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Block 4 Week 1 Meg > Lewandowski: Pain > Flashcards

Lewandowski: Pain Flashcards

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1
Q

Health and illness to be viewed as a result of interacting mechanisms at the cellular, tissue, organism, interpersonal, and environmental levels.

A

biopsychosocial model

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2
Q

The biophyschosocial perspective says that pain is influenced by a variety of factors. What are they?

A
  1. biological/physical: ex: tissue damage
  2. psychological/emotional: ex: mood
  3. social factors
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3
Q

Pain is a (blank) experience. No two people will have the same pain experience. Neither somatic or completely psychological models can explain pain/disability by themselves. Chronic pain is a (blank) response in some individuals.

A

subjective; learned

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4
Q

Biological/physiological factors that make chronic pain worse

A

inappropriate medications
non-restorative sleep
physical deconditioning
dysfunctional activity patterns

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5
Q

Psychological/emotional factors that make chronic pain worse

A

avoidance behaviors
disturbed mood
past learning with pain/injury
cognitions/beliefs about pain

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6
Q

Social factors involved in chronic pain

A

significant other influence
external disincentives
cultural factors
physician influence

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7
Q

1 reason people will come see you as a physician?

A

pain

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8
Q

Why is there no respect for pain?

A 
Renee Descarte (mind versus body)
Pain historically seen as an epiphenomenon of disease, or a response of secondary importance. Belief that if you eliminate the physical cause, you "cure" the pain.
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9
Q 
Serves as a valuable "warning signal"
Spans 0 to 12 weeks
Lasts a short duration then ceases
Symptom of tissue damage
Minimal life disruption
A

acute pain

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10
Q

Treatment of acute pain

A

correct damage, rest, and take meds

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11
Q

Example of acute pain

A

broken leg, appendicitis

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12
Q

Cognitive expectation of acute pain

A

cured/fixed/relieved/eliminated

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13
Q 
Pain signal may be the problem and not a sign of tissue damage
Spans 13 weeks to many years
Long duration, many flare-ups
Not a symptom, but IS the problem
Significant life disruption
A

chronic pain

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14
Q

Treatment of chronic pain

A

movement in a graded fashion

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15
Q

Example of chronic pain

A

back pain accompanied by depression, anxiety, sleep disturbance

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16
Q

Cognitive expectation of chronic pain

A

manage, cope, deal with, accept

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17
Q

T/F: It is important to inform your patients of healing times, so that they/you can determine if their pain is chronic or exceeding the normal expectation for healing

A

true

18
Q

It is important to recognize that your patient has invisible pain that cannot be seen. What are the concepts of social disbelief and credibility?

A

Patients believe that their doctor doesn’t realize how bad their pain is, and feel the need to convince the doctor that it is bad

19
Q

Who was responsible for realizing that the mind and body interact?

A

Renee Descarte

20
Q

What are some “Cartesian” ways of thinking today?

A 
If I can't see it on an MRI, it's not real.
Organic vs functional labels.
Tissue damage = pain intensity
Pain ends upon healing
Fix, cure, eliminate mindset
Hurt means harm
21
Q

It’s important to know your patient’s history with pain and trauma. What are some factors involved?

A

Physical abuse
Sexual abuse
Parental abandonment
Parental drug use

22
Q

It’s important to know your patient’s sleep quality/quantity. Why?

A

Lack of sleep plays a huge role in chronic pain.

23
Q

Why is it important to know how pain interacts with your patient’s activity levels?

A

When patients are unable to do the things they love, secondary problems arise. Inactivity plays a pervasive role in our lack of wellness.

24
Q

It’s important to know the “meaning” of your patient’s pain. Why?

A

Important to know if there’s anyone to blame and if they are worried about getting better – these things can affect their prognosis

25
Q

Which math functions are the most positive predictors for patients?

A

addition and multiplication

26
Q

Should you use the term opioid or narcotics?

A

opioid

27
Q

T/F: It’s important to know if your patient’s pain is acceptable, but not necessarily optimal.

A

true

28
Q

T/F: ~40% of patients believe that they have not received comprehensive care for their pain.

A

true

29
Q

Physical therapy aimed at activity increase in a paced manner
CBT
Biofeedback and relaxation training
Medications

A

Validated treatment approaches for pain

30
Q

T/F: medications can be useful when treating pain IF integrated with other forms of treatment. Medications = only about half of treated patients respond, and their pain reduction averages only about 30 percent

A

true

31
Q

What are the goals of cognitive-behavioral therapy?

A 
problem solving orientation
develop a sense of resourcefulness
reconceptualize attitudes/beliefs
manage rather than cure/fix
pacing and modification of activities
32
Q

Most pain treatments have (blank) as the primary purpose. CBT is a (blank) model (gaining control over your pain). CBT is about changing the (blank) of the thoughts, like reducing non-productive thinking (catastrophizing)

A

pain reduction; control based; content

33
Q

How is the third-generation of CBT different?

A

Places an emphasis on changing awareness of and relationship to thoughts, NOT the content

34
Q

When referring patients to psychologists, what should you refer to them as?

A

behavioral medicine specialist

35
Q

T/F: It’s important to emphasize self-management, not cure.

A

True

36
Q

Aspects of controlling pain in primary care setting

A 
assess pain systemically
identify comorbid conditions
develop an individual treatment plan
treat pain early/diligently
consider using multiple modalities
measure improvement over time
reinforce positive/family involvement
37
Q

Describe the intergrated biobehavioral approach

A

multidimensional versus interdisciplinary

does not have to take place in a specialized pain clinic

38
Q

What does symptom magnification really mean?

A

a loss of control

39
Q

T/F: Survivors are people who move purposefully towards either resolution or acceptance.

A

True

40
Q

T/F: Psychological, social and environmental factors are involved in the maintenance of chronic pain

A

True

41
Q

T/F: Addiction to opioids among patients prescribed opioid analgecis for pain is not common

A

True

Block 4 Week 1 Meg (13 decks)

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