IHS 110: Test 2 – Flashcards
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Biological factors of pain
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Transmission of pain to a conscious level in the brain and in the medical management of pain
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Psychological factors of pain
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Reactions, meanings, interpretations, and expressions of pain Including emotional or affective responses to pain such as fear and depression Pain threshold
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Psychosocial factors of pain
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Include improvement in self-efficacy along with changes in attitudes, emotions, and pain related behaviors
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Social and cultural factors of pain
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National origin, ethnicity, educational level, and socioeconomic statues, affect treatment and recovery from painful conditions Some praise those who tolerate pain as being brave Stoic
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Social Support of pain
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Includes friends and family members who are willing to assist patients in reducing stress, fear, pain, and discomfort Pain support groups
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Biological definition of pain
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An unpleasant sensation resulting from situations of nerve ending injury, disease, or other harmful factors
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Reaction to pain
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Medications Seeking medical care
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Anguish
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Severe pain that continues for long periods of time
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Pain and Stress
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Pain is an important cause of stress, an stress can also cause pain Ex. Migraines and headache
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Chronic pain Examples
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Back Pain Joint pain Arthritis Rheumatism
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Nociception
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Perception of pain produced when body tissue is damaged
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Pain results when? Where does it move?
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Sensory nerve fibers are irritated by injury or disease Moves from the site of injury or disease through the spinal core to the brain and consciousness
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Endorphins
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Block the sensation of pain
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Visceral pain
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Results from injury or disease to an organ in the thoracic or abdominal cavities
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Somatic pain
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Originates in the skin, ligaments, muscles, bones, and joints
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Sensations of pain
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Numbness Tingling Burning
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Tenderness
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Refers to a slight but unusual pain when affected area is touched or pressed
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Biological usefulness of pain
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Warns us of damage to our bodies
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Pain behaviors
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Hear a groan Grasp to some part of they body Cry Moaning
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Distorted ambulation
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An abnormal walking behavior indicating pain in some area of the body Difficultly walking
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Guarding
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Protective behavior that may indicate a painful injury
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Pain Threshold
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The point at which an individual describes a sensation as being painful
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Tolerance
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To the point at which people want the sensation to stop The older a person is, the great the tolerance for pain
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Psychogenic pain
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A chronic pain with no currently identifiable physical basis
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Stoic
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A person who is a patient and who endures adversity including pain
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Socialization
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Process of teaching or learning what behavior is acceptable Attitudes about pain are learned in the family Distraction helpful for children
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Secondary gain of pain
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Any benefit of pain used by persons to avoid some task to to draw attention to themselves
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Malingering
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Medical term for patient exaggeration about symptoms of a disease or injury to gain some end
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Biological causes of Headaches
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Sinus infections, flu, dehydration, tumors, allergies, changes in air pressure
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Psychological causes of headaches
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Difficult to separate from social because most stressors include both components Stress related headaches caused by anxiety or worry
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Specificity theory of pain
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Suggested that sensory receptors in the skin were specific to pain sensations
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Pattern theory of pain
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Proposed that the pattern and quantity of nerve fiber discharged produced differences in pain sensations
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Gate control theory of pain
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Most widely accepted pain theory (biopsychosical) Explains pain as a sensation that can be blacked by a neutral gate in the spinal cord that modifies pain signals Information can also move int he apposite direction
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Neuromatrix model of pain
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Merges the gate control theory with the concept of stress Pain is a unique experience for each individual
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Actue pain
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Comes on suddenly and is severe Indicates tissue damage Prevents further damage
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Chronic pain
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Persists for a very long period of time, usually more than 6 months Even after body tissue appears to have healed Rarely cured but can be managed Accompanied by depression and frustration
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Recurrent pain and chronic intermittent pain
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Brief but acute pain episodes repeated over and over and distressing to patients
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Three Stage Diathesis-Stress Model
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Patents become increasingly demoralized due to the stress of coping with pain
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Three Stage Diathesis-Stress Model : Stage 1
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Fear, anxiety, and worry about the pain and its cause
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Three Stage Diathesis-Stress Model: Stage 2
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Characterized by the negative affect or emotions such as helplessness, depression, anxiety, and anger
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Three Stage Diathesis-Stress Model: Stage 3
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Patients accept that a pain is chronic and adopt a maladaptive sick role to behavior
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Chronic intermitten pain
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Arthritis: Weather Migraines: Social situations Sinus headache Comes and goes and is often unpredictable
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Chronic intractable pain
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Severe and constant, often triggered by sociopsychological events Lower back pain or headaches
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Progressive pain
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Gets worse over time
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Referred pain
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Pain due to confusion of sensations within the nervous system Felts in one part of the body, but the injury or disease is actually in another part
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Phantom limb pain
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Persistent pain perceived to be located in a part of the body that was removed or amputated
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Pain syndrome
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A combination of sings an symptoms More than 14 pain syndromes
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Pain syndrome include
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Whiplash Back pain Headaches Cancer pain Pain from Muscular dystrophy MS Herpes Zoster Rheumatic disease Sickle-cell disease
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Signs of Pain
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Objective indicators of an injury or illness that can be obsessed by medical personal Ex. vomiting, bleeding
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Symptoms of Pain
