Podcast
Questions and Answers
What mediates chronic throbbing pain?
What mediates chronic throbbing pain?
- C polymodal fibres (correct)
- A alpha fibres
- A beta fibres
- Delta fibres
Which type of fibres can counteract pain perception according to the Gate Control Theory?
Which type of fibres can counteract pain perception according to the Gate Control Theory?
- C polymodal fibres
- A beta fibres (correct)
- B motor fibres
- D sensory fibres
Anxiety and depression are likely to affect pain tolerance in which way?
Anxiety and depression are likely to affect pain tolerance in which way?
- Only affect pain reporting
- Decrease pain tolerance (correct)
- Increase pain tolerance
- Have no effect on pain tolerance
What cognitive aspect can increase the experience of pain?
What cognitive aspect can increase the experience of pain?
What psychological factor can lead to a self-fulfilling prophecy regarding pain perception?
What psychological factor can lead to a self-fulfilling prophecy regarding pain perception?
What is the first step in the Gate Control Theory's pain transmission process?
What is the first step in the Gate Control Theory's pain transmission process?
Which aspect does NOT influence the pain experience according to the Gate Control Theory?
Which aspect does NOT influence the pain experience according to the Gate Control Theory?
Which fibre type is not represented in the diagram associated with the Gate Control Theory?
Which fibre type is not represented in the diagram associated with the Gate Control Theory?
What best describes pain in relation to its nature?
What best describes pain in relation to its nature?
Which theory explains the interaction between different stimuli and pain perception?
Which theory explains the interaction between different stimuli and pain perception?
What is a significant misconception about pain?
What is a significant misconception about pain?
Which of the following is NOT an approach to pain assessment?
Which of the following is NOT an approach to pain assessment?
What is an example of pain that occurs after healing?
What is an example of pain that occurs after healing?
In which demographic is pain considered a significant issue?
In which demographic is pain considered a significant issue?
What is the relationship between pain and doctor consultations in the US?
What is the relationship between pain and doctor consultations in the US?
What is a potential risk associated with prescription drugs in pain management?
What is a potential risk associated with prescription drugs in pain management?
Which of the following factors is likely to open the pain gate?
Which of the following factors is likely to open the pain gate?
What is the significance of the statement 'Pain is what the patient says it is'?
What is the significance of the statement 'Pain is what the patient says it is'?
Which of the following is NOT a cognitive factor that can close the pain gate?
Which of the following is NOT a cognitive factor that can close the pain gate?
Which of the following behaviors can help close the pain gate?
Which of the following behaviors can help close the pain gate?
Which emotional factor is likely to open the pain gate?
Which emotional factor is likely to open the pain gate?
What can be a useful approach to pain assessment?
What can be a useful approach to pain assessment?
Which of the following practices can help close the pain gate through behavioral strategies?
Which of the following practices can help close the pain gate through behavioral strategies?
Which statement best reflects the objective measurement of pain?
Which statement best reflects the objective measurement of pain?
What is the modern aim of pain management?
What is the modern aim of pain management?
Which method is NOT considered a psychological intervention for acute pain management?
Which method is NOT considered a psychological intervention for acute pain management?
What is an example of a secondary gain associated with chronic pain?
What is an example of a secondary gain associated with chronic pain?
Which of the following is NOT one of the 'five D's' related to chronic pain management?
Which of the following is NOT one of the 'five D's' related to chronic pain management?
What role does hypnosis play in pain management?
What role does hypnosis play in pain management?
What percentage of the Irish population experiences chronic pain?
What percentage of the Irish population experiences chronic pain?
What is the estimated annual cost of pain in Europe?
What is the estimated annual cost of pain in Europe?
How long must pain persist to be considered chronic?
How long must pain persist to be considered chronic?
Which type of fiber is associated with transmitting sharp pain quickly?
Which type of fiber is associated with transmitting sharp pain quickly?
According to the gate control theory, which type of fibers can inhibit the perception of pain?
According to the gate control theory, which type of fibers can inhibit the perception of pain?
What type of response is acute pain considered to be?
What type of response is acute pain considered to be?
What type of fibers are responsible for transmitting dull, throbbing pain?
What type of fibers are responsible for transmitting dull, throbbing pain?
What does the gate control theory suggest about pain sensation?
