Week 11 - Progressive Goal Attainment Program Flashcards
How much variance does pain explain in pain-related disability?
10% (point being- so many other factors at play!)
Why don’t symptom-focused interventions work as well as some people might think they do?
Some interventions, such as opioids can increase a persons chance of disability by 1400 times. Interventions in the past have focused on pain management, and have ignored psychological factors that may be contributing.
What is the most common pain condition? And has it changed over time?
muscle skeletal, i.e., back pain, overall number has remained fairly stable, but the number of disabilities related to back pain have increased greatly (recorded as work absenteeism).
List the disability-related psychosocial risk factors that play a role in delayed recovery.
Catastrophising
Injustice
Beliefs/ expectations
Fear
How much variance does psychosocial risk factors account for in pain maintenance. What is their role?
30%. Psycho-social risk factors are not the cause, but they amplify suffering, distress and disability.
If you’re high in catastrophising how are you more likely to experience the pain?
- More severe symptoms (pain is spread over larger areas)
- susceptibility to mental health problems
- Prone to sedentary activity
- More pronounced disability
- Less responsive to treatment
What are the impacts of symptom exacerbation fears?
Person focuses on pain symptoms, so more likely to disengage in activities that may trigger pain, i.e., increase disability
What are the four Impacts of Disability Beliefs?
- Longer periods of work disability
- difficult to engage in rehab
- reduced motivation for rehab
- less benefit from rehab
What are the five impacts of perceived injustice?
- Increases symptom severity
- Persistence of mental health problems
- Triggers anger experience and expression
- Leads to prolonged disability
- Fosters transition to chronicity
Why is it not good for a clinician to assume that a client has a lack of motivation to engage in an intervention?
A clinician who claims their client is lacking motivation may cause insurance companies to cancel financial support.
Disengagement is more likely due to the psychosocial risk-factors- need to screen for them
What are the steps for the P-GAP?
- Screen for psychosocial risk factor
- Educate and engage client
- Initiate PGAP
What are the four main concepts of PGAP?
- Life-role re-intergration
- Community based
- Risk-factor targeted intervention
- Return to work, quality of life
In the PGAP program, the facilitators refrain from mentioning things like catastrophising, fear, disability etc., but they try and use behaviour to change the way people think. What specifically about behaviour do they focus on?
Activity is used as a tool to reduce the negative impact of psychosocial risk factors on disability.
Why focus on ‘return to work’?
- Work gives a person one of the highest levels of independence
- The longer you are work-disabled the harder your life becomes (as humans, we need to feel like we are effective participants)
People who participated in the PGAP study plus physio, as opposed to people who only participated in physio sessions, had an increased ____% chance that they would return to work.
40%
