PUBH 122 Chapter 10 The Management of Pain and Discomfort

Arrange the steps in the biofeedback process in the correct order of occurrence.

1. the target function to be controlled is identified. 2. The target function is tracked by a machine, which gives feedback to the patient. 3. The patient learns what behaviors or thought will modify the bodily function through trial and error and continuous feedback

Identify the pain behaviors that arise from chronic pain. (Check all that apply.)

Avoidance of activities Facial and audible expressions of distress Distortions in posture or gait

______involves providing biophysiological feedback to a patient about some bodily process of which the patient is usually unaware.

Biofeedback

Coping skills training helps _____pain patients manage pain.

Chronic

Identify the motivational, behavioral, and emotional responses that accompany the experience of pain. (Check all that apply.)

Crying Fear Withdrawal

_________reflects the feelings of despair or hopelessness that can accompany long-term experience with unsuccessfully treated pain.

Depression

_____ worsen the experience of pain.

Depression, anxiety, and anger

_____ is most effective for coping with low-level pain.

Distraction

True or false: Pain has objective referents.

False

True or false: Chronic pain patients never require special guidance to get benefits from slow breathing.

Reason: This is false. Slow breathing, which is a part of relaxation therapy, works to manage pain much of the time, but chronic pain patients may require special guidance to get benefits from these techniques.

True or false: Individualized programs of pain management are typically structured and time limited.determination theory. (Check all that apply.)

Reason: This is true. Individualized programs of pain management are typically structured and time limited.

Identify the goals a patient needs to achieve in individualized programs of pain management. (Check all that apply.)

Reducing the intensity of pain Reducing dependence on medication and perception of disability Increasing physical activity and improving psychosocial functioning

Identify the statements that show the medical significance of pain. (Check all that apply.)

The presence of both pain and mental or physical disorders complicates diagnosis and treatment. Complaints of pain often accompany mental and physical disorders. Pain is a symptom that will lead a person to seek treatment.

Identify the maladaptive coping strategies developed by chronic pain patients. (Check all that apply.)

Withdrawing socially Engaging in wishful thinking Catastrophizing their illness

__________ show greater sensitivity to pain.

Woman

From a patient's standpoint, pain is a problem, whereas to a medical provider, it is _____.

a by-product of a disorder

Chronic pain leads to a variety of pain-related behavior, and these alterations in a person's life then become _____.

a part of the pain problem and may persist and interfere with successful treatment

While passive coping skills have been tied to poor pain control, _____.

active coping skills can reduce pain in patients with a variety of chronic pains

Unlike the surgical, sensory pain management, and pharmacological techniques, psychological techniques require _____.

active participation and learning on the part of a patient

The fear of not being able to reduce one's suffering _____.

arouses more anxiety than the prospect of losing a limb or even death

The third objective in cognitive-behavioral intervention is that clients are encouraged to reconceptualize their own role in the pain management process from _____.

being passive recipients to competent individuals who can aid in the control of pain

The experience of pain is a protective mechanism to _____.

bring tissue damage into conscious awareness

Relapse prevention techniques that help patients continue their pain management skills _____.

can maintain posttreatment pain reduction

Coping skills training helps______ pain patients manage pain.

chronic

The pain problem must be perceived to be modifiable for _____ and _____ methods to have any impact.

cognitive and behavioral

Unlike acute pain, chronic pain involves a great amount of _____.

complex interaction of physiological, psychological, social, and behavioral components

In relaxation, ______ ________ is added, in which breathing shifts from relatively short, shallow breaths to deeper, longer breaths.

controlled breathing

Spinal cord stimulation is an example of _____.

counterirritation

___________ involves inhibiting pain in one part of the body by stimulating or mildly irritating another area.

counterirritation

Patients may be taught to identify situations likely to give rise to their pain and to _____.

develop alternative ways of coping with the pain

One barrier to the treatment of pain is the _____.

difficulty people have in describing it objectively

Clients are encouraged to attribute their success to their own efforts, making them see themselves as _____.

efficacious agents of change and pain modification

Clients must be convinced that the skills necessary to control the pain can and will be taught to them, thereby _____.

enhancing their expectations that the outcome of the training will be successful

Pain questionnaires help a practitioner _____.

get a full picture and address the psychosocial components of a patient's pain

The degree to which pain is felt and how incapacitating it is depends in a large part on _____.

