Psychological Assessment and Management of Chronic pain Evaluating a chronic pain condition from a biological perspective is limiting, and often fails to fully explain the patient’s symptoms. In contrast to the biomedical model, which explains pain purely in terms of pathophysiology, the biopsychosocial model views pain, suffering and disability, as the result of dynamic interactions among biological, psychological, behavioral, social, cultural and environmental factors. Consequently, assessment requires not only the examination of the biological dimension, but of the psychological and social dimensions as well. A patient’s experience of pain and response to any treatment for pain are affected not only by biologically determined nociceptive (nervous system transmission) processes, but also by psychological factors such as mood (for example, depression, anxiety) and appraisals (thoughts and beliefs about the pain), as well as by psychosocial factors such as the responses of others (for example, family, friends, …show more content…
Cognitive Behavioral Therapy (CBT), 2. Relaxation Training, and 3. Biofeedback. These approaches are often used together to provide simultaneous interventions at cognitive and physical levels. Research on cognitive behavioral interventions in chronic pain involves CBT, relaxation therapy, biofeedback, or some combination of the three. Generally, some form of CBT is combined with either relaxation training or biofeedback. Assessment Patients with chronic pain need to feel understood by those who are providing care to them. On the other hand, a therapist requires relevant and adequate information about the patient from a bio-psychosocial perspective to establish therapeutic goals. Therefore, a comprehensive psychological assessment is a prerequisite for CBT and other interventions (Please refer to chapter “Psychological Assessment of Patients with Chronic Pain”). Before starting the therapy clinician should have understanding of the
In the article, “Sometimes Pain Is a Puzzle That Can’t Be Solved”, Abigail Zuger, the author, describes her own experiences with pain along with some examples and generalizations about the feeling. She claims that she is “ruled by (her) elbow” and “it is (her) constant companion, whimpering, and tugging at (her) sleeve.” She goes on to say that many people have the same problems, especially when drugs, “like naproxen and ibuprofen” are unhelpful and “might as well be cornflakes.” Finally, she explains how far we have advanced in the medical field, but “ none of (the) knowledge has translated into new treatments,” to help people such as herself.
I am so happy you picked pain as your ICP project. Pain, in my eyes, has always been all encompassing. It can affect sleep, ability to move around, eating, healing, breathing, mood and relationships (Shega, Tiedt, Grant, & Dale, 2014). Personally when I am in severe pain I really do not want people around and it affects every aspect of my life. To think that persistent pain affects 80% of elderly residents in nursing homes and 50% of community dwellers, and we still do not treat this properly (Veal& Peterson, 2015).
Bipolar disorder most often requires pharmacological treatment as an intervention. Less than half of individuals with bipolar disorder are successful with just the pharmacological treatment approach. CBT shows positive results when used together with pharmacological intervention in treating bipolar disorder (Gregory, 2010). Bipolar disorder treatment benefits from CBT as it focuses on improving identifying distorted thoughts, improving communication and problem solving skills, areas that need intervention for individuals with bipolar disorder. CBT is effective in teaching coping skills to address times when symptoms are first displayed, but are not at top severity (Driessen & Hollon, 2010, p. 544).
Considerable evidence demonstrates substantial ethnic disparities in the prevalence treatment progression and outcome of pain-related conditions. Elucidation of the mechanism underlying these group differences is of crucial importance in reducing and eliminating disparities in these pain experience. Over recent years, accumulating evidence has identified a variety of processes, from neurophysiological factors to structural elements of Healthcare system. That may contribute to shaping individual difference in pain. For example, the experience of pain differentially activate stress- related physiological response across various ethnic groups appear to use differing coping strategies in managing pain complaints treatment decision vary as a function
Refer to be determine by medical doctor if patient has an underlying illness or condition. Intervention 3: complete pain management and substance abuse agreement Objective 3: discuss with primary care physician cautious use of medications (Perkinson, Arthur, & Bruce, 2014) Problem 3: Major depressive disorder Goal 3: refrain from any type of self-harm to self or others
In this crosspost, the author will elaborate on the original threaded discussion by Ellerbee Mburu, Vail, and Barlow and add additional information on pain assessment and management. Healthcare providers are the major group of healthcare professional who perform crucial functions in delivering and providing nursing care to inpatient and outpatients. As mentioned in the threaded discussion by Ellerbee, Mburu, Vail, and Barlow, undertreated pain causes unnecessary distress and negatively affects the quality of life. In additional to the original threaded discussion, pain is a factor that is thought of differently by many. It has been added as the fifth vital sign and is considered to be subjective.
