Sleep & Misc
Name 3 practices that promote restorative sleep
consistent wake and sleep times, turn off screens, limit caffeine, no naps, exercise during day not at night, no big meals close to bedtime, diaphragmatic breathing/relaxation/ routine at bedtime, manage stress
What are 5 ways you can moderate or modify?
20/20/20, take breaks, don’t stay for an entire event, use relaxation during breaks, body mechanics such as golfers swing, how to carry something heavy, use legs vs. back for lifting
Name 5 relaxation activities.
diaphragmatic breathing, meditation/mindfulness, yoga, tai chi, music, autogenic relaxation, progressive muscle relaxation, etc
What are 3 problems associated with perfectionism?
too much time on work, not enough time with leisure activities, stressful, nothing is ever good enough, associated with mental health problems like anxiety and depression, eating disorders, difficulty viewing failure as learning opportunity
What are 3 ways friendships might look different upon your return home?
more engaged, more reliable, less pain talk, more talk about them, less sedentary activities
Give 4 REASONS why napping is generally discouraged at PRC?
interferes with normal circadian rhythm/sleep cycles, pain behavior, not doing PRC concepts/avoidance, don’t feel refreshed when wake up from nap
Many PRC participants become ________ through long term inactivity.
deconditioned
What are 4 benefits of relaxation?
decrease stress and anxiety, alleviate depression, alleviate pain and other symptoms such as nausea and fatigue, decrease sympathetic nervous system response, self-efficacy/self reliance, manage emotions
What are 3 of each-- common emotions and thoughts in the cycle of chronic pain?
depression, anger, anxiety, hopelessness, loss of motivation, etc. Thoughts- Why me? Will this ever end? I can’t do anything. I can’t handle this. My life sucks. It will never get better, etc
What are 3 reasons we discourage further medical workup?
Teens have already seen a multitude of doctors and specialists, causing financial problems, missed work and school, travel time, etc. This reinforces the cycle of pain; the most important problem is that it causes a loss of hope and desperation as no answers or solutions are offered. It reinforces dependent behavior as patients seek to have someone else “fix” them instead of using coping strategies.
What are 4 causes of insomnia (other than pain)?
stress/anxiety, depression, not practicing good sleep hygiene tips as listed above- napping, etc
What are 5 benefits of daily cardio exercise?
improved mood, muscle tone, blood flow-POTS, self- esteem, healthy heart and lungs, weight management, can be part of sport or socializing, etc
How long of deep breathing does it typically take to activate the parasympathetic nervous system?
10 minutes
What are 5 symptoms of Depression?
lack of interest in previously enjoyed activities, irritability, increased or decreased appetite or sleep patterns, isolation, thoughts of self harm or suicide, feelings of guilt or worthlessness, etc
What are 4 benefits of warm neutrality?
encourages independence and motivation, does not focus on illness, is supportive and kind without coddling, allows for a more “mature” and respectful relationship, parent is more able to “have their own life”
Describe what self-compassion is and how it can be helpful for managing chronic symptoms?
Extending compassion to ones-self in instances of perceived failure or general suffering. Self compassion can reduce stress, improve mental health, improve coping, improve well-being,
Fill in the blank: Motion is _____, sore but ______, hurt does not equal __________.
lotion, safe, harm
What are the goal number of breaths per minute when using diaphragmatic breathing?
6-8
Give 4 assertive responses to people who ask about your pain or where you have been.
Tell them about the program without symptom talk, ask about them, thank them for expressing concern, change the subject, stay positive, tell them what they can do to be helpful i.e., not ask about symptoms
Describe 3 main differences between acute and chronic pain
acute pain pasts 3-6 months, chronic indeterminate; acute pain is a signal that tissue damage is occurring; chronic pain is usually not related to tissue damage; goal of acute pain is to diagnose and fix; goal of chronic pain is to develop coping skills and increase quality of life, “pain behavior” is appropriate during acute pain- not appropriate for chronic pain
Describe the difference between fixed mindset and growth mindset, then give three statements for each.
Fixed mindset: The belief that intelligence, skill or talent are something that you are born with, something that is fixed or not amenable to change. “I am a natural born athlete. I’m not good at math. I don’t do emotions. I can’t get this, it’s too hard. I can’t hear my alarm. I have a bad back.”
Growth mindset: The belief that with effort, training and perseverance, you can succeed in developing skills and talents. “I didn’t do well on the test, but now know what I need to study. I will eventually figure out how to do PST. I’m not good at breathing, yet. I will ask my nurse for suggestions. I will try a new strategy to learn to hear my alarm.”
What is the definition of pain behavior and 4 negative consequences of pain behavior? Every team member must provide an example of a pain behavior.
pain behavior- verbal or nonverbal maladaptive pain coping mechanisms. Examples- rubbing the area, wincing, grimacing, talking or thinking about pain, sunglasses inside, gait aids such as walker, cane, wheelchair, compression socks, ben-gay, taking certain medications- not all, withdrawal/isolation, etc. Negative consequences- makes pain worse, makes others pity you, dependence on parents and others, identity as a patient or sick kid, reinforces cycle of pain, etc
What are 3 main components of mindfulness?
Attending to the present moment, attending to thoughts and sensations, non-judgmental/not trying to change your reality
Describe how CBT is used in the management of chronic pain.
cognitive behavioral therapy is used to challenge negative thoughts and help you choose positive thoughts instead, which facilitates positive behavior change, which then leads to more positive emotional responses. i.e., choosing the thought that things will get better will help you engage with your friends, which uplifts mood. Versus choosing the thought that I’ll never be able to do the things I want, which may lead one to stop trying, which will of course result in negative emotions.
Describe pillow fluffing versus punitive responses & name 4 negative consequences of each.
pillow fluffing is overly caring, solicitous parental behavior that maintains illness behavior- asking about symptoms, not requiring the teen to complete chores, does not encourage independence or motivation, contributes to debilitation and dependence, parent becomes resentful over time, unhealthy relationship with child. Punitive is blaming, unsupportive, blatantly angry, resentful, or uncaring. This parenting style alienates the teen, makes the teen feel guilty or responsible for their symptoms, the teen does not feel as though they can openly talk to their parent, the teen resents the parent