Behaviour

Question 1

Name from yellow flag signs a patient might exhibit

Answer 1

Extended sickness rest, social withdrawal, belief that pain and activity are harmful, poor job satisfaction, lack of family support

Question 2

What happens if you over and under identify yellow flags?

Answer 2

Under - reinforcing factors that are disabling maybe further increasing rest when it isn’t needing, reinforcing kinsiophobia.

Over - waste of resources, losing confidence in themselves and practitioners.

Question 3

What are the seven categories of yellow flags?

Answer 3

Attitudes and beliefs, behaviours, compensation issues, diagnosis and treatment, emotions, family and work.

Question 4

What are some of the advantages of questionnaires for yellow flags?

Answer 4

Quick to administer, useful for large numbers, little skill needed, statistically based on evidence.

Question 5

Disadvantages of yellow flag questionnaires?

Answer 5

Requires time to score, bad for reading problems, not applicable to all community, susceptible to social desirability.

Question 6

Yellow flags, advantage of clinic assessment?

Answer 6

Clinical experience useful, judgements about severity can be made non bias, less susceptible to social desirability, clinician can adapt to characteristics of individual.

Question 7

Disadvantages of clinical assessment yellow flags?

Answer 7

Potentially too time consuming, may result in confused picture unless adequate skill, maybe observer bias or prejudice

Question 8

Advantages of combining a questionnaire with clinic assessment for yellow flag?

Answer 8

Improved accuracy, integrate quantitive information, two stage process to screen and narrow down.

Question 9

Disadvantages of questionnaire and clinical assessment yellow flag?

Answer 9

Require more resources, including adequate training and organisation.

More time needed, potential for delays.

Question 10

Define the term non organic in waddells context and what is it for

Answer 10

Findings that deviate from usual presentation of disease. “Behavioural signs” or “inappropriate signs”. However should not be assumed malingering or presence of psychological problems, merely just a need for further investigation. It’s for low back problems.

Question 11

What are the five organic signs of waddells

Answer 11

Tenderness, simulation, distraction, regional disturbances, overreaction

Question 12

What is the relevance of one, two and three non organic signs?

Answer 12

One sign is negative, two is negative, three or more are considered positive.

Question 13

Describe waddells sign tenderness

Answer 13

Tenderness not related to specific structure, superficial or nonanatomic, not localised or hyperalgaesia,

Question 14

Simulation tests?

Answer 14

Simulation giving patient impression a particular examination is being carried out when it is not. Axial loading, press down on head and back pain reported.

Rotation, shoulders pelvis passively rotated

Question 15

Distraction test?

Answer 15

Positive finding found with patient attention then patient is distracted and findings disappears, a non organic sign.

Question 16

Regional disturbances,

Answer 16

Checking for dysfunction that cannot be explained by anatomy. Widespread maybe, sensory disturbances not in dermatomal pattern, weakness including giving away of many muscles that cannot be neurologically explained.

Question 17

Overreaction?

Answer 17

Disproportionate verbalisation, facial expression, muscle tension and tremor, collapsing, sweating

Question 18

Relationship between two or more Waddell signs and muscoskeletal?

Answer 18

Organic signs can be influenced by non organic. More organic signs (2) caused weakness in muscles and reproduced pain , rom, compared to just one,

Question 19

How does non organic signs affect functional testing of muscles?

Answer 19

Due to the force weakness, reduced rom, pain etc the muscular testing is a better predictor of illness behaviour than physical impairment.

Because functional testing does not reflex maximum physical capacity in regards to having non organic signs. And also suggest s possible psychological aspect to disability.

Question 20

Relationship between non organic signs and treatment outcomes?

Answer 20

Poor outcomes if patient had non organic signs. They also received more treatments, if showing no progress it suggests over utilisation of resources for illness behaviour.

Question 21

What’s the importance of context in pain assessment

Answer 21

Because pain is not a manner of matching symptom intensity to behaviour intensity but looking at a life context due to the fact pain is perception and an experience. Behaviour needs to be decided on appropriate context for that person. Without it, pain can be under perceived,

Question 22

What is somatization?

Answer 22

The symptoms created by distress and presented as if they were created by the disease,

Question 23

How does estimation of appropriate behaviour become a moral judgement?

Answer 23

The practitioner must look at the persons life in relation to the social context they are in and make a judgement on whether or not their pain behaviour is rational. It is a morally based judgment because it is measured against some standard of what is good or correct.

Question 24

Discuss how suffering may influence pain behaviour

Answer 24

Suffering is comprised of fear, anxiety, stress that cause psychological pain. Also associated with perception of harm. Pain behaviours can come from these

Question 25

What is a yellow flag definition

Answer 25

A psychosocial barrier to recovery