What does the gate control theory suggest about pain sensation?
What is a key focus of cognitive strategies in pain management?
What is a key focus of cognitive strategies in pain management?
What role do multidisciplinary teams play in pain management?
What role do multidisciplinary teams play in pain management?
Which behavioral strategy is emphasized for managing pain?
Which behavioral strategy is emphasized for managing pain?
What is the purpose of providing analgesic medication at set times?
What is the purpose of providing analgesic medication at set times?
Which of the following is a common element of pain management programs?
Which of the following is a common element of pain management programs?
Which psychological intervention is commonly used for managing acute pain?
Which psychological intervention is commonly used for managing acute pain?
Which of the following is part of the 'five D's' associated with chronic pain?
Which of the following is part of the 'five D's' associated with chronic pain?
What trait is indicative of acute pain management strategies?
What trait is indicative of acute pain management strategies?
Which of the following factors can contribute to an increase in reported pain?
Which of the following factors can contribute to an increase in reported pain?
What role do peripheral pain receptors play in the Gate Control Theory?
What role do peripheral pain receptors play in the Gate Control Theory?
Which psychological factor can enhance pain tolerance according to the Gate Control Theory?
Which psychological factor can enhance pain tolerance according to the Gate Control Theory?
In the context of pain perception, what does the term 'self-fulfilling prophecy' mean?
In the context of pain perception, what does the term 'self-fulfilling prophecy' mean?
What type of fibers deliver the chronic throbbing pain that is moderated by A beta fiber activation?
What type of fibers deliver the chronic throbbing pain that is moderated by A beta fiber activation?
During pain transmission, which type of fibers carry information from the brain down the spinal column?
During pain transmission, which type of fibers carry information from the brain down the spinal column?
What effect can anxiety and depression have on pain perception?
What effect can anxiety and depression have on pain perception?
What cognitive factor can diminish the experience of pain?
What cognitive factor can diminish the experience of pain?
Which statement best describes pain as a phenomenon?
Which statement best describes pain as a phenomenon?
What is one major psychological approach to managing pain?
What is one major psychological approach to managing pain?
What does the term 'phantom limb pain' refer to?
What does the term 'phantom limb pain' refer to?
Which factor does NOT influence the perception of pain according to current understandings?
Which factor does NOT influence the perception of pain according to current understandings?
What percentage of the adult European population is estimated to be affected by pain?
What percentage of the adult European population is estimated to be affected by pain?
Which of the following statements about the cost of pain is true?
Which of the following statements about the cost of pain is true?
Which approach is NOT typically included in pain assessment methods?
Which approach is NOT typically included in pain assessment methods?
Which of the following aspects of pain is often misunderstood?
Which of the following aspects of pain is often misunderstood?
What is a primary focus of cognitive strategies in pain management?
What is a primary focus of cognitive strategies in pain management?
What role does a multidisciplinary team (MDT) play in pain management?
What role does a multidisciplinary team (MDT) play in pain management?
Which behavioral strategy is central to the management of pain?
Which behavioral strategy is central to the management of pain?
What is the objective of providing analgesic medication at set times?
What is the objective of providing analgesic medication at set times?
Which of the following is NOT a component of the program for chronic pain management?
Which of the following is NOT a component of the program for chronic pain management?
What is a challenge associated with behavioral strategies in pain management?
What is a challenge associated with behavioral strategies in pain management?
What do pain assessment tools primarily rely on?
What do pain assessment tools primarily rely on?
Which factor is considered essential in the multidisciplinary approach to chronic pain management?
Which factor is considered essential in the multidisciplinary approach to chronic pain management?
What is a significant influence on pain perception according to the content?
What is a significant influence on pain perception according to the content?
In the context of pain management, which aspect is emphasized for effectively addressing chronic pain?
In the context of pain management, which aspect is emphasized for effectively addressing chronic pain?
Which physical factor is likely to close the pain gate?
Which physical factor is likely to close the pain gate?
How does humor influence the perception of pain according to the gate-control theory?
How does humor influence the perception of pain according to the gate-control theory?
What cognitive behavior is associated with an increased perception of pain?
What cognitive behavior is associated with an increased perception of pain?
Which behavioral strategy is effective in closing the pain gate?
Which behavioral strategy is effective in closing the pain gate?
