Exam 1 Measuring Pain Psych Flashcards
is pain intensity the same for everyone?
no, very variable
what is the current scheme when thinking about physical and psychological factors
we think that standard practice only looks at the physical things, and psychological things are only for mental health specialists
what is the proposed scheme
that we have psychologically informed practice, meaning we look at the body, with their beliefs, attitudes, moods and responses to pain, and try to decrease disability.
red flags
serious pathology, like caudate equina syndrome or fracture or a tumor
orange flags
depression personality disorder
black flags
healthcare system, like legislation or insurance limitations
blue flags
work related, like thinking work caused their injury and that their boss sucks
yellow flags
beliefs judgements and pain catastrophizing, things like worry stress and fear and avoidance.
how do we find flags
screen them, and ask follow up questions
what are the depression screening questions
during the last two months, have you often been bothered by feeling down, depressed or hopeless?
during the past month, have you often been bothered by little interest or pleasure in doing things?
TF: the probability of severe depression decreases from 20-5% with one negative response to the depression questions?
true
with 2 positive depression questions, what does the probability increase to
20-50%
if they answered yes to both questions, what can you do
give them the full questionnaire (PHQ-9) to see severity of depression and question 9 looks at suicide
how is PHQ-9 scored
0-4 none 5-9 mild 10-14 moderate 15-19 mod-severe 20-27 severe
what is the Orebro Musculoskeletal Screening questionnaire (OMSQ)
a 21 item thing to look at people who were injured at work, and if they will have long term pain
how is the OMSQ scored
o pain days off if less than 57
28+ days off with score over 72 (POOR RECOVERY)
TF: the probability of poor functional outcome increases to 75% then a person scores over a 72 on the OMPQ
true
what is the STarT back
subgroups for targeted treatment back screening tool, to help with management
how is STarT back scored
low risk (less than 4) medium risk (over 4) high risk (psychological sub scale over 4): need PT and cognitive behavioral help
the STarT back scores will predict 6 month ___ scores, but not…
disability, not pain or impairment
describe the fear avoidance model
you have an injury that leads to a pain experience. you can either have high or low fear. low fear, and you can confront it and recover. high fear and you will get afraid, avoid things, not recover, have more pain, disability, disuse and depression, and continue down this rabbit hole.
what are the cut off scores for PA and work sub scale of the fear-avoidance beliefs scale
PA: over 15 is the cut off
work: work related low back pain is over 29, and no compensation general back pain is over 22
can you use FABQ in any joint,
sure, its not specific
what is the Tampa scale of kinesiophobia (TSK)
assesses pain related fear and fear of re-injury.
