Catastrophising – and controversy
There are few constructs more widely known in pain psychology than catastrophising. Defined as “an exaggerated negative mental set brought to bear during actual or anticipated pain experience” (Sullivan et al., 2001), catastrophising is associated with poor outcomes including greater pain intensity, distress and disability in almost every situation where pain is experienced (Sullivan & Tripp, 2024). Cognitive biases associated with catastrophising include interpretive bias, attentional bias and attentional fixation – in other words negatively interpreting situations, attending to the negative in a situation, ...
Source: HealthSkills Weblog - April 21, 2024 Category: Anesthesiology Authors: BronnieLennoxThompson Tags: Coping Skills Pain Pain conditions Research Science in practice catastrophising catastrophizing Chronic pain pain-related worry Source Type: blogs

“ Exercise ” – what does it do for people living with persistent pain?
No, I’m not going to assemble a bunch of papers and point out the effect sizes of exercise on pain and disability! In fact, I’m not even going to point to much research in this post. I want to pose some questions and put some thoughts out for discussion. See, the people I’ve seen over the years who live with pain have, by and large, not been great ‘exercisers’ before their pain came on, and many haven’t really changed their lifestyle a heap since their pain either. In fact, there is research showing that people with chronic pain don’t change the overall quantity of their activit...
Source: HealthSkills Weblog - March 10, 2024 Category: Anesthesiology Authors: BronnieLennoxThompson Tags: Assessment Chronic pain Clinical reasoning Occupational therapy Physiotherapy Psychology Resilience Science in practice Health Research Source Type: blogs

The difficult balance between evidence-based healthcare … and person-centred self-management
For decades I’ve been an advocate for evidence-based healthcare because the alternative is ’eminence-based healthcare’ (for healthcare, read ‘medicine’ in the original!). Eminence-based healthcare is based on opinion and leverages power based on a hierarchy from within biomedicine (read this for more!). EBHC appealed because in clinical practice I heard the stories of people living with chronic pain who had experienced treatment after treatment of often invasive and typically unhelpful therapies, and EBHC offered a sifting mechanism to filter out the useless from the useful. Where has EBHC...
Source: HealthSkills Weblog - February 18, 2024 Category: Anesthesiology Authors: BronnieLennoxThompson Tags: Chronic pain Clinical reasoning Coping strategies Pain conditions Professional topics Research Science in practice pain management Therapeutic approaches Source Type: blogs

Guarding and flow: an observational study
This study is an observational study of physiotherapists watching videos of people with chronic low back pain doing movements. The movements are pretty decontextualised (ie they’re not integrated with everyday life activities) but they are the kinds of movement that people can find difficult. They were: reaching forward with arms horizontal in standing position (reach forward), bending down towards the toes in standing position (forward-bend), standing from sitting stand), and sitting from standing (stand-to-sit). The videos were of 10 people with low back pain, and were chosen from a larger set of 16 people all perf...
Source: HealthSkills Weblog - February 4, 2024 Category: Anesthesiology Authors: BronnieLennoxThompson Tags: Assessment Chronic pain Clinical reasoning Coping strategies Low back pain Physiotherapy pain management Research Source Type: blogs

Do clinicians know how to help people develop pain self management?
In recent posts I’ve been discussing pain self management and why it’s not only necessary, but inevitable for people living with pain. Today I turn my gaze to health professionals, and the skills needed to support developing self management – because it’s not the same as ‘telling’, or ‘educating’, or even ‘advising’. Firstly, let’s check out what people with pain want in self management. Lim and colleagues (2019) conducted a systematic review examining studies identifying ‘health information needs’ of people with low back pain. I put that tit...
Source: HealthSkills Weblog - November 5, 2023 Category: Anesthesiology Authors: BronnieLennoxThompson Tags: Chronic pain Coping Skills Low back pain Professional topics Science in practice Clinical reasoning healthcare pain management self-management Therapeutic approaches Source Type: blogs