What role does sleep hygiene play in pain management?
What role does sleep hygiene play in pain management?
Which approach is NOT typically considered effective in pain assessment?
Which approach is NOT typically considered effective in pain assessment?
Which of the following cognitive strategies potentially increases pain perception?
Which of the following cognitive strategies potentially increases pain perception?
Which of the following is a critical component of effective chronic pain management?
Which of the following is a critical component of effective chronic pain management?
What is the main aim of providing education within a pain management program?
What is the main aim of providing education within a pain management program?
Which statement accurately reflects the complexity of pain perception?
Which statement accurately reflects the complexity of pain perception?
In which way can group therapy be beneficial for pain management?
In which way can group therapy be beneficial for pain management?
What role does family involvement play in pain management programs?
What role does family involvement play in pain management programs?
What is a key function of the cognitive strategies in pain management?
What is a key function of the cognitive strategies in pain management?
Which statement best describes the approach used in contingency management?
Which statement best describes the approach used in contingency management?
What best defines the nature of pain?
What best defines the nature of pain?
Why is information provision considered beneficial in pain management?
Why is information provision considered beneficial in pain management?
Which statement accurately describes the effects of psychological factors on pain perception?
Which statement accurately describes the effects of psychological factors on pain perception?
What are the primary factors influencing pain as described in pain studies?
What are the primary factors influencing pain as described in pain studies?
What is a potential drawback of solely relying on behavioral strategies for pain management?
What is a potential drawback of solely relying on behavioral strategies for pain management?
Which roles comprise a multidisciplinary team in pain management programs?
Which roles comprise a multidisciplinary team in pain management programs?
Which scenario exemplifies pain occurring without injury?
Which scenario exemplifies pain occurring without injury?
What does the gate-control theory primarily explain?
What does the gate-control theory primarily explain?
Which approach is NOT considered a major psychological strategy for managing pain?
Which approach is NOT considered a major psychological strategy for managing pain?
In what way can the concept of phantom limb pain challenge traditional views on pain?
In what way can the concept of phantom limb pain challenge traditional views on pain?
What is a significant feature of acute pain compared to chronic pain?
What is a significant feature of acute pain compared to chronic pain?
Which of the following best describes the common impact of chronic pain on society?
Which of the following best describes the common impact of chronic pain on society?
What is the role of A beta fibres in the Gate Control Theory of Pain?
What is the role of A beta fibres in the Gate Control Theory of Pain?
How is pain typically experienced according to the Gate Control Theory?
How is pain typically experienced according to the Gate Control Theory?
What is a characteristic commonly associated with the financial burden of chronic pain?
What is a characteristic commonly associated with the financial burden of chronic pain?
Which of the following accurately describes the role of C polymodal fibers in pain perception?
Which of the following accurately describes the role of C polymodal fibers in pain perception?
Which aspect of chronic pain is often underestimated according to the content?
Which aspect of chronic pain is often underestimated according to the content?
What describes the primary function of nociceptors within the Gate Control Theory framework?
What describes the primary function of nociceptors within the Gate Control Theory framework?
How do A beta fibers influence pain perception according to the Gate Control Theory?
How do A beta fibers influence pain perception according to the Gate Control Theory?
Which statement accurately reflects the difference between acute pain and chronic pain?
Which statement accurately reflects the difference between acute pain and chronic pain?
Which cognitive factor is linked to an increase in pain experience?
Which cognitive factor is linked to an increase in pain experience?
What is a key psychological factor that can lead to a reduction in pain tolerance?
What is a key psychological factor that can lead to a reduction in pain tolerance?
Which mechanism describes the interaction of emotional experiences and physical pain sensations?
Which mechanism describes the interaction of emotional experiences and physical pain sensations?
What describes the process involved in the descending modulation of pain?
What describes the process involved in the descending modulation of pain?
Which type of thought has been shown to dilute the experience of pain?
Which type of thought has been shown to dilute the experience of pain?
Under what condition could attentional focus on pain lead to increased reporting of pain?
Under what condition could attentional focus on pain lead to increased reporting of pain?
Which of the following factors is most likely to help close the pain gate?
Which of the following factors is most likely to help close the pain gate?
What emotional state is least likely to result in an increased perception of pain?
What emotional state is least likely to result in an increased perception of pain?
