Chapter 13: Managing Pain Continued

StudyBlue printing of Chapter 13: Managing Pain Continued html, body, div, span, applet, object, iframe, h1, h2, h3, h4, h5, h6, p, blockquote, pre, a, abbr, acronym, address, big, cite, code, del, dfn, em, font, img, ins, kbd, q, s, samp, small, strike, strong, sub, sup, tt, var, b, u, i, center, fieldset, form, label, legend, table, caption, tbody, tfoot, thead, tr, th, td { margin: 0; padding: 0; border: 0; outline: 0; font-size: 100%; background: transparent; } body { line-height: 1; } blockquote, q { quotes: none; } blockquote:before, blockquote:after, q:before, q:after { content: ''; content: none; } /* remember to define focus styles! */ :focus { outline: 0; } /* remember to highlight inserts somehow! */ ins { text-decoration: none; } del { text-decoration: line-through; } /* tables still need 'cellspacing="0"' in the markup */ table { border-collapse: collapse; border-spacing: 0; } /* end RESET */ .header { min-width:800px; } .logo { padding:6px 20px 2px 20px; margin:0; font-size:25px; 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} ul li { list-style: disc; } ol li { list-style: decimal; } img { border: 0; } table { clear: both; width: 100%; border: 1px solid #c5c5c5; border-width: 1px 0; margin: 0; page-break-after: always; } table#page { page-break-after: auto; } td { text-align: center; font-size: 12px; border-bottom: 1px dashed #c5c5c5; height: 1.75in; width: 50%; padding-left: 15px; } .leftside { border-right: 1px solid #cccccc; padding: 0 15px 0 0; } .bottom td { border-bottom: none; } .clearfix { clear:both; line-height:1px; height:1px; } img { max-width:80%; max-height:150px; margin:20px; } @media print {.header { display: none; } .content .header{ display:inherit; } table { border: 1px dashed #bbb; border-width: 1px 0; } .theNote{ background-color:white; } } 4-21-2011 Is there a pain-prone personality acute chronic pain suffers show elevated score s on 2 MMPI scales: hysteria: tendency to exaggerate symptoms and use emotional behavior to solve problems hypochondria- tendency to be overly concerned about health and to over-report body symptoms chronic pain suffers also score high in depression dysfunctional- patients-report high levels of pain, feel they have little control over their lives interpersonally distressed patients-perceive little social support and feel other people in their lives don't take their pain seriously adaptive copers-report lower levels of pain and distress and continue to function at a high level Sociocultural Factors groups differ greatly in their norms for the degree to which suffering should be openly expressed and the form that pain behaviors should take pain tolerance versus pain threshold Social Learning repetitive strain injury occupational disorder first noted in the 1980s among keyboard operators and computer programmers social constriction of illness how we learn to respond to pain begins with the socialization process of childhood Treating Pain pharmacological treatments analgesic (pain-relieving) drugs are the mainstay of pain control include central acting opioid drug opioid analgesics formely called narcotics agonists that act o n receptors in the brain and spinal cord to reduce the intensity of pain messages of the brain's response to pain messages most powerful and widely used opioid is morphine patient-controlled analgesia--possible solution to the tendency of many physicians to under-medicate pain Non-opioid Nonsteroidal anti-inflammatory drugs (NSAIDS) asprinin, ibprophen prostsglandin the chemical responsible for localized pain and inflammation, also causes free nerve endings to become sensitized Other medical interventions surgery a centuries-old treatment for pain destroying cells in the thalamus may alleviate some deep, burning pain results of surgery are often unpredictable Counterirritation-analgesia in which one pain is relieved by creating another, counteracting stimulus trancutaneous electrical nerve stimulation (TENS)--a counterirritation form of analgesia involving electrically stimulating spinal nerves near a painful area CBT CBT a multidisciplinary pain-management program that combines cognitive, physical, and emotional no single pain control technique has proven to be the most effective in relieving chronic pain many providers use an eclectic "cafeteria" approach components education and goal-setting component is used to clarify cognitive interventions teaching ner skills promote increased exercise cognitive errors in the thinking of pain patients catastrophizing overgeneralizing victimization--why me? self-blame dwelling on the pain Interventions rational-emotive therapy--to challenge illogical beliefs internal dialogue--maladaptive thoughts replaced with more positive thoughts cognitive distraction imagery--a form of self-hypnosis invloving focused concentration and attention often used to supplement other techniques most effective with low to medium levels of pain intensity component of Lamaze Reshaping pain behavior behavioral interventions of being by identifying the events that precede pain behaviors as well as the consequences that follow treatment focused on altering the contingencies between responses and stimulus