. Subjects are allowed to leave the room
before the 24 hours are complete, however fewer than 10% actually do.
❖ Benefits of the therapy
These therapies have many physical and mental benefits.
o It provides an unparalleled level of relaxation
o Old wounds and injuries are allowed to heal faster
o Strengthens the immune system
o Vasodilatory effect ( the body's circulation is increased while the blood pressure and heart
rate are reduced)
o Muscles and joints release tension .
o Reducing Pain and fatigue
o Increase vitality and further problems as migraine headache, hypertension and insomnia are
similarly reduced
o Can help with eliminating compulsive behaviours such as alcoholism and smoking
o People with psychological and emotional problems as anxiety and depression cam also
benefit from this therapy
❖ Role of nurse
Nurse- client interaction
The nurse- client interaction promotes sensory health functions. The nurse most compensate
for the patient’s absent sensations to prevent sensory deprivation.
Nursing interactions
o Providing meaningful external stimuli can help a client overcome sensor deprivation or
sensory deficit as playing the television or the radio occasionally playing tennis.
o Encouraging use of a clock and calendar
o Encouraging the client to dress or the day's activities, putting till pictures
o Encouraging visitors, openings the drapes, and turning on lights
o Plan: the bed or chair so the client can see or hear activities in the area.
❖ Summary
Sensory deprivation a condition in which an individual receives less than normal sensory
input. It can be caused by physiological, motor, or environmental disruptions. Sensory
deprivation facilitates the production of an altered state of consciousness through the
reduction of extroceptive stimulation and / or motor activity . Sensory deprivation functions
to similar manner as meditation both reduce the perception of external stimulus.
❖ Conclusions
Today we have dealt in detail about sensory Deprivation the normal sensory perception and
the normal sensory stimuli, how sensory deprivation occurs, the factors causing sensory
deprivation, the effects of sensory deprivation, it’s impact on daily activities, relaxation
technique and the role of nurse in sensory deprivation.
❖ Bibliography
BOOKS:-
✓ LEWIS, BUCHER( 2008) “ MEDICAL-SURGICAL NURSING-
ASSESSMENT AND MANAGEMENT OF CLINICAL PROBLEMS”,
ELSEVIER PUBLICATIONS, 7TH EDITION, PAGE NO- 1603
✓ SUZZANE & BRENDA 0, “MEDICAL SURGICAL NURSING”,
LIPPINCOTT PUBLICATIONS, 10th EDITION, PAGE NO; 1099

JOURNAL:-

✓ The American Journal Of psychiatry, October 1st, 2009 VOL-114, NO.4,

114:357-365

NET REFERENCES

✓ http://www.google.com/sensoryDeprivation
✓ http://www.wikipedia.org/sensoryperception
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