Which cognitive behavior is likely to open the pain gate?
Which cognitive behavior is likely to open the pain gate?
Which physical factor can potentially close the pain gate?
Which physical factor can potentially close the pain gate?
What is the most accurate statement about the measurement of pain?
What is the most accurate statement about the measurement of pain?
Which behavioral strategy is less effective in managing pain compared to others?
Which behavioral strategy is less effective in managing pain compared to others?
Which statement reflects a misconception regarding the nature of pain?
Which statement reflects a misconception regarding the nature of pain?
What approach is least likely to be part of a holistic pain assessment strategy?
What approach is least likely to be part of a holistic pain assessment strategy?
Flashcards
Pain definition
Pain definition
An unpleasant sensory and emotional experience associated with actual or potential tissue damage.
Gate-control theory
Gate-control theory
A theory suggesting that pain signals are modulated by a 'gate' in the spinal cord, influenced by various factors like attention and emotions.
Complex perceptual phenomenon
Complex perceptual phenomenon
Pain isn't just a physical sensation, it's influenced by biological, psychological, and social factors.
Pain assessment
Pain assessment
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Pain management
Pain management
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Pain disproportionate to injury
Pain disproportionate to injury
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Pain without injury
Pain without injury
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Injury without pain
Injury without pain
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Chronic Pain Prevalence
Chronic Pain Prevalence
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Chronic Pain Impact
Chronic Pain Impact
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Economic Cost of Pain
Economic Cost of Pain
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Acute Pain
Acute Pain
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Chronic Pain Definition
Chronic Pain Definition
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Nociceptors
Nociceptors
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A Delta Fibers
A Delta Fibers
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Gate Control Theory of Pain
Gate Control Theory of Pain
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Pain Management Goal: Modern
Pain Management Goal: Modern
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Acute Pain Management - Psychological Interventions
Acute Pain Management - Psychological Interventions
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Virtual Reality (VR) for Pain Management
Virtual Reality (VR) for Pain Management
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C-polymodal fibers
C-polymodal fibers
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Spinal cord gates
Spinal cord gates
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Chronic Pain - Primary Gain
Chronic Pain - Primary Gain
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Chronic Pain - 'Five D's'
Chronic Pain - 'Five D's'
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Psychological influence on pain
Psychological influence on pain
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Pain perception
Pain perception
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Pain signals transmission
Pain signals transmission
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Attributions, beliefs, expectations influencing pain
Attributions, beliefs, expectations influencing pain
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Factors that open the pain gate
Factors that open the pain gate
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Factors that close the pain gate
Factors that close the pain gate
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"Pain is what the patient says it is"
"Pain is what the patient says it is"
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Objective measures of pain
Objective measures of pain
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Pain Management Strategy: Behavioural
Pain Management Strategy: Behavioural
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Pain Management Strategy: Cognitive
Pain Management Strategy: Cognitive
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Pain Management Program (PMP)
Pain Management Program (PMP)
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What is a multidisciplinary team (MDT)?
What is a multidisciplinary team (MDT)?
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Information Provision: Pain Management
Information Provision: Pain Management
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What is pain?
What is pain?
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Why is pain subjective?
Why is pain subjective?
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What closes the pain gate?
What closes the pain gate?
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What opens the pain gate?
What opens the pain gate?
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Psychological Influences
Psychological Influences
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Cognition & Mood
Cognition & Mood
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Expectations
Expectations
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Placebo Effect
Placebo Effect
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Modern Pain Management Goal
Modern Pain Management Goal
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Acute Pain Management Techniques
Acute Pain Management Techniques
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Pain Assessment: Objective vs. Subjective
Pain Assessment: Objective vs. Subjective
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Pain Management Approaches
Pain Management Approaches
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Multidisciplinary Pain Management Team
Multidisciplinary Pain Management Team
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Information Provision for Pain Management
Information Provision for Pain Management
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Operant Learning in Pain Management
Operant Learning in Pain Management
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Cognitive Strategies for Pain
Cognitive Strategies for Pain
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What are PMPs?
What are PMPs?
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What is an MDT?
What is an MDT?
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What is GCT?
What is GCT?
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What factors influence pain?
What factors influence pain?
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What makes pain management complex?
What makes pain management complex?
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Why is education important for pain management?
