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HCA250 Treatment Options for Clinical Pain


HCA250 Treatment Options for Clinical Pain fin571

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HCA250 Treatment Options for Clinical Pain
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This 8 page Study Guide was uploaded by an elite notetaker on Tuesday November 10, 2015. The Study Guide belongs to fin571 at Kaplan University taught by in Fall 2015. Since its upload, it has received 23 views.

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Date Created: 11/10/15
*This tutorial is to be used as a guide with examples of what your instructor is looking to see in your submission. Be sure work submitted is that of your own efforts to avoid copying the work provided in the tutorial. As this tutorial is likely to be pre­submitted, original work you should not re­submit as your own original work. * Treatment Options for Clinical Pain SAMPLE TUTORIAL Clinical pain is pain which requires and benefits from medical treatment (Sarafino, 2006). The treatment of acute clinical pain is necessary for humane patient care as well as for promoting uncomplicated recovery. In treating acute clinical pain patient stress is greatly reduced thus  contributing to increased healing times and overall positive emotional well being of the patient.  In cases where pain has become chronic a more complex and comprehensive plan of pain  treatment must be implemented. These comprehensive approaches can often include the multi­ angle approach including surgical, pharmacological, behavioral and cognitive treatment designed to best benefit the patient on an individual basis (Sarafino, 2006). Considerations of Treatment for 3 Individual Cases The use of four possible treatment approaches for the clinical pain patient should be  assessed an individual case basis. These approaches include surgical treatment to eliminate or  reduce pain, medications, and behavioral or cognitive therapies which can provide the patient  with useful tools for dealing with their chronic clinical pain (Sarafino, 2006). For considerations sake we will assess three individual cases. Case 1 involves the patient  who is suffering clinical pain resulting from below the knee amputation. Case 2 involves the  individual suffering post­operative acute pain from abdominal hysterectomy. Case 3 involves an  individual plagued by chronic headache pain which is not diagnosed as migraine headaches  (Axia College, 2007). In assessing the first case we immediately understand the phantom limb pain often  associated with amputation (Sarafino, 2006). We must also assess the patient for underlying  causes of referred pain. Is it possible a prosthetic limb is not fitting properly causing irritation of  additional stress at the amputation site? Is the patient receiving adequate physical exercise?  Surgical treatment for the patient is not recommended (Nelson­Hogan, 2007). However,  temporary pharmaceutical treatment combined with behavioral and cognitive treatment will  benefit the patient.  Case 2 involving acute post operative pain will require little more than temporary  pharmaceutical treatment to relieve discomfort following major surgery. In addition, the patient  might also be responsive to an operant approach to promote healing. Minor behavioral and  cognitive approaches while hospitalized will be sufficient in treating such cases of acute pain  (Sarafino, 2006). The chronic headache sufferer is also not recommended for surgical procedure as the  headaches are likely definable as tension or stress related (Sarafino, 2006). In addition,  pharmacological treatment through use of pain medication should be used only if the headaches  are frequent, severe and prolonged. However, other pharmacological approaches may benefit the  patient if he or she is also suffering from mood disturbances or poor coping skills related to the  chronic pain produced by the headaches. Behavioral and cognitive approaches might be most  beneficial for this patient as developing effective coping strategies and implementing relaxation  techniques and stress reduction may eliminate or at minimum significantly reduce the frequency  of occurrences (Sarafino, 2006). Recommended Treatment Approaches  In assessing the needs of each patient the author would first rate the complexity of the  cases. Case 2, the post operative acute pain patient, will require the least complex treatment plan  as the pain is temporary and easily treatable with use of pain medication and minor behavioral  and cognitive therapy approaches. Case 1, involving the amputee, would be more complex and  require a multi­angle approach. In addition, this patient will likely require a treatment plan which needs to be appropriately designed for prolonged care and management of symptoms. The most  complex case, in the author’s opinion, would be Case 3, the headache patient. The reasoning in  the author’s assessment is derived through the probability that multiple factors are contributing  to the pain and will need to be addressed with careful use of pharmacological methods and most  extensively with behavioral and cognitive approaches. The clinical pain suffered by the individual recovering from