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Subjective indicators of pain that must be reported by patients PAIN IS A SYMPTOM
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JCAHO
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Requires the use of scales to document pain severity
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Measurement of Pain
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Visual Analogue Scales The McGill-Melzack Pain Questionnaire Physiological Measures
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Visual Analogue Scales
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Usually ask about the amount of pain from a range of 1 to 10 Posters with a sequence of faces
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The McGill-Melzack Pain Questionnaire
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Allows patients to select words that fit their pain Amount of pain and qualities of pain 3 classes of pain descriptions, 20 subclasses, and over 100 adjectives Score pain from 1-7
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Physiological Measures
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Assessment of movement
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Pain management is based on 3 separate stages
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Primary Management Secondary Management Tertiary Management
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Primary pain management
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Appropriate for short-lived and less severe acute pain Information and encouragement so patients can return to the sam activity level that existed before the injury or disease Analgesics
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Analgesics
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Relieve pain and allow healing
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Secondary pain management
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More intensive psychosocial interventions promote a return to pre-pain productivity levels to prevent further deterioration in the patient's biological and psychological well-being
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Tertiary pain management
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Intense interdisciplinary treatments to offset physical deterioration and prevent permeant disability
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Biological Approaches to Pain Management
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Pharmacological treatments Prescriptions Anesthesia
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General Anesthesia
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Results in unconsciousness for surgery
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Local anesthesia
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Numbness is limited to specific nerves
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Epidural anesthesia
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Prevents pain below a certain point on the body
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Two solutions to tolerance
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Patient-controlled analgesia Continuous Infusion
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Patient-controlled analgesia
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Allows patients to activate doses of medicine for their pain Doses are controlled Ex. Opiate Analgesics
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CARF
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The Commission on Accreditation of Rehabilitation Facilities Requires that a pain management team include a physician who acts as director of the treatment plan Meet once a week Functional restoration is the goal
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Psychosocial Approaches to Pain Management
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Biofeedback Relaxation Training Hypnosis PT, TENS, and Massage Chiropractic Acupuncture Herbal Therapy
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Complementary health care or alternative medicine
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Refers to therapeutic interventions developed outside of traditional Western medical practice that may be used in combination within traditional medical treatments
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Examples of Complementary health care or alternative medicine
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Acupuncture Massage Relaxation therapy Self-help groups Herbal medicine Megavitamins Chiropractics Self-hypnosis
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Bio-feedback
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Requires special training, equipment, and time on the part of both the therapist and patient Used in behavioral medicine and clinical psychology to treat pain and stress in muscle tension
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Muscle relaxation
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Coping with stress and is also appropriate for pain management to relax without the electrodes of biofeedback
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Hypnosis
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Similar to relaxation trying and biofeedback Puts individuals in a highly focused state/altered state of consciousness
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PT, TENS, Massage
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PT: Used in addition to traditional medical approaches for injury and pain TENS: Transcutaneous electrical nerve stimulation Massage: Manipulation of soft tissue to reduce pain and stress
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3 types of massages
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Swedish Shiatsu Rolfing
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Swedish
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Tissue is kneaded
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Shiatsu
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Manipulated the pressure points
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Rolfing
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Deep muscle massage
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Chiropractic
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Ease pain and suffering though manipulations of joints and other parts of the body 3rd largest group of health care providers
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Acupuncture
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Ancient traditional healing and pain-control technique practiced by over 2,500 years in China Health problems arise from an imbalance of energy in the body Needles
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Herbal Therapy
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Plant-based or botanical medicines are used to relieve pain
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Cognitive techniques
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The least invasive of pain control methods, they involve changing thinking about pain and pain perspectives Meditation Deep Breathing Progressive muscle relaxation Distraction Redefinition
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Distraction
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Used for pain control and stress management Works best with mild to moderate pain useful for short-term pain relief of about 3 days
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Norman Cousins
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Credited with "laugh therapy"
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"laugh therapy"
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Related to distraction, relaxation, and pain control
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Redefinition
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Related to distraction and is used by therapists to change the ways we think about chronic stressors like pain Substitutive constructive thoughts to replace their fears Coping statements
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Stress has:
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Biological Psychological Sociocultural CAUSES
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Biological
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Physiological responses in the nerves and endocrine systems that may cause both immediate and long term threats to health
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Psychological
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Based in each individual's perception of a problem or trouble
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Sociocultural
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Individual's reactions to stressful situations and influenced by social and cultural experiences in their past, present, and future
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Stress
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A physical and psychological reaction to a threat to physical, psychological, or social health
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Stressor
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An event or situation perceived by persons to be a danger to their physical, psychological, and social health
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Mind-body connection
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Idea that emotions, personality, and culture affect physical health and that the revers his also true
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Panic Disorder (PD)
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A tendency of humans to experience fear and anxiety in many situations where dangers are either imagined or real
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Post-Tramatic stress disorder (PTSD)
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Anxiety disorder that occurs after having experienced a serious threat of death or injury to oneself or others
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3 different ideas of stress:
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Stimulus Response to the stimulus Interaction between the two
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Coping
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Strategies or processes used by individuals to deal with stressors or demands Respond
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Distress
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Indicated an unpleasant state of suffering
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The Flight or Flight Syndrome by?
