12) Motivational Interviewing and Pain

Question 1

What are strategies for changing health behaviour?

Answer 1

Education
Incentives to change e.g. financial
Behavioural skills and resources e.g. smoking cessation

Question 2

What is motivational interviewing?

Answer 2

Patient-centred method for enhancing intrinsic motivation to change by exploring and resolving mixed feelings

Question 3

What are the techniques used in motivational interviewing?

Answer 3

Focus on patient’s arguments for change
Listen and empathise
Avoid argumentation
Increase internal motivation

Question 4

When is motivational interviewing helpful in the stages for change model?

Answer 4

Pre-contemplative/contemplative

Question 5

What is pain?

Answer 5

Signals that body has been damaged or something is wrong

Question 6

Describe acute pain:

Answer 6

Short lasting, protects us from damage and infection

Question 7

Describe chronic pain:

Answer 7

Greater than 3 months
Original damage likely to have healed but pain pathways oversensitised
Sometimes no cure
Cause sometimes not known

Question 8

What happens after 3 months of stimulation to a pain pathway?

Answer 8

Pain neurones adapt and get changes to neural pathways

Question 9

What are the limitations of the bio-medical model of pain?

Answer 9

Pain can be increased by negative emotion, cognitive processes and behaviour

Question 10

What is the bio-medical explanation of pain?

Answer 10

Results from physical damage

Treatment is analgesia and surgery

Question 11

How can psychological factors affect pain?

Answer 11

Anxiety can lead to reduced pain tolerance

Fear can lead to increased pain tolerance

Question 12

What is nociception?

Answer 12

Stimulation of peripheral pain receptors which send pain messages to CNS

Question 13

What is the pain threshold?

Answer 13

Point at which a stimulus becomes painful

Similar for most people

Question 14

What is pain tolerance?

Answer 14

Degree to which pain can be tolerated

Wide variation

Question 15

What is the gate theory of pain?

Answer 15

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

Question 16

What theory does the gate theory of pain explain?

Answer 16

Rubbing it better

Question 17

How can the gate theory of pain be used as part of pain management?

Answer 17

Helps those with chronic pain understand that their attitudes and behaviour can influence pain

Question 18

What factors open the gate?

Answer 18

Injury 
Alcohol and drug use 
Depression and anxiety
Stress
Focussing on pain

Question 19

What factors close the gate?

Answer 19

Medication
Exercise
Distraction
Positivity - laughter

Question 20

What is the aim of pain management programmes?

Answer 20

Assist people in effectively managing their pain so they can lead a functional and positive life

Question 21

What negative cycle can occur in chronic pain?

Answer 21

Pain -> behavioural changes -> negative emotion -> social withdrawal -> more pain

Question 22

What are the outcomes of good pain management programmes?

Answer 22

Less pain 
No depression 
Successful coping 
Increased activity 
Improved social functioning