Chronic Pain And Illness: Dental Patient Perspectives And Experiences Flashcards
What are patient experiences of distinctive events and long term course of suffering like toothache and TMD called? Also what significant others will recount about their loved ones sufferings.
‘Illness narratives’
What is pain?
A physiological, social and psychological experience. Dentists are trained to deal with pain as a physiological phenomenon but should be very aware of it’s social and psychological aspects as well. They can learn a lot by listening to patients experience of pain, especially chronic orofacial pain.
Why do dentists need to listen to their patient’s illness narratives?
- To understand the experience of illness more (and will have a better relationship with their chronically ill/in pain patients)
- To realise that pain and chronic illness has a disruptive impact on the lives and well being of patients
- To learn more about how people cope with chronic illness and pain
- This info will direct dentists to work in the best interests of their patients
- Contribute to evidence based dentistry
What is the medical model of health?
- Social history
- Patient examination
- Diagnosis
- Treatment planning
- Informed consent for treatment
- An appropriate mix of care, cute and prevention
- Payment of services
What will affect a patients illness behaviour? (7 things)
- Culture
- Previous experience of being ill
- Ethnicity
- Age
- Gender
- Class
- Previous experience of doctors/dentists
What is the ‘sick role’?
Refers to the social process that surrounds sickness i.e customs, rules, duties and obligations that emerge for the person who is ill and those around them. I.e:
1. When we are sick, we become less productive
2. We tend to avoid certain responsibilities
3. We are looked after by others
4. When we are better we resume our duties and responsibilities
This sick role theory creates the expectation that the sick person can’t care for themselves and are dependent on medical experts for getting well which demonstrates the sense of power, status and authority that surrounds medical doctors and dentists. We have a role in shaping health behaviour.
What are the different types of illness behaviour?
- To seek medical help
- To ignore symptoms
No.1 if:
- bad news motivates you to go for medical help
- symptoms begin to interfere with your social life
- sanctioning (other people telling you to go)
- symptoms begin to interfere with your ability to work
- bargaining tool ‘if symptoms aren’t gone by Friday I’ll go to the dentist’
What are zola’s 5 triggers for seeking medical assistance?
- bad news motivates you to go for medical help
- symptoms begin to interfere with your social life
- sanctioning (other people telling you to go)
- symptoms begin to interfere with your ability to work
- bargaining tool ‘if symptoms aren’t gone by Friday I’ll go to the dentist
What’s the best way to comprehend the impact that chronic illness and pain has on people’s lives?
Through their ‘illness narrative’
What are the different types of illness narratives according to frank?
- Restitution narrative- patient falls ill, goes to doctor/dentist and the issue is eventually resolved.
- Quest narrative- the experience of being ill has resulted in unintended benefits.
- Chaos narrative- patient doesn’t feel in control of their illness, may have had failed attempts at getting better.
What do illness narratives show us?
- How chronic illness disrupts everyday life
- How being chronically ill can change your relationship with others (more dependent on others, limits to what you can do)
- How all this impacts on patients self-concept
- How it causes ‘biographical disruption’
What is TMD?
Temporalomandibular disorders. Chronic disorder of the musculoskeletal system.
There are 2 types:
1. Muscle generated pain
2. Jaw joint generated pain
What are the symptoms of TMD?
- head pain eg. Shooting pain up back of head
- eye problems eg. Pain behind eyes
- mouth problems eg. Limited mouth opening
- ear problems eg. Buzzing or hissing
- jaw problems eg. Clicking, popping jaw joints
- neck problems eg. Neck pain
- throat eg. Swallowing difficulties
- teeth eg. Clenching, grinding at night
Who gets TMD?
Majority female, onset 20s and 30s.
Prevalence hard to measure.
What causes TMD and what are it’s treatments?
Causes:
- mostly unknown
- can develop as a result of trauma
- may be psychogenic or stress related
Treatments:
- pain management
- physical therapy
- bite guards
- no cure