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Walter Cannon Biological
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The Flight or Flight Syndrome
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The response of animals when threatened with harm Arousal by the sympathetic nervous and endocrine system to attack of flee After danger over bodies return to homeostasis
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Homeostasis
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Bodies normal state In balance Back to the warm/happy place
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General Adaptation Syndrome (GAS) by?
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Hans Selye Biological
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Steps of GAS?
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Alarm Resistance Exhaustion
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Alarm
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The body is mobilized through the nervous and endocrine systems to fight or flee
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Resistance
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The body's immune system is in jeopardy and people may become ill
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Exhaustion
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The body is in a low level of functioning until either recovery or death occurs
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Physiological Reactions to Threats
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Neuroendocrine Responses
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Neuroendocrine Responses
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Cells in the central nervous system control and coordinate all body functions in response to stress SAM and HPA system involved
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Symatho-adrenomedullary (SAM) and Hypothalamus-pituitary-adrenocortical (HPA)
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Release catecholamines such as epinephrine and norepinephrine into the body
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Autonomic nervous system
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Affects involuntary action so conscious control is not required
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Sympathetic nervous system
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Mobilized the body to meet threats
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Parasympathetic nervous system
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Part of the nervous system that shows the heart rate, dilated blood vessels, and relaxed muscles stimulating digestion
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Endocrine system
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Network of glands that secrete hormones into the bloodstream
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Richard Lazarus
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Theory of Stress Psychosocial
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Theory of Stress
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A person's perception and interpretation of a stressful situation are more important than the reality of the event People can learn to cope or respond to stress in healthful way
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Transactional Analysis by?
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Richard Lazarus and Susan Folkman
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Transactional Analysis
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Continuing exchange between people and their social and physical environments
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3 stages of Transactional Analysis
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Primary Appraisal Secondary Appraisal Reappraisal
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Primary Appraisal
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Different people will view identical situations as threatening, as harmless, or as a helpful opportunity One you can learn or run from
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Secondary Appraisal
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If a situation is judge to be a threat than people consider their options and devise strategies High levels of self-efficacy for the situation, they will not feel threatened
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Self-efficacy
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Confidence to be successful
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Reappraisal
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People often reevaluate situations due to new information and judge situation to less of a threat
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U-stress
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Stress you can use Good stress
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Example of measurement of stress
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Polygraph tests Heart rate Blood pressure
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Polygraph tests
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Results are objective and quantifiable but are unreliable, expensive, and invasive
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Social Readjustment Rating Scale
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An effort to assess the effect of stressors on health Created by Holmes and Rahe 43 life events ranging from death of a spouse (100 points) to minor violation of the law (11 points)
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Perceived Stress Scale (PSS)
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Cohen, Kamarck, and Mermelstein 117 item questionnaire measuring the severity and frequency of minor stressors and an uplifts scale to measure positive life events
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Psychoneuroimmunology (PNI)
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A science studying the bidirectional connections between behavior and the nervous, endocrine, and immune system
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Causes of Stress:
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Mind-body damage Changes in Immune system Unhealthy behavior
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Mind-body damage
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Respiratory disorder Skin disorder Cancer
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Changes in Immune System
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Suppression of T- and B-cell functions Decreased interferon synthesis
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Unhealthy behavior
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Smoking Alcohol abuse Drug abuse Poor diet
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Biological stressors
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Pathogens Physical injuries
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Psychological stressor
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Humiliation
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Psychosocial stressor
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Being chased across campus by an angry mob
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Type A personality
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A person who tried to do more and more in limited periods of time and often ignores symptoms of physical illness
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Acute Stressors
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Catastrophic events or sudden aggravations in the environment involving coping effort
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Chronic Stressors
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Aggravations that last months to years
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Immunology
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Study of the body's response to foreign invasion
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Human Immunodeficiency Virus (HIV)
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Is a contagious, life-threatening deficient of the immune system
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Acquired immune deficiency syndrome (AIDS)
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HIV many progress to this
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Anaphylactic shock
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Serious allergic response to insect stings, foods or to medicines
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Psychoneuroimmunology (PNI) three areas of study:
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Negative Emotions Contribute to Illness/Death Stress and Chronic Health Problems Stress Influences Health Habits
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Negative Emotions Contribute to Illness/Death
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Negative emotions intensify the threats to health Depression, anxiety, anger, and hostility
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Depression
