Chapter 10- Pain catastrophizing and pain-related fear

Question 1

What is iatrogenic communication? (3)

Answer 1

• Medical Imaging Reports
• Traditional Education
• Degenerative disc disease

Question 2

What is Therapeutic Communication? (4)

Answer 2

-Listening
-Pain Validation
- Pain neuroscience Education
-Familiar terms

Question 3

What are 4 reasons to why therapeutic commmunication is appropriate/good?

Answer 3

• Increased compassion
  -Increased hope/self-efficacy
• Decreased maladaptive beliefs/fear
  -Decreased stimatized

Question 4

Why should pain catastrophizing not be used infront of patients and only between clinicians and healthcare professionals?

Answer 4

-It may seem to dismiss the medical basis of pain
- Question the authenticity of pain complaints
- Blame individuals for their pain

Question 5

What is Pain Catastrophizing?

Answer 5

It is an exaggerated threat appraisal of ones pain. It is NOT the exaggaeratione of the pain itself

Question 6

Best way to measure pain catastrophizing?

Answer 6

With The Pain Catastrophizing Scale (PCS)

Question 7

Describe the PCS?

Answer 7

• Its 13 items describing thoughts and feelings about pain
• On a scale from 0-52 on a scale of 0-5 with 5 being all the time and 0 being not at all
  -Prioritize to address PCS when score if more or equal to 20

Question 8

After what score does a profeessional health care worker have to prioritize pain catatrophizing?

Answer 8

After greater or equal to 20.

Question 8

Can PSC explain why patients sometimes don’t get better?

Answer 8

YES

Question 8

What are the 3 major factors of pain catastrophizing that happens to someone?

Answer 8

1. Magnification –> The tendency to exaggerate the threat value of pain
2. Rumination –> Excessive focus/thinking about the pain
3. Helpessless –> Perceiving myself as unable to cope with the pain

Question 8

What are 3 ways that you can introduce the PCS to the patient?

Answer 8

1. Present it as a routine questionnaire
2. Use the patients own words to introduce the questionnaire in order to make them better understand how their pain has affected their life
3. Tie it back to the ultimate end goal of your scope of practice, which is getting the patient to doing what they were doing before they got hurt and to do that, they need to better understand their pain

Question 8

What is Pain-Related Fear?

Answer 8

-Pain-related fear has some overlap with pain catastrophizing, but pain catastrophizing is mainly conceptualized as a cognitive interpretation of pain as threatening whereas fear is mainly conceptualized as an emotional reaction that motivates protective behaviour (typically: avoidance).

• Pain-related fear usually refers to fear of the pain itself or fear of doing physical movement/activity that could worsen the pain, injury, or cause re-injury.

Question 8

What should you do after giving someone the PCS?

Answer 8

1. After the first appointment, make them write in their pain reaction journal
2. After the second time you see them, you review what they wrote and you ask them what could have they done differently
3. The third following appointment, you review and brainstorm ways of coping

Question 8

What is the tampa scale made up in terms or scoring system?

Answer 8

• 11 items assessing pain-related fear
• scale of 11-44 scale of 1-4 (disagree to agree)
• more or equal to 25