Why is education important for pain management?
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Pain: Complex Perception
Pain: Complex Perception
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Pain Assessment: Subjective & Objective
Pain Assessment: Subjective & Objective
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Multidisciplinary Pain Management
Multidisciplinary Pain Management
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Pain Management: Information is Power
Pain Management: Information is Power
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Pain and Operant Conditioning
Pain and Operant Conditioning
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Cognitive Therapy for Pain
Cognitive Therapy for Pain
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Operant Learning in Pain
Operant Learning in Pain
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Multidisciplinary Pain Management Programs (PMPs)
Multidisciplinary Pain Management Programs (PMPs)
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Multidisciplinary Team (MDT)
Multidisciplinary Team (MDT)
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Multidisciplinary Pain Management Team (MDT)
Multidisciplinary Pain Management Team (MDT)
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Objective vs. Subjective pain
Objective vs. Subjective pain
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Patient education in pain management
Patient education in pain management
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What factors open the pain gate?
What factors open the pain gate?
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What factors close the pain gate?
What factors close the pain gate?
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Pain's Influence
Pain's Influence
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What Makes Pain Management Tricky?
What Makes Pain Management Tricky?
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Why is Education Key in Pain Management?
Why is Education Key in Pain Management?
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The Power of Multidisciplinary Teams
The Power of Multidisciplinary Teams
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Pain Assessment: Two Sides
Pain Assessment: Two Sides
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Study Notes
Introduction to Pain
- The presentation discusses pain, describing, assessing, and managing it.
- The material is from a Psychology Department at a medical school.
Learning Outcomes
- Students will define pain as a complex perceptual phenomenon, influenced by biological, psychological, and social factors.
- Students will describe the gate-control theory of pain.
- Students will outline approaches to pain assessment.
- Students will identify major psychological approaches to managing pain.
BMF Case Study (Hip Fracture)
- Lisa, an 80-year-old woman, experiences a hip fracture.
- Her husband, Joe, requires constant supervision and eventual end-of-life care planning.
- Lisa also requires a more sustainable health care management plan.
- The hip surgery was uncomplicated and successful.
- Post-rehabilitation, Lisa experiences pain in her left knee and lower back.
Learning Outcome 1: Defining Pain
- Pain is a complex perceptual phenomenon influenced by biological, psychological, and social factors.
What is Pain?
- Pain is a multifaceted experience.
The Puzzle of Pain
- Describes a few types of pain, including: injury without pain, pain without injury, pain disproportionate to injury, pain after healing (phantom pain), success of multimodal treatments.
Definition of Pain
- Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage.
- It is subjective and includes sensation and emotion.
- Pain can occur without injury, and injury can occur without pain.
Pain: An Important Social Issue
- Prescription drugs are cited as a major social issue.
The Cost of Pain
- Approximately 20% of adult Europeans are affected by pain.
- 80% of all doctor consultations in the US are related to pain.
- Chronic pain prevalence in Ireland is 35.5% (48% in the UK).
- Pain is associated with extensive hospital stays, lost work, and increased social welfare use.
- The cost of pain is estimated in the hundreds of billions in Europe and the US.
Acute vs. Chronic Pain
- Acute pain is a useful biological response to injury or illness, often short-lived and adaptive.
- Chronic pain lasts for six months or more and does not typically respond well to pharmacological treatments, often being maladaptive.
Learning Outcome 2: Gate-Control Theory of Pain
- Details the gate-control theory of pain.
- Pain sensations are transmitted from the site of injury to the spinal gate by nerves.
- Different types of nerve fibers exist, including A delta fibers and C polymodal fibers, transmitting pain signals at different speeds.
- A-beta fibers contribute to pain modulation.
- The theory proposes a gating mechanism in the spinal cord that can modulate pain perception.
- Cognitions and emotions also play a role in pain perception.
Gate Control Theory of Pain: Psychological Influences
- Mood, anxiety, and depression can impact pain tolerance and reporting.
- Attention focused on pain may exacerbate the experience.
- Expectations regarding pain reduction or increase can influence pain perception.
- Types of thought influencing pain include pain origins' attributions, tolerability beliefs, controlling beliefs, and placebo effects.
Combined Gate Control Theory Inputs
- Peripheral pain receptors transmit information about physical damage to spinal cord "gates".
