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Unpleasant symptoms theory

The role of the nurse provider is to analyze the symptoms of the patients. The theory of unpleasant symptoms posits that symptoms include four dimensions: time, intensity, quality, and distress. Each of these dimensions can be measured. Influencing factors, including physiological, psychological, and situational, can affect the experience of symptoms. Furthermore, the symptoms themselves can affect performance outcomes, such as attention-seeking behaviors or quality of life. (Lenz, E. R., & Pugh, L. C., 2018)

The theory of unpleasant symptoms divides the patient’s symptoms into those that are unpleasant and those that are not. It proposes that the emotional reaction of individuals to a physical injury or illness is influenced by the way in which they interpret the environment (Blakeman, 2019). Therefore, the unpleasant symptoms model should be used during patient assessment because it provides the patient’s symptoms in a holistic way. Therefore, the condition of the patient can be easily identified.

Unpleasant symptoms mainly include mental anguish or physical discomfort. Symptoms always range from mild to severe and should always be documented in detail. The theory focuses primarily on the patient’s symptoms and defines them based on how the patient reports. The symptoms experienced by the patient are always perceived as indicators of change in her state of health, and may differ according to intensity, quality of time and suffering (Gomes et al., 2019).

It is also necessary to evaluate and document the various contributing factors, such as pre-existing medical conditions or lifestyle choices, as well as other elements that could affect symptoms, including; culture, age and gender. The consequences of the symptoms must also be identified.

Other symptoms that may not be uncomfortable should also be addressed. Some examples include; changes in sleep patterns, appetite, and energy levels. It is also vital to take note of any other abnormal behavior that may indicate lifestyle habits and other underlying issues contributing to the patient’s condition (Blakeman, 2019). The symptom can cause changes in functional and cognitive responses.

There is a need to identify any signs of improvement over time. It can play a role in determining the effectiveness of the treatment plan. Through this, healthcare providers can understand the need to change the treatment plan if it is not effective.


Lenz, E. R., & Pugh, L. C. (2018). The theory of unpleasant symptoms. In M. J. Smith & P. R. Liehr (Eds.), Middle range theory for nursing (4th ed.). New York, NY: Springer.

Blakeman, J. R. (2019). An integrative review of the theory of unpleasant symptoms. Journal of Advanced Nursing, 75(5), 946–961. https://doi.org/10.1111/jan.13906

Gomes, G. L. L., Oliveira, F. M. R. L. de, Barbosa, K. T. F., Medeiros, A. C. T. de, Fernandes, M. das G. M., & Nóbrega, M. M. L. da. (2019). THEORY OF UNPLEASANT SYMPTOMS: CRITICAL ANALYSIS. Texto & Contexto – Enfermagem, 28. https://doi.org/10.1590/1980-265x-tce-2017-0222

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