HPHD Motivational Interviewing and Pain Management

Question 1

What is motivational interviewing?

Answer 1

A patient centred directive method for enhancing motivation to change by exploring and resolving uncertainty.

Question 2

What are the aims of motivational interviewing?

Answer 2

To elicit the patients own arguments for change to make them feel more motivated, willing and ready to change.
Helpful with people in the precontemplative or contemplative stages

Question 3

What is the difference between acute and chronic pain?

Answer 3

Chronic pain:
>3 months
No ongoing tissue damage
Prolonged medication
Rest not useful

Question 4

What is the problem with the biomedical model in chronic pain?

Answer 4

The biomedical model concentrates on pain being in response to injury and repair, however in chronic pain there is no tissue damage.

Question 5

What is the gate control theory of pain?

Answer 5

Says that pain is experienced through complex pathways between the brain and damage source via nerve fibres. Messages have to pass through ‘gates’ in the spine, and these gates can be opened and closed by physiological and psychological factors.

Question 6

What are some of the factors that can open and close the gates?

Answer 6

Open gate:

• injury
• stress or tension
• focussing on pain (expectation of pain)
• sensitivity of the NS

Close gate:

• medication
• exercise
• distraction
• positive beliefs and control
• relaxation

Question 7

What are the aims of pain management programmes?

Answer 7

Pain management programmes aim to help patients cope better with chronic pain by reducing negative emotion, maladaptive behaviour and increasing their control through activity and social functioning.

Deconstructing the pain through monitoring, completing a diary to assess patterns and identifying maladaptive thoughts.

Reconstructing beliefs about coping involves relaxation techniques, setting goals and exercising and going out more often.