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Theory of Unpleasant Symptoms and Assessment Tools for Patient Symptoms

The theory of unpleasant symptoms suggests that healthcare providers need to find a holistic method of exploring multiple facets of the symptom experiences, including the factors influencing symptoms and the consequences of the symptoms. The theory is widely applied to various populations and symptoms. Notably, the hypothesis was built on the premise that symptoms have a lot in common (Gomes et al., 2019). As a result, the hypothesis is broad enough to be applied to a wide spectrum of symptoms. There are four dimensions to symptoms: timing, intensity, quality, and distress. Each of these qualities is quantifiable. The symptom experience can be influenced by various factors, including physiologic, psychological, and environmental aspects.

Furthermore, symptoms may impact performance outcomes such as seeking medical help or quality of life. Notably, as the hypothesis has evolved, more emphasis has been placed on the possibility that symptoms interact, possibly catalyzing one another (Iragorri & Spackman, 2018). Symptoms may influence influencing factors through feedback, and changes in performance may have a reciprocal effect on symptoms and influencing factors. The theory indicates the complex nature of the symptoms, which involve innumerable potential variables.

A good assessment tool for patient symptoms will assess the patient’s emotional and physical symptoms (Christalle et al., 2019). It will ensure that pain management includes their social environment and physical symptoms. The causes and symptoms of chronic and acute pain are detailed along with the different assessment tools used, and for the patients, they are suitable (Gomes et al., 2019). Through assessing various factors, other than just the current patient symptoms, the initial assessments will cover a lot of ground since they are used as part of much wider exercises designed to help health professionals understand why the patients are seeking treatment and what treatment and interventions will be suitable for their physical symptoms, social environment, and their emotional issues. The assessment tool needs to provide healthcare providers with a broader understanding of the patient’s current situation. Pain assessments after this point may focus on a smaller range of pain experiences to monitor treatment, the course of the disease, and the patient’s recovery process.
The assessment tool should also allow the patients to lead or participate in discussions about their pain. Nurses have to consider patient participation before choosing the most appropriate assessment strategy. The self-reports of pain-guided questions are the best way to assess pain. The assessment tool also needs to consider patients who cannot verbally report pain and provide a range of methods they can use to rate the pain. The tool should assess the patient’s behavioral signs of pain, including physiological changes (Christalle et al., 2019). It should also assess the psychological aspects of pain. For instance, a patient with cancer may have emotional issues that could intensify their pain. Such a patient has a considerable burden of treatment, leading to other conditions such as depression, which can exacerbate cancer symptoms. The assessment tool should include social and psychological factors that may exacerbate the physiological signs (Melile et al., 2022). For instance, a patient with considerable pain from cancer may demonstrate behavioral signs such as crying out and rocking. The patient may also have panic attacks, which may increase their heart rate, respiratory rate, and blood pressure 


Christalle, E., Zill, J. M., Frerichs, W., Härter, M., Nestoriuc, Y., Dirmaier, J., & Scholl, I. (2019). Assessment of patient information needs: A systematic review of measures. PloS One14(1), e0209165. doi: 10.1371/journal.pone.0209165

Gomes, G. L. L., Oliveira, F. M. R. L. D., Barbosa, K. T. F., Medeiros, A. C. T. D., Fernandes, M. D. G. M., & Nóbrega, M. M. L. D. (2019). Theory of unpleasant symptoms: critical analysis. Texto & Contexto-Enfermagem28.

Iragorri, N., & Spackman, E. (2018). Assessing the value of screening tools: reviewing the challenges and opportunities of cost-effectiveness analysis. Public Health Reviews39(1), 1-27.

Melile, M. B., Moga L. F., & Ena D. L. (2022). Pain assessment practice and associated factors among nurses working at adult care units in public hospitals in Wolaita Zone, Southern Ethiopia, 2021. BMC Nursing21(1), 1-7.

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