All by myself … don ’ t wanna be
Throughout my career, I’ve been interested in how and why people see clinicians about their pain. I’m intrigued by the journey before, during and afterwards. I’m interested in the social factors influencing choices in healthcare. If I’ve been gardening over the weekend and I wake up Monday with a sore back it’s easy to see a physio here in NZ. That visit is likely paid for by our accident compensation system (24/7 no-fault scheme paid for by taxes and levies). And the jolly joy germ in me thinks “Well at least that means people don’t have to see a doctor first” – but...
Source: HealthSkills Weblog - October 15, 2023 Category: Anesthesiology Authors: BronnieLennoxThompson Tags: Back pain Chronic pain Coping strategies Interdisciplinary teams Low back pain Occupational therapy Physiotherapy Psychology Research Science in practice Health pain management Therapeutic approaches Source Type: blogs

Shhhhh! The secret we don ’ t talk about …
For all my writing about ACT, there are some things that ACT doesn’t directly deal with: what do people use to help them do what matters in their life? OK we do discuss actions, values, perspective-taking, mindfulness, willingness and defusion, but we don’t talk about the specifics of what people living with pain might do to live well. The skills or ways of going about daily life, using things that help people with pain do things. *Scroll to the bottom to see my totally unscientific survey for people with pain* So for a few weeks I’m exploring self-management: this is one of those poorly-defined terms ...
Source: HealthSkills Weblog - October 1, 2023 Category: Anesthesiology Authors: BronnieLennoxThompson Tags: Back pain Chronic pain Clinical reasoning Coping Skills Coping strategies Low back pain Occupational therapy Research Science in practice biopsychosocial Health pain management self-management Therapeutic approaches Source Type: blogs

Dancing around the hexaflex: Using ACT in practice 5
Acceptance and commitment therapy (ACT) can be slippery to describe. It’s an approach that doesn’t aim to change thought content, but instead to help us shift the way we relate to what our mind tells us. It’s also an approach focused on workability: pragmatic and context-specific analysis of how well a strategy is working to achieve being able to do what matters. Over the next few posts I want to give some examples of how non-psychologists can use ACT in session (remember ACT is open for anyone to use it!). Values: Qualities of living Oh so much has been written about values…Values bring meaning to what w...
Source: HealthSkills Weblog - September 17, 2023 Category: Anesthesiology Authors: BronnieLennoxThompson Tags: ACT - Acceptance & Commitment Therapy Chronic pain Coping strategies Occupational therapy Pain conditions Psychology Science in practice acceptance and commitment therapy Clinical reasoning Health pain management Therapeutic approach Source Type: blogs

Dancing around the hexaflex: Using ACT in practice  5
Acceptance and commitment therapy (ACT) can be slippery to describe. It’s an approach that doesn’t aim to change thought content, but instead to help us shift the way we relate to what our mind tells us. It’s also an approach focused on workability: pragmatic and context-specific analysis of how well a strategy is working to achieve being able to do what matters. Over the next few posts I want to give some examples of how non-psychologists can use ACT in session (remember ACT is open for anyone to use it!). Values: Qualities of living Oh so much has been written about values…Values bring meaning to what w...
Source: HealthSkills Weblog - September 17, 2023 Category: Anesthesiology Authors: BronnieLennoxThompson Tags: ACT - Acceptance & Commitment Therapy Chronic pain Coping strategies Occupational therapy Pain conditions Psychology Science in practice acceptance and commitment therapy Clinical reasoning Health pain management Therapeutic approach Source Type: blogs

Dancing around the hexaflex: Using ACT in practice 3
Acceptance and commitment therapy (ACT) can be slippery to describe. It’s an approach that doesn’t aim to change thought content, but instead to help us shift the way we relate to what our mind tells us. It’s also an approach focused on workability: pragmatic and context-specific analysis of how well a strategy is working to achieve being able to do what matters. Over the next few posts I want to give some examples of how non-psychologists can use ACT in session (remember ACT is open for anyone to use it!). Cognitive defusion I’m guessing that for psychologists and those who primarily work wit...
Source: HealthSkills Weblog - September 4, 2023 Category: Anesthesiology Authors: BronnieLennoxThompson Tags: ACT - Acceptance & Commitment Therapy Chronic pain Clinical reasoning Coping strategies Occupational therapy Pain conditions Physiotherapy Psychology Science in practice acceptance and commitment therapy cognitive fusion pain managem Source Type: blogs

