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NURS2000 > Module Three > Flashcards

Module Three Flashcards

1
Q

What is pain

A

Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage

Pain is whatever the experiencing person says it is, existing whenever he says it does

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2
Q

What is the importance of acute pain

A

Important protective mechanism and response to nociceptive experience

-Directing attention to a situation and promoting a reflexive withdrawal (gate control theory)

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3
Q

What is chronic pain

A

Persistent, intermittent pain - over months to years

Usually under-recognised and undertreated

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4
Q

What is the biomedical component of pain

A

Nociception: pain arising from actual or threatened damage to non-neural structures due to activation of nociceptors

Neuropathy: pain that is the result of an injury/lesion, or disease in the somatosensory system (peripheral or CNS) — often chronic

Mixed pain may coexist

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5
Q

Explain the biopsychosocial model of pain

A 
Biomedical - nociception and neuropathy 
Pain perception 
Attitudes and beliefs
Psychological distress
Pain behaviour 
Environment
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6
Q

What is pain perception

A

Robust psychological predictor of pain related outcomes

Research makes link between catastrophising pain and increase in disability, distress and pain intensity

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7
Q

What are pain perception models

A

Gate control theory

Fear avoidance model

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8
Q

Explain gate control theory

A

Explains pain perception e.g. small fibers and large fibers

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9
Q

Explain fear-avoidance model

A

Explains impact of pain perception on recovery from their experience of pain
e.g. someone scared to exercise because they are worried it will cause too much pain

Includes Pain Catastrophising: tendency to describe a pain experience in more exaggerated terms or thinking of worst-case, irrational outcomes

Look at diagram

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10
Q

What is a predisposing factor

A

factors that put someone at risk of developing a problem e.g. genetics, life events, knowledge

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11
Q

What is a precipitating factor

A

specific event or trigger to the onset of the current problem

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12
Q

What is a perpetuating factor

A

maintain the problem once it has become established

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13
Q

What is a protective factor

A

reduce vulnerability to chronic pain and create more positive outcomes such as exercise, healthy diet, sleep, coping skills, social support

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14
Q

What is attitudes and beliefs associated with biopsychosocial model of pain

A

Stoicism
Self-blame
Self-efficacy
Locus of control

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15
Q

What is psychological distress associated with biopsychosocial model of pain

A

Fear – of increasing pain
Anxiety – relating to impact on life
Stress – physiological response (fatigue)

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16
Q

What is pain behaviour associated with biopsychosocial model of pain

A

Avoidance behaviour – reduced activity/mobility
Reduced social interaction – which could result in depression and reinforcement behaviour
Sick role – how people respond to another persons pain

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17
Q

What is environment/external factors associated with biopsychosocial model of pain

A

Physical barriers – to mobilising
Social influences – pain experience is influenced by others
- Reinforcers
- Detractors e.g. stigma

Gender and social perception
Cultural norms

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18
Q

How to assess pain

A

Scales
History (provoking, quality, region, severity, frequency)
Diary
Pain belief and coping strategies

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19
Q

What should goals of care for patients receiving treatment for chronic pain

A

what does the client/patient want to achieve? Realistic?

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20
Q

What is the biomedical approach to treating chronic pain

A

WHO analgesic ladder

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21
Q

What are some psychosocial interventions for treating/managing chronic pain

A

‘Closing the gate’ (brain perception) - massage, TENS, movement, heat packs

Psychological - depression, anxiety and fear through education & therapy

Social - address social impacts and work issues

Environmental - adaptation to barriers, transport

22
Q

Define the biophysical definition of stress

A

Stress is the body’s reaction to any change that requires an adjustment or response to return to homeostasis

23
Q

Define the biopsychosocial definition of stress

A

stress is a physical, cognitive, emotional and behavioural reaction of an individual (or organism) to a stressful event [real or perceived] that threatens, challenges or exceeds the individual’s internal and external coping resources

24
Q

Describe stress as a response

A

Reaction to a perception of threat

The SNS and endocrine system are aroused, preparing the organism to respond to the anticipated danger by fight or flight

25
Q

Describe stress as a biomedical response

A

General Adaptation Syndrome (Selye, 1956)

Alarm Reaction – person or organism is alerted to a perceived threat
Resistance Stage – body attempts equilibrium
Exhaustion Stage – when the body’s attempts to resist the stressor are unsuccessful

