12) Motivational Interviewing and Pain Flashcards
What are strategies for changing health behaviour?
Education
Incentives to change e.g. financial
Behavioural skills and resources e.g. smoking cessation
What is motivational interviewing?
Patient-centred method for enhancing intrinsic motivation to change by exploring and resolving mixed feelings
What are the techniques used in motivational interviewing?
Focus on patient’s arguments for change
Listen and empathise
Avoid argumentation
Increase internal motivation
When is motivational interviewing helpful in the stages for change model?
Pre-contemplative/contemplative
What is pain?
Signals that body has been damaged or something is wrong
Describe acute pain:
Short lasting, protects us from damage and infection
Describe chronic pain:
Greater than 3 months
Original damage likely to have healed but pain pathways oversensitised
Sometimes no cure
Cause sometimes not known
What happens after 3 months of stimulation to a pain pathway?
Pain neurones adapt and get changes to neural pathways
What are the limitations of the bio-medical model of pain?
Pain can be increased by negative emotion, cognitive processes and behaviour
What is the bio-medical explanation of pain?
Results from physical damage
Treatment is analgesia and surgery
How can psychological factors affect pain?
Anxiety can lead to reduced pain tolerance
Fear can lead to increased pain tolerance
What is nociception?
Stimulation of peripheral pain receptors which send pain messages to CNS
What is the pain threshold?
Point at which a stimulus becomes painful
Similar for most people
What is pain tolerance?
Degree to which pain can be tolerated
Wide variation
What is the gate theory of pain?
Pain signals compete with other neural signals to get through synaptic gate at neurones in spinal cord
Physiological and psychological factors can open or close this gate
What theory does the gate theory of pain explain?
Rubbing it better
How can the gate theory of pain be used as part of pain management?
Helps those with chronic pain understand that their attitudes and behaviour can influence pain
What factors open the gate?
Injury Alcohol and drug use Depression and anxiety Stress Focussing on pain
What factors close the gate?
Medication
Exercise
Distraction
Positivity - laughter
What is the aim of pain management programmes?
Assist people in effectively managing their pain so they can lead a functional and positive life
What negative cycle can occur in chronic pain?
Pain -> behavioural changes -> negative emotion -> social withdrawal -> more pain
What are the outcomes of good pain management programmes?
Less pain No depression Successful coping Increased activity Improved social functioning
