People Have Mixed Reactions to Both Physiological and Psychological Explanations of Disproportionate Pain

Abstract

systematically by two coders and then discussed with the entire research team to arrive at consensus. We stopped enrolling patients when the authors agreed that additional themes did not arise in five consecutive interviews. ResultsThe following themes and interpretations were derived from the analysis: Neither the physiological nor the psychological explanation for disproportionate pain (1) avoided the stigma associated with mental health, (2) was consistently understood, (3) provided a consistent sense of control, (4) consistently provided hope, and (5) represented the stress and emotion of disproportionate or persistent pain. The physiological explanation also generated mixed reactions regarding whether or not it: (1) was a useful point of conversation, (2) was reassuring or frightening, and (3) supported physiological or psychological treatments. The psychological explanation made some people feel worse. Conclusion People have mixed reactions to both physiological and psychological explanations of disproportionate pain. As such, without direction on content, communication might be most effective by focusing on relational aspects, such as emotional connection and trust. Clinical Relevance Although there is room to improve the content of strategies for explaining more pain than expected to patients, our findings extend the discoveries of others in highlighting the need for tailored relational communication strategies that prioritize feeling heard, validated, and accompanied. 10 "It feels very philosophical." Volume 480, Number 7 Mixed Reactions to Explanations of Disproportionate Pain 1393

Mental Health Among People Presenting for Care of Physical Symptoms: The Factors Associated with Suicidality and Symptoms of Depression and Anxiety are Similar Across Specialties

“…A combination of screening questionnaires, discussion of those questionnaires, and further assessment when appropriate to determine patients’ needs from available integrated mental health represents a comprehensive, whole-person approach to health that, evidence suggests, is more effective than addressing pathophysiology alone. 7 , 8 , 24 – 27 …”

“…The first identification of an opportunity for improved mental health may occur in the care of physical symptoms. 3 – 8 And many people who die by suicide had recently passed through specialty or non-specialty medical care as an outpatient or inpatient. 9 , 10 Consider also that symptoms of depression on their continuum correlate notably with symptom intensity and magnitude of incapability.…”

The mind and the hand

“…Lack of time during the surgical consultation, the stigma of mental health and feeling uncomfortable are all potential barriers (Vranceanu et al, 2017;Wegener et al, 2017). To a patient, talking about misconceptions and feelings of worry or despair can feel as if their physical symptoms are not being taken seriously (Gonzalez et al, 2021(Gonzalez et al, , 2022. There is no perfect approach, and it is better to focus on developing a relationship of respect and trust, first and foremost.…”

Recovery After Musculoskeletal Injury: Mental and Social Health

“…Mental health stigma creates a scenario where talking about misconceptions and feelings of worry or despair can feel to a patient as if they are being set aside as not fully human or as if they are flawed or broken. 60 Crafted communication strategies can improve patient receptiveness to a more comprehensive approach to recovery. 61 There is no perfect approach, and it is best to meet patients where they are and focus on developing a relationship of mutual curiosity, respect, and trust first and foremost.…”