Yesterday I started reviewing the coping strategies survey I’ve been running. 33 participants, a mix of health professionals – and some interesting results. Today I’m looking at when to use pain management strategies, and why.
Question 1 – Reducing pain behaviour has been recommended as a part of effective pain management. When do you think it should be encouraged?
24.1% When the person’s pain is at a ‘usual’ daily level
69.0% At all times, even during a flare-up of pain
6.9% When the person is around other people
As often as the person can sustain the focus without stressing out
Interesting responses to this question – I’m curious because I don’t read much specific information about how therapists typically address reducing pain behaviour. I’ve personally used video, role play and the ‘pain thermometer’ – but I’m sure there are other ways. I’d love to know how you do it – let me know via the comments section at the bottom of this post.
Question 2 – Assertiveness is part of effective communication, and has been included in many pain management programmes. When would you consider suggesting a client/patient should use this approach?
0.0% Never, assertiveness is not part of pain management
10.3% Only in situations where the person can cope with the consequences
24.1% At all times, honesty is the best policy
65.5% Selectively, when the person has the skills, energy and can cope with the consequences
Again, I was surprised at the responses to this question – what? No-one argued with me that assertiveness shouldn’t be included?! I haven’t read much about this in my perambulations through the literature, so again I’d love to hear from you to see how you include communication skills in pain management.
Question 3 – Self regulation is defined as systematic efforts to direct thoughts, feelings, and actions, toward the attainment of an individual’s goals. Why would you include this in pain management?
40.7% To help the person focus on the future rather than on pain
63.0% To help the person become more able to implement coping strategies
18.5% To ensure the person maintains the use of newly acquired coping skills
To faciliate increased awareness of a persons responses to things and facilitate increase self-control and self efficacy.
Self regulation encompasses a large range of skills, and yes, I agree it needs to be included to help people move from being ‘patients’ to ‘people’, actively using their skills to achieve things they really want in their lives. It does involve increasing the person’s awareness of their responses – and ability to adjust their responses to achieve the result they want.
Question 4 – Most people participating in a chronic pain management programme will be encouraged to participate in a regular exercise schedule. Why would you encourage someone to exercise?
59.3% Exercise provides an opportunity to use pain management skills – especially task persistence
33.3% Exercise is good for reducing pain intensity
18.5% Exercise is easy to do on a regular basis so it encourages pacing
Maintains healthy lifestyle, holistic approach
For muscle strength, endurance, cardiovascular fitness, and because normal movement can impede pain signals
Maintaining an active component helps maintain general health and wellness
ALL! And mood elevation, and stress management…
Hope for some translation to improved function. Specific exercises movements can target fear avoidance and also improve general confidence with activity.
All of the above
Exercise in moderation and tailored to the patient is a necessary physical progression for health and a prophylactic against other maladies
Well, that brought you all out of the woodwork! Exercise looks like it is an essential part of what health professionals think should be included in pain management. As a confirmed exercise-free zone, it looks like I might have to sway to popular opinion!
Question 5 – Having chronic pain can be a very challenging experience. Cognitive therapy emphasises the role of realistic thoughts. When a person’s thought is realistic, but not helpful, would you challenge their thinking?
14.8% Yes – they may still be using maladaptive thinking patterns
7.4% No – it’s difficult to argue against reality
81.5% Yes – but not to challenge the reality, just to establish a more helpful view of the situation
I was curious to see that some people wouldn’t use cognitive therapy to help people develop a more helpful view of their situation. While a person might be describing ‘reality’ to them, simply acknowledging this without checking out that the thought is helping them achieve goals may produce a ‘reality’ that is more negative than it needs to be. I’m reminded of an illustration someone once gave of a line-up of swimmers at the beginning of a race – do they look left, they look right and say ‘Oh no, everyone else is bigger than me, what chance do I have?’, no!! ‘They say ‘I’m going out there to go, go, go!’
My last post will be tomorrow – looking at the ratings of importance for each of the coping strategies. See you then!