Striving to Thriving

Your Toolbox-The Appendices

Your Toolbox

ToolboxThis is the “toolbox” for both patient and providers. Since readers will repeatedly copy many of the tools, templates, assessments, logs, etc. Therefore, I made them available here instead of forcing the user/reader to continually copy pages from the book. Like any other toolbox, not everyone needs all the tools in their toolbox all the time. Likewise, no one single patient needs all the assessments, templates, logs, etc. all the time.  However, all the appendices are available in one file titled “All Appendices” at the top of the list. This might be useful in an office environment for multiple patients. Using this file requires the user to know how to find, select and print specific pages as needed. Users will find it easier to copy those “tools” to their local hard-drive. This eliminates the need of continually download files each time they need them.

ALL Appendices – Striving to Thriving

Appendix 1 – Current Medications List

Appendix 2 – Healthcare Providers Contact Information

Appendix 3 – Systems Review is a listing of common physical/biological health conditions.

Appendix 4 – Pain Medications and Therapies – Just as it implies, this is a list of the most common medications used in pain management. This is valuable tool for both you and your providers as it helps trigger your memory of therapies and medications you’ve tried. This will help you pull un-needed or useless tools from your toolbox.

Appendix 5 – Pain Descriptors and Assessment – This provides the physician/therapist with specific information regarding your pain, such as location, quality, intensity, cause and location(s). etc.

Appendix 6 – Potential Pain Triggers -Many things can affect your pain. These can include stress, sleep, money worries, and even the weather. Pain can adversely affect one’s entire biopsychosocial being. When you and your doctor understand what makes your pain worse, you can begin to work together on ways to reduce or deal with your pain “triggers.”

Appendix 7 – Office Visit Prep Questions – These are recommended questions the patient should ask their pain management providers. This shows the provider(s) that the patient prepared for the office visit before the provider enters the room.

Appendix 8 – Questions to Ask Your Doctor on the Day of Your First Appointment – These questions help both the patient and provider to make the most of the first office visit and gets the patient mentally engaged and thinking before that first appointment. This has to potential to show the provider that the patient is serious about engagement level.

Appendix 9 – Office Visit Goals Questions and Concerns – This is a snapshot of one’s activities, goals ADLs (activities of daily living) and QOLs (quality of life). The patient completes this and gives it to the provider. This worksheet serves multiple purposes, but mainly providing data for assessing measurable outcomes, treatment plan efficacy and patient progress. The patient should complete and give this to their provider(s) for EACH office visit. The data is useful if entered into an EMR system.

Appendix 10 – Patient Health Questionnaire (PHQ-9) – The PHQ-9 is a multipurpose instrument for screening, diagnosing, monitoring and measuring the severity of depression: The PHQ-9 incorporates DSM-IV depression diagnostic criteria with other leading major depressive symptoms into a brief self-report tool. A score of 10 (or higher) indicated further examination or diagnosis for depression. Is does not necessarily indicate clinical depression, rather you should see someone for clinical diagnosis.

Appendix 11 – Monthly Pain Log – This log provides the prescriber valuable information regarding medication efficacy. The prescribing physician can use this for evaluation of dosing changes.

Appendix 12 – Stretching Log Sheet – This is a checklist for the patient to use to ensure they perform any stretching the providers assign. Movement is medicine and stretching is one of the best tonics. This log sheet should be one of the first tools you pull from your toolbox. You’ll start feeling better for doing so.

Appendix 13 – Walking Log – This log captures steps taken, distance traveled, time goals and ideas captured on the walks. This is another data capture tool for both providers and patients.

Appendix 14 – Sleep Log – This 14 day sleep log captures 8 sleep metrics both patient and provider can use to quantify sleep hygiene and quality.

Appendix 15 – Weekly Migraine Log – This log helps gather data related to assessing migraine triggers.

Appendix 16 – Stress Indicators Questionnaire – This assessment examines physical, sleep, behavioral, emotional and personal habit indicators related to stress inducing risks.

Appendix 17 – General Stress Self-assessment – This self-assessment provides only an indication to patient and providers to determine if interventions may be required. Some of the questions asked, may simply reflect preference vs. anxiety. An example might be, such whether or not you want to fly in a commercial aircraft. The assessment considers panic attacks, general anxiety, PTSD, OCD, social phobias and fear of flying.

Appendix 18 – Anger Assessment – The is a self-assessment that examines thoughts, processing, events, behaviors, attitudes, etc. related to anger behavior or patterns. Anger is a natural emotion. That is to say, it is neither good nor bad. How we react to it determines goodness or badness. People struggling with chronic pain commonly struggle with anger. This might be an important tool in your toolbox.