- Simultaneously, CNS nerve fibers transmit information from the brain to these spinal cord "gates" to affect perceived pain level, based on emotional and cognitive states.
Gate-Control Theory (diagram)
- Illustrates the concept of an open or closed pain gate, influencing the experience and level of pain perception.
Factors that Open or Close the Pain Gate
- Physical factors that open the pain gate: injury, inactivity, poor fitness, long-term drug use.
- Physical factors that close the pain gate: appropriate medication use, heat/cold application, massage, appropriate exercise.
- Behavioral factors that open the pain gate: poor/insufficient pacing of activity, poor sleep.
- Behavioral factors that close the pain gate: exercise, relaxation training, sleep hygiene.
- Emotional factors that open the pain gate: anxiety, depression, stress, helplessness.
- Emotional factors that close the pain gate: laughter, humour, optimism.
- Cognitive factors that open the pain gate: focusing on pain, worrying about pain.
- Cognitive factors that close the pain gate: distraction.
Learning Outcome 3: Pain Assessment
- Pain is "what the patient says it is" (Sternbach, 1982).
- Pain assessment utilizes various scales like unidimensional (verbal rating scales, visual analogue scales) and multidimensional (McGill pain questionnaire).
- Different dimensions are considered in multi-dimensional assessments (sensory, sensory-discriminative, affective, evaluative), and the scales involve detailed descriptor words.
- Short form McGill pain questionnaire is also useful, which incorporates sensory and affective scales which are scored according to the perception (ranging from none to severe).
Think, Pair, Share (Discussion Points)
- Is pain truly immeasurable?
- Is patient self-reported pain a good indicator of injury or pathology?
- What useful mnemonics can help with pain assessment?
Learning Outcome 4: Psychological Approaches to Managing Pain
- Historical pain management aimed for its elimination.
- Modern pain management goals are less drastic: reducing perception, improving coping, enhancing function, decreasing reliance on drugs, and valuing self-management efforts.
Pain Management - Acute
- Initial approach to acute pain management is usually pharmacological.
- Second-level interventions may involve increasing patient control, e.g., patient-controlled analgesia (PCA), and teaching coping skills, including distraction, relaxation, and hypnosis.
- Virtual reality (VR) pain management may be used for distraction.
Pain Management - Chronic
- Chronic pain management considers complex, multifactorial causes, such as interpersonal and intrapersonal gains, expressions of pain linked to avoidance of other activities, and satisfaction in others sympathizing.
- Common results (the "five D's") of poorly managed chronic pain include: dramatization of complaints, disuse through inactivity, drug misuse (overmedicating), dependency on others, and disability due to inactivity.
Behavioural Strategies
- Operant learning principles are utilized in behavioral strategies to reinforce adaptive behaviors, such as appropriate exercise, and to discourage pain-related behaviours.
- Attention withdrawal and analgesic medication are adjusted to minimize or eliminate the rewards of pain-related behaviors.
Cognitive Strategies
- Cognitive strategies help adjust beliefs about pain and encourage a less catastrophic view of the condition.
- Techniques for these include challenging negative or distorted thoughts, providing information to reduce anxiety, and distraction to help re-direct attention.
Pain Management Programmes (PMPs)
- Multidisciplinary teams (doctors, nurses, therapists) manage chronic pain.
- Cognitive behavioural therapy (CBT) principles guide the programmes.
- Education on pain, physiology, psychology, healthy function, and self-management are provided.
- Treatment is provided in a group setting and includes patient assessment, education, skills training, exercise schedules, relapse prevention, and family work.
Summary
- Pain perception involves biological, psychological, social, and cultural influences.
- The gate-control theory is a valuable concept for understanding pain.
- Pain is subjective, and assessment tools should consider the patient's experience.
- Effective chronic pain management requires a multidisciplinary approach, examining the interplay of physical, psychological, and socioeconomic factors.
Reading Material
- Provides suggested readings, including chapters, journal articles, and YouTube videos related to pain, pain assessment, and psychology of medicine.
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Description
This quiz explores the intricacies of pain, focusing on its definition, assessment tactics, and management strategies. Learn about the gate-control theory and the impact of biological, psychological, and social factors on pain perception through a real-life case study. The material is structured by the Psychology Department at a medical school.
