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HAKIM - Coggle Diagram
HAKIM
Hospital Anxiety and Depression Questionnaire (HADQ)
Hakim's story includes factors that cumulatively can exacerbate feelings of mental distress
Pressure of stepping up and helping out the family at home and raising 3 kids
Has a history of not taking much sick leave, therefore he may feel pressure to maintain identity as a "consistent and reliable employee" - doesn't want to let down his colleagues
Has a friend who recently had surgery performed on his lower back and is scared that his situation is similar - indicates fear and anxiety about the situation
On Hakim's health questionnaire he states he sometimes has trouble understanding medical conditions and medical terminology. This can create confusion and potentially further increase his anxiety/fear regarding the outcome of his back pain.
On the health questionnaire, Hakim ticked boxes that indicated he had neutral feelings regarding the satisfaction of his life and slightly disagreed his life was close to perfect - this could be indicative many things but one point that stands out is that he is relatively unhappy with his current life situation - potentially feeling depressed.
Hakim rates his social activities and relationship status as "fair" and rates his ability to perform these activities as "poor" which can exacerbate mental distress. With no social outlet or ability to perform normal tasks that may alleviate stress, this can contribute to an allostatic load that may increase any negative feelings surrounding his situation.
Presuming this PROM gets a fairly high score from Hakim due to his psychological risk factors and questionnaire results indicating a mediocre level of life satisfaction.
Would potentially implement some small behavioural changes to support mental health - I personally would wait to manage pain for a few weeks and then re-assess this PROM with Hakim before referring out to see if any reduction in pain improves this.
Quebec Pain Disability Questionnaire (QPDQ)
The QPDQ assesses an individual's ability to perform Activities of Daily Living (ADL) that may be reduced due to back pain. This form is straightforward, easy to fill out and simple to read. Hakim mentions on his questionnaire that he is "fairly confident" when filling out medical forms.
This questionnaire allows us to also visibly simulate ADL's that Hakim may perform in day-to-day life, giving us more information regarding how he moves, where the pain may be occurring and allow for us to introduce some variations that may reduce pain for Hakim.
This questionnaire will help us to assign a "performance" component to Hakim and potentially bring his focus back to his current issue whilst trying to separate it from his other concerns that may be affected by psychological stressors.
It is anticipated that the results of this PROM will be fairly high given Hakim's pain rating in his questionnaire. But should be looked at alongside the FABQ and HADQ for additional information.
This is a great tool to help gather information on further biomechanical weaknesses Hakim may be experiencing that could be exacerbating his pain, strengthening our rehabilitation program for him.
The aim of said rehabilitation protocol would be partly based on this to improve stability and structural integrity surrounding the pelvis and spine, as well as building tissue tolerance.
Fear-Avoidance Belief Questionnaire (FABQ)
This outcome measure is useful for individuals who may be more inclined to experience exaggerated pain due to their beliefs and/or fears.
Hakim mentioned he had a friend who was experiencing back pain and had to get surgery in order to recover, which appears to make Hakim fearful that he will require surgery and never recover.
Hakim explains his pain is a 12/10 at worst. Individuals with fear-avoidance beliefs may experience exaggerated pain due to their perception.
Hakim appears to have several psychological factors that indicate he is highly stressed/anxious which can increase pain and sensitivity within bodily structures.
the FABQ has been identified as being useful in populations where individuals believe they may be at risk for prolonged disability - this is evident where Hakim mentions he is worried he will never recover.
On Hakim's health questionnaire he states he sometimes has trouble understanding medical conditions and medical terminology. This can create confusion and potentially further increase his anxiety/fear regarding the outcome of his back pain.
The purpose of this PROM is to assess whether Hakim's beliefs around pain could be contributing to increased intensity surrounding his back pain.
It is expected that this PROM results in a high score for Hakim and is important that we consider this factor when designing a successful treatment plan for Hakim.
Due to the high result that we are likely to receive after implementing this PROM, would be very careful with the words that we use around Hakim and his injury so as to not further create any fear-avoidance behaviours.