We all know that pain is usually one of the major complaint of patients with chronic problems or those recovering post operatively thereby making pain evaluation a fundamental requisite in the outcome assessment during hospital visits. Interpreting the data from a pain assessment scale is not as straightforward as it may seem since the provider must consider the intensity, related disability, duration, and affect to define the pain and its effects on the patient (Williamson & Hoggart, 2005). Pain rating scales are used in the clinical settings to measure pain and these include Visual Analogue Scale (VAS), Verbal Rating Scale (VRS), Numerical/numeric Rating Scale (NRS) (Haefeli & Elfering, 2006). Each scale is unique on its own in terms of sensitivity and simplicity that generates data that can be statistically analyzed for audit purposes. The EHR in our hospital utilizes the three rating scales mentioned as part of the pain assessment tool to measure pain that sets the tone for the direction of the type of pain management will .be given to the
The United States Centers for Disease Control and Prevention (CDC) have strongly recommended the use of PT, non-drug, non-opioid as the first-line of treatment for chronic pain. The public tends to think that physical therapy deals more on the physical aspect of health. As we have learned in Health and Wellness, there is more than to the physical aspect of health. Wellness do not only include
Some patients prefer not to take pain medication because they fear addiction or may have a history of substance abuse. Educating the patients on their right to be free of pain and having their pain managed aggressively is a priority in the recovery phase. The goals that I hope to achieve during this clinical practicum
Cognitive Behavioural Therapy (CBT) is an evidence-based psychological therapy. The emphasis is on recognising and modifying negative thoughts and beliefs and maladaptive behaviours, subsequently impacting on mood and emotions. I am a Psychologist and Clinical Hypnotherapist based in Castlebar, Co.Mayo that offers Cognitive Behavioural Therapy sessions to clients based in Castlebar and the wider Mayo hinterland. Cognitive Behavioural Hypnotherapy (CBH) is a combination of cognitive, behavioural and hypnosis interventions.
1.Evaluate the discrepancy between the patient’s pain rating, behavioral signs of pain, and degree of participation in daily care/treatment for a patient in each scenario. 2.Explain a rationale for this discrepancy, using nursing knowledge and science. Numerous factors can affect a person pain perception and reaction to pain. It Includes person ethnic, cultural values, developmental age, environment, support, previous pain experience, and the meaning of pain. Pain Tolerance, "Is the duration or intensity of pain that person can endure," (Treas & Wilkinson, pg. 1093).
The literature shows that multidisciplinary/interdisciplinary intervention approach is the best selected intervention for individuals with LBP [40-43]. The effectiveness of the interdisciplinary treatment for LBP is supported by the literature; it significantly relieves pain, improves physical function and mental health, and reinforces the use of self-management skills for individuals with LBP [40-42]. A systematic review shows that interdisciplinary intervention has a greater effect on long, medium, and short term pain and disability compared to the usual care and physical therapy treatment (i.e. “heat and electrotherapeutic modalities; aerobic, stretching, and strengthening exercises; manual therapies; and education interventions”) [44].
The Biopsychosocial model (Suls & Rothman, 2004) is one of the earliest multi-dimensional models of the health field. This model demonstrates the interaction between biological and social factors in regard to disease analysis. It displays levels above and below a person arranged from global systems at the top and genetic systems at the bottom. In the Social and Behavioral Foundations of Public Health, Coreil (2010) describes how the biopsychosocial is more concerned with the biological systems within the human body and pays greater attention to this interplay. In the case study, Cockerham (2013) details how social conditions act as the ultimate causes of diabetes and diabetes related fatalities in the community of East Harlem.
We assist and care for patients from children to elderly, the one-dimensional is used for patients whose pain is intense. Visual scale, verbal rating and numeric scale are used on young-older adults with zero being “no pain to 10 being the worst” or the express possible pain of mild, moderate and sever. Lastly, the one we use on children is Flaccs-(“face, legs, activity, cry, consolability”) and the Wong-Baker- 6 Faces for ages 2-7 (“no hurt”-“hurts worst”). (Jensen, 2011.pp.121-126) Pain intensity, pain-related illnesses, pain duration and pain affect are characteristics that define pain and its effects. These pain characteristics can be major complains of patients, they influences surgical outcomes, effect coping strategies and pain perception.
Psychotherapy is as effective as medication in treating depression and is more effective than medication in preventing relapse (DeRubeis, Siegle, & Hollon, 2008). Cognitive-behavioral therapy (CBT) pertains to a class of interventions whose premise is that mental disorders and psychological distress are maintained by cognitive factors. Beck (1970) and Ellis (1962), were the pioneers Cognitive Behavioral Therapy approach of the core premise of holds that maladaptive cognitions contribute to the maintenance of emotional distress and behavioral problems. A review of meta-analytic studies by Hofmann, Asnaani, Vonk, Sawyer, and Fang (2012) examined the efficacy of CBT and it demonstrated that this treatment has been used for a wide range of psychological problems such as cannabis and nicotine dependence, schizophrenia and other psychotic disorders, depression, anxiety disorders, bulimia, insomnia, personality disorders, stress management and more studies being conducted to study its effectiveness. There is a well-established literature regarding effective cognitive behavioral therapy in treating mental health problems, specifically those utilizing face-to-face counseling.