abdominal hysterectomy will be reduced or eliminated through use of centrally acting analgesics as they are proven most  effective in treating severe acute pain (Sarafino, 2006). Codeine or hydrocodone can be  administered to the patient orally or intravenously while recovering on a short­term, inpatient  basis (Hanley Center, n.d.). The patient, upon discharge from the hospital, may continue to  reduce post­operative pain through use of a non steroidal anti­inflammatory drug which will also  aid in reduction of swelling and inflammation caused by the surgical procedure (Hanley  Center, n.d.). While still on an inpatient level the individual having difficulty dealing with the acute  pain following surgery should receive cognitive training on redefinition of pain and  implementation of imagery or distraction techniques to promote healthy coping skills (Sarafino,  2006, p.332). Should the patient be non­compliant with after surgery care and plans which  promote healing an operant approach should be implemented in dealing with the patient.  Ignoring non­beneficial behavior and rewarding positive behavior will address the patient’s  behavior (Sarafino, 2006). Pain treatment for the amputee is a more complex issue. The patient will require  comprehensive care, perhaps through a pain clinic, which will include group psychotherapy to  address psychological aspects as the patient is able to relate with others suffering chronic pain.  The patient will benefit by reducing isolation periods and reduce likelihood of depression. In  addition, the patient may benefit from an increased social support network which may be found  through such therapy. Individual therapy should also be implemented to help develop relaxation  techniques as well as to strengthen cognitive skills by use of imagery and distraction techniques  to help cope with pain. Redefinition may also help the patient develop a more positive outlook  (Sarafino, 2006). This patient will also require a pharmacological approach to pain treatment.  Antidepressants will reduce possible depression, aid sleep and reduce pain. Prescribing of a  sedative antidepressant with analgesic properties will address multiple complaints of the patient  (Nelson­Hogan, 2007). Phantom limb pain has been effectively treated with a combination of  methadone and anti­depressants (Sarafino, 2006) therefore the author feels this anti­depressant  treatment to be imperative for proper case management of the amputee patient.  Other possible treatment methods which may be implemented dependent upon the  effectiveness of the behavioral, cognitive and pharmaceutical approaches would be massage  therapy or use of a TENS unit (Sarafino, 2006). In addition, the patient’s prosthetic limb will be  examined for issue regarding fit on the stump which may be contributing to the patient’s distress  and chronic pain issues (Nelson­Hogan, 2007). In treating the chronic headache patient things become far more complex. Social factors  are likely playing a large role in this chronic pain. Stress from relationships or other life  circumstances is likely causing tension in the muscles and tendons. The patient will require  extensive behavioral and cognitive approaches to treatment. No surgical treatment is suggested. The individual will undergo psychotherapy to develop healthy coping skills and  relaxation techniques. Biofeedback will be used and therapy will take an operant approach  (Sarafino, 2006). Biofeedback is expected to have immense benefit as it has proven 40 to 50%  effective in the reduction of tension type headaches (Sarafino, 2006). Cognitive approaches will  include the use of imagery to induce relaxation as well as redefinition of pain (Sarafino, 2006).  The patient may also be referred for acupuncture treatment or massage therapy to reduce pain  and increase relaxation (Sarafino, 2006). In addition, the patient will work with the therapist in  assessing physical activity and develop a regular regime of exercise in the attempt to reduce the  adverse effects of stress on the patient. Conclusion While each of the three cases examined by the author include treatment plans excluding  the use of surgical treatment for clinical pain it remains a suitable approach for various types of  clinical pain and should not be excluded as an option for treatment. All four options of treatment, surgical, pharmacological, behavioral and cognitive approaches, should be carefully considered  when developing a plan of treatment for the clinically pained patient. A comprehensive approach comprised of multiple approaches is often most beneficial for the treatment of pain and should  therefore be available to all patients receiving care. References Axia College. (2007). Treatment options for clinical pain. Retrieved date?, from  Axia College, Week Seven, HCA250 ­ The Psychology of Health. Hanley Center (n.d.). Managing post­surgical pain for those in addiction recovery. Retrieved  November 28, 2008, from Nelson­Hogan, D. (2007). Diagnosis and treatment of post­amputation pain. The Pain  Practitioner, 8­11. Sarafino, E.P. (2006). Health psychology biopsychosocial interactions (5th ed.). Hoboken, N.J.:  John Wiley & Sons.


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