26
Q

Describe stress as a stimulus

A

Yerke’s-Dodson Law 1908
Performance is affected by stress
Stress necessary to complete activities (source of motivation)
However, too much stress will mean the person cannot perform any type of activity (impaired)

27
Q

What is the social readjustment rating scale

A

Statistical Prediction Model

Stressful events can cause the development of a disease (score over 300 indicates stress can impact health)

28
Q

Describe stress as a process

A

Lazarus Two Factor Model of Stress Appraisal

Primary Appraisal – is the stressor harmful?
Secondary Appraisal – are my internal and external coping resources adequate for this stressor?
These then determine whether stress is initiated

Focused on nature of stressors and own of coping abilities

29
Q

What are the symptoms of psychological distress

A

Altered sleep, appetite, headache, memory and sensory perception

30
Q

What are negative coping styles

A

Denial, escape/avoidance and repression associated with:

  • Increased in alcohol intake and self-medication (prescribed and illicit)
  • Mood changes – unpredictable anger, depression
  • Social isolation
31
Q

How does prolonged stress effect the body

A

High levels of cortisol contribute to health problems such as: gastric ulcers, delayed wound healing (immune systems), and osteoporosis (through decreased calcium absorption), also effects autoimmune diseases (AIDS, diabetes, cancer)

32
Q

What is burnout

A

Occurs in situations of prolonged chronic stress

Characterised by:

  • Emotional exhaustion which manifests as depersonalisation and cynicism
  • Diminished sense of self-efficacy and personal accomplishment
  • Negative coping practices – excessive alcohol use or medication use
33
Q

What are psychological impacts of burnout

A

depression, anxiety

34
Q

What are psychosomatic impacts of burnout

A

headaches, increased vulnerability to infection

35
Q

What are physical health problems of burnout

A

CVD

36
Q

Describe burnout amongst nurses

A

Social context of work more than content of work - context issues included:

  • Lack of professional recognition
  • Professional uncertainty
  • Interpersonal and family conflicts
  • Tensions in work relations
37
Q

Describe post-traumatic stress disorder

A

Debilitating mental illness affecting some people who have experienced or witnessed an extremely stressful event – involving threat of death or serious injury to self or others

38
Q

What are symptoms of PTSD

A

insomnia, intrusive dreams and thoughts, irritability and outbursts of anger, poor concentration
May also include survivor guilt, detachment from loved ones and relationship difficulties
Could cause immunosuppression

39
Q

Examples of intermediate social determinants that affect stress

A 
Inadequate housing
Poverty 
Low levels of education 
Overcrowding 
High levels perceived stress 
Social dysfunction
40
Q

Define coping

A

Process by which people try to manage the perceived discrepancy between demands and resources they appraise in a stressful situation

41
Q

What are internal resources of coping

A

Personality factors, perceptions and beliefs
Internal locus of control and health LOC – belief that one has ability to change the situation
Self-efficacy – positive self-talk
Optimism
Resilience (protective factor) – self-belief, good communication

42
Q

What are external resources of coping

A

Social support – family, friends, work or student colleagues
Resources:
- Finances
- Time
- SES (higher –> greater access to resources)
- Access to and utilisation of health and social support services

43
Q

What are methods of coping

A

Problem-focused

Emotion- focused

44
Q

Explain problem-focused coping

A

aimed at resolving stressful situations or altering the source of stress e.g. problem-solving, time-management, social support

45
Q

Explain emotion-focused coping

A

Trying to reduce the negative emotions associated with the situation, rather than changing the situation itself e.g. drug therapy, distraction, meditating, eating more, drinking alcohol, journaling

46
Q

Example coping styles: Diagnosed with diabetes

A

Emotion - join support group

Problem - enrol in education class

47
Q

Example coping styles: Made redundant at work

A

Emotion - take holiday

Problem - register employment agency

48
Q

Example coping styles: Recurrent arguments with partner

A

Emotion - go out with friends

Problem - seek relationship counseling

49
Q

Example coping styles: Wake up feeling ill on day of exam

A

Emotion - roll over and go back to sleep

Problem - make GP appointment to obtain medical certificate

50
Q

Describe carer stress assessment tool

A

The Carer Strain Index is used to assess the level of stress/strain experienced by a family carer looking after a person with dementia

Gender and relationship to the person with dementia can affect the level of stress experienced. Daughters, daughters-in-law and wives also score higher than husbands

NURS2000 (4 decks)

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