Appendix 19 – Generalized Anxiety Disorder 7-item (GAD-7) Scale – The GAD-7 is a quick and simple assessment of anxiety in only seven questions. We recommended further evaluation when the score is 10 or greater. Using the threshold score of 10, the GAD-7 has a sensitivity of 89% and a specificity of 82% for GAD. It is moderately good at screening three other common anxiety disorders – panic disorder (sensitivity 74% , specificity 81% ), social anxiety disorder (sensitivity 72% , specificity 80% ) and post-traumatic stress disorder (sensitivity 66% , specificity 81% ).

Appendix 20 – Depression Risk Factors -This short assessment determines the level of potential risks depression may play in your life. Take notice that of the 10, the six are common to those struggling with chronic pain. Certainly, the purpose of this assessment is to provide you a quantifiable level of risk you have to depression. It graphically shows the likelihood of specific risks of depression common to chronic pain. Please realize, a higher score DOES NOT indicate clinical depression. It simply means risk factors exist of which you should be aware.

Appendix 21 – Feelings of Shame Scale – Sometimes those with chronic pain experience shame for both internal and external reasons. This assessment helps measure the influence shame might play in how one processes life and their pain experience.

Appendix 22 – Self-assessment for Guilt – This is a quick assessment for those who may be experiencing guilt. Guilt is concerned with the negative evaluation of a specific behavior in a particular situation. It results in a desire to confess, apologize, and repair. In contrast, shame involves the negative evaluation of the self and elicits a desire to vanish or escape. Said another way, guilt is a negative feeling much more related to the specific event, rather than to the self. In contrast, shame involves a global negative feeling about the self. It is in response to some misdeed or failure often triggered by a social event. For example, a perceived drop of personal status, or feelings of rejection.

Appendix 23 – Migraine Assessment – This questionnaire asks the per with migraine about the nature, frequency, intensity, location, etc. of the migraine attacks as well as potential triggers for migraines.

Appendix 24 – OIC Assessment – The assessment helps both patient and provider better understand what side-effects (and life-style causes) must be addressed in order to reduce OIC.

Appendix 25 – Negative Emotions and Feelings That Can Arise from Your Pain Experience – This is a list of feelings and emotions commonly associated with the pain experience. Its purpose is for use in expressive writing exercises to help patients describe their experience.

Appendix 26 – Feelings, Attitudes and Behavior Descriptors – This is a more extensive list than that in Appendix 25 as it includes feelings, emotions, attitudes and behaviors.

Appendix 27 – Anti-inflammatory Food Pyramid – This is a graphic showing the types of food considered anti-inflammatory and their proportions.

Appendix 28 – Weekly Success Plan – This template is for both patient and providers to use. It provides a weekly snapshot or review of those things included in SMART Goals or overall treatment plan. This is a valuable tool for helping one stay motivated to work “the plan.”

Appendix 29 – SMART Goals Worksheet  –  This template is used to develop or define goals that are Specific, Measurable, Attainable, Relevant and Time-bound. Therefore, this is one of the most important tools in the toolbox. Print out several copies and post them conspicuously after completing them.

Appendix 30 – Expressive Writing Prompts by Chapter – Writing prompts are provided at the end of each chapter in the book. For convenience they are provided here. Expressive writing is one of the most powerful tools in your toolbox. This is a listing of all the writing prompts in each chapter. This is for your convenience only and does not provide any additional information beyond the book.

Appendix 31 – Ten High-impact Chronic Pain Conditions – This was initially part of the text in the book but was removed and placed here because this information is general and not serve or support specific needs, but still provides insight and information on multiple pain conditions.

Appendix 32 – Parts of the Brain – This material is more detailed and is available for those who want more information on the various parts of the brain and what they do.

Appendix 33 – The Body’s Nervous Systems – This material is more detailed and is available for those who want more information on the various parts of the nervous systems and what they do.

Appendix 34 – VA-Pain Outcomes Questionnaire – Short Form – The Pain Outcomes Questionnaire-Short Form (POQ-SF) is a 20-item inventory, one of which is the date the inventory is taken. The other 19 primary pain items rated on a 11point (0-10) Likert-type scale and one demographical question. These 19 items are identical to those found in the longer and original version of the instrument, the POQ-VA. This questionnaire excludes a number of items relating patient history, opioid use, treatment satisfaction, and other demographics. Its original purpose was to function as a multi-dimensional measure of pain in veterans. It was designed to keep pace with the emergence of the biopsychosocial model of pain. It has proven to be a reliable, valid, and robust measure of the diverse cluster of symptoms associated with pain.




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