Psychological strategies

As part of pain management, the role of psychological strategies must not be forgotten. As described above, there are several psychological variables that influence pain. If these can be understood then they may be used to improve a patient's quality of life and provide appropriate pain management.

Self-help focused on improving physical functioning, mood, and pain over seven weeks compared to an educational booklet group demonstrated improvements in function and pain intensity with a three-month follow up.75 Self-management strategies to control emotions were shown to alter pain intensity in the older popula-tion.76 There were differences in the patients' ability to regulate their emotions, with the oldest group (over 80 years), men, and those living alone being less able to control their emotions.76 Those who did benefit have a potential tool to manage their pain without the risks and costs associated with pharmacological interventions. Depression has an influence on pain. A study looking at musculoskeletal pain in elderly women and the effect on activities of daily living found that an outpatient inte-grative psychotherapeutic programme for depression provided improvements in daily activities and quality of life compared to the untreated group.77[II]

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