Pain Flashcards
What is the perception of pain?
“pain is what the patient says it is” (Meinhart and McCaffery, 1983)
o We all experience pain differently
o Subjective
o Can’t talk about it in exactly the same way
What did Beecher (1950s) find in treating WW2 soldiers?
o Injured soldiers from WW2 and ran out of pain killing morphine
o Administered saline placebo with no pain relieving properties
o Found 50 % reported lowered pain
What is pain?
“unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage” (IASP, 1979)
- Acute or chronic (over 3 months)
- Revision of the original definition above:
o “Pain is a distressing experience associated with actual or potential tissue damage with sensory, emotional, cognitive, and social components,” (Craig & Williams, 2017).
o Can inhibit your life and plans
o It dominates and interferes with cognition and attention
How big of a problem is chronic pain in the UK?
- 19 studies
- 139 993 adult UK residents
o Prevalence of chronic pain 35.0 – 51.3% (continuous or intermittent)
o Prevalence of moderately-severely disabling chronic pain – 10.4%-14.3%
o Increasing prevalence with age
o Possibly, 30% in 18-39 year olds.
Is pain adaptive?
- Congenital analgesia – experience no pain at all. They can badly damage themselves and be unaware. They can show us that pain is adaptive
o If you touch something hot, you move your hand
o It you do something that is damaging to your body, you feel pain and so stop doing that activity – protects you from physical harm
At what age do individuals start to feel pain?
- From about 20 weeks, babies in the womb can feel pain
- It took until 1908’s for babies to be anesthetised
o Scared that it would harm them weren’t sure about pain perception
Why is important to measure pain?
Informing treatment, increase understanding of the concept, whether treatment is necessary, understand severity
How might we measure pain?
Numerical rating scale (0-10), pain location, physical measures (HR and sweating), the faces scale (for children – visual analogue scale), imaging
What are some of the main challenges faced with measuring pain?
Subjective, people that can’t talk or read and self-report (babies – non-verbal), think about age-appropriateness, individual differences in physiology, habituation, ethical issues, cultural differences
What are the physiological measures (objective) of pain?
Inflammation, sweating, heart rate.
What are the observational measures (objective?) of pain?
Pain behaviours (e.g. FLACC, Merkel et al., 1997) E.g. facial expression, position of limbs, crying, squirming...
What are the self-report measures of pain?
Scales: Pain severity, impact on functioning
o Wong-Baker Faces Pain Scale
o Words: punishing, cruel, intense
78 adjectives, relating to senses, emotions, evaluating oneself
Body map
18 languages, covering duration, intensity, quality, location
Short-Form McGill Pain Questionnaire
(SF-MPQ, Melzack, 1987) : 15 items
Give some other ways of measuring pain.
o Diary studies
o Qualitative methods
o More creative ways?
- Common with children e.g. Pain squad
• App to take the place of a pain journal
• Got together a group of actors to film videos about ‘pain squad’.
• They earn badges and watch videos about moving up the ranks and helping to solve the problem – ‘putting pain in its place’
What psychological approaches are there in treating chronic pain?
CBT (Carter & Threlkeld, 2012)
Relaxation and biofeedback techniques
Sessions on relaxation – imagine they are in particular setting, visualisation etc.
Biofeedback is not so well used, gets people to be aware of your own heart-rate, you will notice when it is lower and as such notice what activities lower it to take ownership over bodily sensations
How can hypnosis be used in treating chronic pain?
E.g. hypno-birth, hypnotic calming methods e.g. with babies and jabs
Hypnoanalgesia – magic glove – used when kids are having IV lines or blood tests in relation to a fear of needles
