Hoofdstuk 12 Flashcards
(30 cards)
Clinical pain
any pain that receives or requires professional care
High pain and related stress after surgery
impairs immune and endocrine function, slows wound healing and increases the likelihood of infection or of the pain becoming chronic
Neurotic triad
hypochondriasis/depression/hysteria
Neuroablation
surgically removing/disconnecting part of the peripheral nervous system or the spinal cord, thereby preventing pain signals from reaching the brain
Epidural Block
near the membrane that surrounds the spinal cord
Patient-Controlled Analgesia
patient pushes button
treatment programs that use the operant approach to treating pain
1) reduce patients reliance on medication
2) reduce the disability that generally accompanies chronic pain conditions (promote “well-behavior)
In vivo exposure for treating pain fears
a hierarchy of feared activities is developed and patient engages in each activity repeatedly
Muscle-contraction (tension-type) headach
Vascular Headache (migrane + combine headache)
Passive coping (naar bed/sociale vermijding)
Active coping (pijn negeren/functioneren en afleiding zoeken)
Cognitive techniques for active coping
- distraction (focus on non-painful stimulus)
- imagery
- redefinition
- amount of attention
- interesting
- the task’s credibility
Non-Pain/Guided Imagery
conjuring up a mental scene that is unrelated to /incompatible with the pain
Pain Redefinition
substitute constructive or realistic thoughts about the pain experience for ones that arouse feelings of threat or harm
- coping statements
- reinterpretive statements
Pin therapists can promote active coping and pain acceptance with a cognitive-behavioral apporach
- Acceptance & Commitment Therapy (ACT)
- mindfulness meditation
- discussions about thoughts & feelings related to experiencing pain
- in vivo exposure feared activities
- assessment life values (commitment to achieving goals)
Active coping effectively reduces acute pain
redefinition can be used for chronic pain
Cognitive-behavioral programs are at least as effective as chemical methods
in reducing a variety of chronic pain conditions
Inter personal therapy
uses psycho-analytic and cognitive-behavioral perspectives to help people deal with emotional difficulties (adjusting to chronic pain) by changing the way they interact with and perceive their social environments
- these emotional difficulties arise from the way they relate to others
Counterirritation
reducing one pain by creating an other
Transcutaneous Electrical Nerve Stimulation (TENS)
electrodes on skin near pain
Gate Control Theory
provides 2 plausible reasons for any effects of acupuncture:
1) stimulation from the needles may close the gate by activating peripheral fibers
2) the release of opioids (endorphine)
Klinische Pijn
pijn die professionele hulp behoeft of verkrijgt
Pijn vermindering om humanitaire & praktische redenen
- medische ingrepen makkelijker
- stress vermindering
- sneller + zonder complicaties herstellen
- verlichten chronische pijn belangrijk ivm ernstige invloed op levenCh
Chronische Pijn
langer dan 3 maanden
* Chronische Pijn Syndrome (volgens IASP - International Association for Study of Pain)
- daadwerkelijke weefselschade
- pijn persisteert ondanks succesvolle behandeling oorzaak óf als onderliggende medische conditie niet succesvol kan worden behandeld
Vormen medische pijnbehandeling
1) Chirurgisch
- neuroablatie - verwijderen/loskoppelen delen perifere zenuwstelsel/ruggenmerg zodat pijnsignalen niet naar de hersenen kunnen
- laminectomy - verwijderen deel van wervel om druk op de zenuwen van ruggenwervels te verminderen
- spinal fusion - verbinden 2 wervels
2) Chemisch
Waarom volstaat chemisch niet bij chronische pijn
- vermeende verslaving + bijwerkingen
- misconcepties bespreken (angst voor verslaving)
- psychosociale factoren: placebo, contraproductieve vormen van coping, gevoelens van hulpeloosheid
