write one page reply to the following discussions, the response to the discussion must be cover the points discussed The discussions: Tiarna Hamamen After reading through the diathesis-stress model, the relationship between the way a practitioner provides a diagnosis and treatment plan, and the way that the patient perceives the severity of the injury, has a great effect on the likely prognosis of the patient. Take the car accident case on page 2 of the text as an example; would the patient have suffered such long-term disability if the initial physician had used a term other than that of ‘whiplash’? The fact the patient was then given a neck collar, radiographs of the neck were taken, and was told to rest, resulted in the belief she suffered an injury more severe than the actual physiological tissue damage that had occurred. This predisposed the patient to be fearful of perceived symptoms, which resulted in fear-avoidance behaviors negatively affecting the patient’s daily life. (Macas-Toronjo et al., 2020) describes the impact of fear-avoidance behaviors has on absenteeism at work, specifically after suffering a work-related injury. I feel as though it is relevant to understand these behaviors before graduating as I expect to see many patients who may have similar pain catastrophic thoughts that in turn, amplify the disability present and result in chronic pain. Macas-Toronjo, I., Snchez-Ramos, J., Rojas-Ocaa, M., & Garca-Navarro, E. (2020). Fear-Avoidance Behavior and Sickness Absence in Patients with Work-Related Musculoskeletal Disorders. Medicina, 56(12), 646. Zachary Gouvas Excellent point Tiarna. I completely agree. With that in mind 2 separate patients suffering from the same type of chronic injury can ultimately recover at a different rate, thus having 2 completely separate prognoses due to pain catastrophizing. In the diathesis-stress model it identifies that pain catastrophizing is a method of cognitively coping with pain and is characterized by negative self-statements, and can impact upon thoughts and ideas about the future. Multiple studies have discovered that a reduction in catastrophizing was directly linked with patients experiencing less pain and improved psychological functioning. Patients who would find their conditions improving following treatment were correlated with a decrease in catastrophizing. On the flip side of that coin, patients who would found their conditions failed to improve post treatment failed to reduce their levels of catastrophizing. Therefore our responsibility as practitioner is to promote healing and, reduce the patients physical limitations and ultimately improve their mental wellbeing. Through carefully planned management approaches, not only with physical treatment but with how we verbally/non-verbally interact with the patients will determine if they in time develop fear avoidance behaviours, disuse and disabilities. Vlaeyen JWS, Kole-Sniders A, Rooteveel A, Ruesink R, Heuts P. The role of fear of movement/(re)injury in pain disability. J Occup Rehabil 1995;5:235-52. Collapse SubdiscussionRhys Callanan Rhys Callanan Tiarna makes a great point. I think semantics in allied health is a huge issue. There had been a study done where numerous people had witnessed a car accident. They were each asked separately how fast the car was going when it hit another car. Half of the group were asked, “At what speed was the car going when it hit the other car?” whilst the other group were asked, “At what speed was the car going when it smashed into the other car?” The questions are more or less the same, but the first group estimated a speed much less, on average, than the second group. While I am sure there are numerous variables and confounding factors, it is interesting how language – particularly semantics – can alter an answer, despite the fact that the same car crash was witnessed by both groups. It can often be a fine line between potentially influencing a patient’s catastrophising behaviour, and ensuring you do not dismiss the patient’s diagnoses or pain. I am curious to know if anyone has changed their language after their patient maybe responded in a way that was unexpected?