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The most common psychiatric illness
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Stress and Chronic Health Problems
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Stress contributes to poor health habits
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Stress Influences Health Habits
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Stress interferes with important social relationships
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Atopic Dermatitis (AD)
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Or eczema, is a neurodermatitis characterized by itching, redness, oozing, crusting, scratching, and thinking of the skin
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Naturalistic Stress
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A stressor faced outside of laboratory testing situations ex. taking exams
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Norepinephrine
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A hormone recreated by the adrenal medulla Involved in memory
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Combat Stress Reaction (CSR)
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Name given to the reaction of some American soldiers to the stress of combat in WW II
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Resilience
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Refers to an ability to maintain balance in the face of trauma and loss
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Rehabilitation psychology
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Focuses on the post-injury phase and center on helping people with disabilities to recover from injuries and disease
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Stress fractures
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Physical injuries usually resulting from reptile impacts on limbs
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2 theories to explain the relationship between stress and sports injuries:
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Stress interferes with concentrations Physical arousal of stress combined with competitive spirit increases muscle tension and reached muscle coordination
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Biological Approaches to Sport Injury Prevention
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Maintaining a regular training program
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Psychological Anpporaches to Sports Injury Prevention
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Clear they minds of negative emotions Visualize successful performances
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Stress management
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Interventions or programs designed to improve people's ability to cope by increasing they knowledge and skills
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Competent coping
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Contributes to biological, psychological, and socicultrual health
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Proactive coping
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Actions to prevent exposure to known stressors
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Biofeedback
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A cognitive-behavioral instructional process combining talk therapy with technology to teach individuals to gain control over anxiety, tension, or pain
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Stress inoculation training (SIT)
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Cognitive-behavior therapy designed to immunize people against stress
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3 Stages of SIT
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Conceptualization Skills development and application Coping skills
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3 heavily researched moderators of stress
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Coping Social Support Stress management interventions
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Guided Imagery
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Imageine a pleasant relaxing situation
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Deep breathing
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Give attention only to one's breathing rather than thinking about anything else
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Progressive muscle relaxation (PMR)
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First tensing and than relaxing muscle groups
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Appraisal
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1st stage coping process in which persons think about a stressor or demand upon them
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2 General Types of Coping
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Problem-focused coping Emotional focused coping
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Problem-focused coping
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Aims at managing a stressor
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Emotional focused coping
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Managing feelings aroused by stressor
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Emotional disclosure
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Relieving stress from a traumatic event by talking with someone or writing it
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Avoidant coping
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Reacting to a stressor by denial or minimizing a threat
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Cognitive Coping
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Thinking, learning or the process of knowing or interpreting
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Social Support
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Efforts by others to make us feel loved and valuable
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Structural support
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Includes networks of close social ties
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Functional support
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Provides resources
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Personality
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Aspects of an individual that may be reveled through conversation and other activities
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Resilience
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The capacity to recover quickly
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Hardiness
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Ability to withstand stressful events and take approbate and decisive action
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Learned resourcefulness
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Skills of a persons who learn to anticipate, plan, self-regulate, cope with failure, and change coping strategies
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Biological Approaches to Stress Management
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Stay physically fit Regular aerobic exercise Being well rested Good decisions Medications Counseling Control body tension Muscle Relaxation
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Psychosocial Approaches to Stress Management
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being mentally fit Meditation Reading therapy relaxation TM
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Transcendental Meditation (TM)
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A form of reflection that instructs people to choose a mantra or secret word to be repeated over and over in order to focus thoughts away from stressful ideas
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Meditation
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Using the mind-body connections to improve health
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Mindfulness meditation
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Focus on the present moment and on noting else
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Stress Inoculating Training (SIT)
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Form of cognitive therapy designed to immunize people against stress
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SIT 3 stages
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Conceptualization Skills development Application
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Redefinition
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Stress management technique Substitutes positive constructive thoughts for frightening ones
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Affirmations
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Statements about one's ability to overcome adversity
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3 characteristics of being hardy
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Commitment Control Challenge
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