how it is interpreted

Chronic pain patients typically show elevated scores on three subscales of the Minnesota Multiphasic Personality Inventory (MMPI). These subscales are _____.

hypochondriasis, hysteria, and depression

Understanding what pain behaviors a patient engages in and knowing whether they persist after the treatment of the pain are _____.

important factors in treating the total pain experience

By making patients responsible for success, they see themselves as agents of change and are _____.

in a better position to monitor changes in the pain and bring about successful pain modification

Social support for pain can _____.

inadvertently act as a reinforcement of pain behaviors, which then become part of the pain problem

Depression increases perceptions of pain, and so it can feed back into the total pain experience, _____.

increasing the likelihood of pain behaviors

While distraction is effective, its practical significance for chronic pain management _____.

is limited because patients cannot distract themselves indefinitely

Crossing and uncrossing our legs, shifting our posture, or rolling over while asleep are all examples of _____.

low-level feedback for pain

Among chronic pain patients whose spouses remain supportive, such positive attention may inadvertently _____.

maintain the pain and disability

Patients are taught how and when to employ overt and covert behaviors in order to _____.

make adaptive responses to pain problems

Clients learn how to monitor their thoughts, feelings, and behaviors to break up ___ ___ ____that accompany chronic pain.

maladaptive behavioral syndromes

Relaxation is modestly successful for controlling some acute pains and _____.

may be useful in treating chronic pain when used with other methods of pain control

Patients with chronic pain may suffer a deterioration in relationships as they _____.

may not communicate well with their families

Social pain, which is the feeling of social rejection or loss, relies on the same pain-related neurocircuitry that physical pain relies on. This suggests there are _____.

meaningful similarities in the way that social and physical pain are experienced

The three kinds of pain perception are _____.

mechanical nociception, thermal damage, and polymodal nociception

Chronic pain patients typically show elevated scores on three subscales of the Minnesota Multiphasic Personality Inventory (MMPI).This group of traits is commonly referred to as the .

neurotic triad

Sometimes pharmacological treatments may not help a patient feel better. Patients may consume large quantities of painkillers that are _____.

only partially effective and have side effects, including inability to concentrate and addiction

Some of the beneficial physiological effects of relaxation training may be due to the release of _____.

opioids

The basis for assessing how pain has disrupted the life of a patient or a group of patients is provided by __________ __________.

pain behaviors

A constellation of personality traits that predispose a person to experience chronic pain is known as a ___ _____ ____

pain-prone personality

Because psychological factors are clearly implicated in the experience of pain, and because pain serves functions for some chronic pain sufferers, researchers have examined the presence of a __ __ ___

pain-prone personality

Due to its temporary nature, counterirritation is used appropriately as _____.

part of a general regimen for chronic pain

While nerve-blocking agents may be administered to reduce pain, these can also _____.

produce side effects including anesthesia, limb paralysis, loss of bladder control, and a quick return of the pain

Pain is critical for survival because it _____.

provides low-level feedback about the functioning of bodily systems

Unlike acute pain, chronic pain often carries an overlay of ______ ___________ , which complicates diagnosis and treatment.

psychological distress

The first objective in cognitive-behavioral interventions is that patients are encouraged to _____.

reconceptualize the problem from overwhelming to manageable

Meditation, slow breathing, and mindfulness _____.

reduce pain sensitivity and can produce analgesic effects

Just as _____ _____is an important part of health habit change, it is important in pain control as well.

relapse prevention

Once a patient is discharged from a pain management program, to prevent patients from reverting back to their previous condition, _______ _________techniques are taught.

relapse prevention

According to Hernandez and Sachs-Ericsson, people from some cultures _____.

report pain sooner and react more intensely to it than those from other cultures

The third objective in cognitive-behavioral intervention promotes feelings of ____ _____ in patients.

self-efficacy

While counterirritation has some success in reducing pain, its effects are often _____.

short-lived and thus more appropriate for temporary relief from acute pain

Psychological techniques are more effective for managing _____.

slow-rising pains, which can be anticipated and prepared for than for sudden, intense, or unexpected pains

Pain is heavily influenced by _____.

the context in which it is experienced

Acceptance and commitment therapy, mindfulness interventions, and self-determination theory are techniques which train patients in pain _____.

to help them control their emotional responses to pain

Drawing on the large and informal vocabulary a person uses to describe pain helps medical practitioners _____.

understand a patient's complaints and the implications of pain

Unlike chronic pain, most pain control techniques _____.

work well to control acute pain