Patient Pain Flashcards

(37 cards)

1
Q

Pain (IASP)

A

An unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage.

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2
Q

Burden of chronic pain

A

Common problem causing people to seek healthcare

Poses major consequences for individuals and society

Warning sign - motivates behavioural change

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3
Q

What is pain according to the people ?

A

Pain is whatever the experiencing person says it is, existing whenever they say it does.

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4
Q

Multidimensional views of pain

A

Biological element
Drug use patterns
Genetic predisposition
Subjective perception

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5
Q

What are the 2 types of pain ?

A

Acute pain
Chronic pain

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6
Q

Describe acute pain

A

Intense, time-limited
Result of tissue damage or disease
Typically disappears after injury heals
Sufferers are highly motivated to seek-out its causes, treat it

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7
Q

How long does acute pain last ?

A

3-6 months

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8
Q

Describe chronic pain

A

Often begins with acute pain
Persists > 12 weeks despite medication/treatment or beyond normal tissue healing time

High anxiety, feelings of hopelessness and helplessness

Interferes with daily life

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9
Q

How long does chronic pain last ?

A

> 12 weeks

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10
Q

What are the 3 sub-categories of chronic pain ?

A

Recurrent acute
Intractable -benign
Progressive

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11
Q

Recurrent acute

A

Caused by benign or harmless condition
Repeated, intense episodes separated by period w/out pain

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12
Q

Intractable benign

A

Benign but persistent pain
Varying levels of intensity, but never disappears

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13
Q

Progressive

A

Pain often originates from a malignant condition
Continuing pain, and discomfort
Pain worsens over time, as underlying condition worsens

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14
Q

How do we perceive pain ?

A

Mediated by ‘nociceptors’ (nerve endings)

Complexity interplay of physiological and psychological processes

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15
Q

Pain mediated by nerve endings

A

Receptor cells associated with pain are not entirely or specifically devoted to pain transmission.

The body senses pain in response to many types of noxious stimuli

Always includes a strong emotional component

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16
Q

3 Theories/Approaches to pain

A

Gate control theory
Biopsychosocial
Cognitive-Behavioural perspective

17
Q

Describe the gate control theory

A

Nerve endings in damaged area transmit impulses to the spinal cord.

A gate exists in the spinal cord - ‘neural gate’

  • OPEN : to let the pain signal through
  • CLOSED : to reduce the pain experience

Gating mechanism modulates incoming pain signals before they reach the brain.

18
Q

What is the gate control theory influenced by ?

A

Amount of activity in pain fibres
Amount of activity in other peripheral fibres
Messages descending form the brain

19
Q

Amount of activity in pain fibres

A

More activity
Gate opens
More pain

20
Q

Describe when the gate is open or closed for a PHYSICAL condition

A

Gate open : Extent of injury, Inappropriate activity level

Gate closed : Medication, Counter stimulation

21
Q

Describe when the gate is open or closed for a EMOTIONAL condition

A

Gate open : Anxiety, worry, tension, depression

Gate closed : +ve emotions, relaxation, rest

22
Q

Describe when the gate is open or closed for a MENTAL condition

A

Gate open : Focus on the pain, Little interest in life activities

Gate closed : Intense concentration or distraction, involvement and interest in life activities

23
Q

What does the gate control theory do ?

A

Explains why the same event can be interpreted by different people as more/less painful

Explains why sometimes pain is not experienced immediately

Describes the individual as having some control over the experience of pain

24
Q

Biopsychosocial model

A

Includes cognitive, affective and behavioural components of pain

Views illness as a dynamic reciprocal interaction among biological, psychosocial and sociocultural variables that shape a persons response to pain.

25
Cognitive-Behavioural perspective
Emphasis on : - Peoples idiosyncratic beliefs - Appraisals and coping repertoires - Sensory, affective and behavioural contributions - Formation of pain perceptions
26
Pain interpreted as significant life-threatening illness
Focus on pain Catastrophising
27
Pain interpreted as the result of minor injury
Focus on other things Realistic appraisal
28
Assessment of pain
Self-report Behavioural Physiological
29
Self report measures
Interview Pain rating scales and diaries Pain questionnaires
30
Example of a pain questionnaire
McGill Pain Questionnaire -evaluative -sensorial -affective
31
Limitations of self report
Misinterpretation of pain Less useful for children; those not fluent in English; communication difficulties
32
Behavioural assessment
Everyday activities Structured clinical sessions
33
Psychological factors influencing the experience of pain
Learning Cognition Personality Stress
34
Management of chronic pain
Physical methods : medical treatment Psychological methods : relaxation; distraction
35
Pain management
Biofeedback Relaxation Distraction Cognitive methods Behaviour therapy
36
Cognitive methods
Change perceptions of, reactions to pain Cognitive re-definition
37
Behaviour therapy
Changing the patient's pain behaviour Enhance social reinforcement