Dancing around the hexaflex: Using ACT in practice 1
Acceptance and commitment therapy (ACT) can be slippery to describe. It’s an approach that doesn’t aim to change thought content, but instead to help us shift the way we relate to what our mind tells us. It’s also an approach focused on workability: pragmatic and context-specific analysis of how well a strategy is working to achieve being able to do what matters. Over the next few posts I want to give some examples of how non-psychologists (remember ACT is open for anyone to use it!) can use ACT in session. Mindfulness – messing about with attention Thanks to Kevin Vowles, I’m adopting t...
Source: HealthSkills Weblog - August 20, 2023 Category: Anesthesiology Authors: BronnieLennoxThompson Tags: ACT - Acceptance & Commitment Therapy Back pain Chronic pain Clinical reasoning Coping strategies Low back pain Occupational therapy Physiotherapy Psychology Research Resilience Resilience/Health Science in practice mindful movem Source Type: blogs

Bonus Features – July 30, 2023 – Amazon gets into the generative AI game, HIMSS plans to sell off the annual trade show, and more
This article will be a weekly roundup of interesting stories, product announcements, new hires, partnerships, research studies, awards, sales, and more. Because there’s so much happening out there in healthcare IT we aren’t able to cover in our full articles, we still want to make sure you’re informed of all the latest news, announcements, and stories happening to help you better do your job. News HIMSS is planning to sell its annual conference to Informa. Fierce Healthcare confirmed the news as initially reported by Trade Show Executive. The deal only appears to involve the trade show – next slated for March 1...
Source: EMR and HIPAA - July 30, 2023 Category: Information Technology Authors: Brian Eastwood Tags: Healthcare IT 3M ABOUT Partners Amazon AWS Babylon Carta Healthcare Cognizant CoxHealth eClinicalWorks eCW Gilead Gozio Health Healthbook Healthcare IT Today Bonus Features Healthcare VR HealthLock HealthScribe HEDIS He Source Type: blogs

ChatGPT Alternatives For Healthcare And Research
ChatGPT has made a name for itself in the world of AI, along with Bard and MedPaLM. Following the success of these first-generation language models, a host of alternatives, including the open-source project Spark NLP for Healthcare, have emerged. Our exploration today focuses on alternative solutions that, while underpinned by the principles of ChatGPT, have potential utility in the healthcare and research sectors. ChatGPT is remarkable, but it does have its drawbacks: a knowledge cut-off in November 2021, unilateral control and updates by OpenAI, an iOS-exclusive mobile app, and API-only integration, which can be quite...
Source: The Medical Futurist - June 13, 2023 Category: Information Technology Authors: Andrea Koncz Tags: TMF Artificial Intelligence in Medicine digital health large language models GPT in healthcare ChatGPT in healthcare AI Source Type: blogs

Unpalatable truths about pain
Recently I read a blog post about the way “Explain pain” had landed with a group of people in the general public. The point being made was that people found the ideas presented unpalatable. They didn’t agree with the points and they thought the ideas were dismissive of their experience. Now I am a critic of any recipe-based approach to helping people. I am especially a critic of clinicians using something they’ve picked up on a weekend course, or out of a book, being applied holus bolus to an individual without nuance. There have been outrageous claims made about the effectiveness of giving some...
Source: HealthSkills Weblog - June 11, 2023 Category: Anesthesiology Authors: BronnieLennoxThompson Tags: Chronic pain Pain conditions Professional topics biopsychosocial pain management Therapeutic approaches Source Type: blogs

Fight Aging! Newsletter, June 5th 2023
In conclusion, higher BMR might reduce lifespan. The underlying pathways linking to major causes of death and relevant interventions warrant further investigation. Betting Against Progress Turns Out Poorly, But Can Work in the Short Term in a Slow Field https://www.fightaging.org/archives/2023/06/betting-against-progress-turns-out-poorly-but-can-work-in-the-short-term-in-a-slow-field/ Setting oneself up as a spokesperson for "we will not achieve this goal", as the fellow noted here is choosing to do, is a bet against technological progress. A glance at any few decade period in the past two hundred yea...
Source: Fight Aging! - June 4, 2023 Category: Research Authors: Reason Tags: Newsletters Source Type: blogs