Pain Management Model

In this essay about pain management, I will be looking at a fictitious case study of Sam and his chronic back pain. Using cognitive theories including; Segal’s roles and duties, Bandura’s self-efficacy theory of reciprocal determinism and Melzack & Wall’s gate control theory, I will discover what the implications are of non-adherence to medical advice as well as poor methods of treatment. The biopsychosocial approach to health will be necessary here to further understand these theories. Introduced in 1977, this model came to be when psychiatrist George Engel believed that physicians were not “concerned with psychosocial issues which lie outside medicine’s responsibility and authority.” (Engel, 1977.) This model is still widely used today with
The term ‘sick-role behaviour’ originally came from psychosocial epidemiologists Stanislav Kasl and Sidney Cobb in the 1960’s, this term was used to describe the behaviour of someone after receiving a diagnosis. Segal then adapted Kasl & Cobbs theory to put forward the three rights and duties of health behaviour (Brannon et al. 2018), one of these duties is to utilise healthcare resources available. Sam had access to the resources he needed to get better as proven by seeing a doctor and being referred to a physiotherapist, sadly a lot of the world is not as lucky. Access to medical care is a global issue, according to the World Health Organisation & World Bank (2017) “At least half of the world’s population cannot obtain essential health services.” Missing these appointments is a huge misstep as according to Physiotherapy New Zealand, (2018), physiotherapy not only strengthens and improves back flexibility but also educates people on how to avoid future back problems. Sams’ reasoning for not going back to physiotherapy because he lived alone and couldn’t find someone to take him also impacting his right to become dependant on
(ACC last reviewed 2017). Regarding being able to rely on others, Sam’s physiotherapist would provide both physical and moral support had he kept up his appointments. Sam indulged both in his right to make decisions regarding his health and his right to be exempt from regular duties, as he did not return to work after his two-week medical certificate ran out. Instead, Sam lived on 80% of his usual wage thanks to ACC and prescription painkillers supplied by his doctor. (Marks, et al). Maintaining health and performing routine healthcare management are responsibilities that Sam neglected. If Sam went to his physiotherapist, not only would he be getting professional help but also given exercises plans and information to look after himself at