Practise pain types and gate control, clinical, rating and observational assessment, and biological, psychological or alternative management through evidence.
Explain one strength of the gate control theory of pain, from the nurture side of the debate.
Explain one strength of the gate control theory of pain, from the nurture side of the debate.
Award 2 marks for a detailed explanation of the strength in context.
Award 1 mark for a basic outline/identification of strength.
Strengths might include:
- Application to everyday life: This theory suggests that when someone experiences pain, they have some control over this perception. Techniques such as imagery and attention diversion can be learned and used to help close the gate and reduce pain.
- Free will: Pain is something that people have control over. The perception of pain is not something we are born with but something where we can exert some control through learning (nurture) techniques to reduce this pain (close the gate).
- Holistic: Gate control theory is a more holistic explanation of pain by extending specificity theory to include psychological gates. These psychological gates can be due to learning. For example, a young child will often look to their carer when they hurt themselves. The child often cries more if their carer seems concerned about their injury.
Example:
Gate control theory suggests that pain can be controlled through learning how to close the psychological gates which will reduce the perception of pain. (1) This has good applications to everyday life as patients can be taught techniques such as imagery or attention diversion to reduce their experience of pain. (1)
Other appropriate responses should also be credited.
2
Context = gate control theory of pain
Becky has broken her leg and is in a lot of pain. She has tried both biochemical and psychological treatments for the pain. Her doctor has suggested that she uses an alternative treatment.
Outline two alternative treatments that Becky could use to manage her pain.
Becky has broken her leg and is in a lot of pain. She has tried both biochemical and psychological treatments for the pain. Her doctor has suggested that she uses an alternative treatment.
Outline two alternative treatments that Becky could use to manage her pain.
For each suggested treatment:
Award 2 marks for an outline of an alternative treatment to manage Becky's pain.
Award 1 mark for a basic outline/identification of an alternative treatment to manage Becky's pain.
Syllabus content:
- alternative treatments: acupuncture;
stimulation therapy/TENS
Likely responses:
Acupuncture
TENS (simulation therapy)
4
1 mark = outline of treatment
1 mark = why or how to reduce pain.
1 mark if candidate identifies both TENS and acupuncture on their own.
Allow for acupuncture that through the insertion of needles this leads to muscle relaxation (or restoring life force leads to muscle relaxation). For TENS that the electric current leads to muscle relaxation.
TENS - the electric current distracts the person from their pain.
Yoga, aromatherapy, Chiropractic, massage, Tai Chi TENS may stimulate production of endorphins.
No credit for meditation/mindfulness, relaxation, attention diversion, non-pain imagery and cognitive redefinition (= psychological techniques).
11(a)
For example
Acupuncture - stimulates sensory nerves under skin/muscles in the leg producing endorphins which reduce pain. (1)
OR
Qi/life force is out of balance and acupuncture restores the flow of Qi so that the pain from the broken leg is cured. (1)
Stimulation therapy/TENS - A mild electric current is passed between electrodes which are places on the skin around where the leg is broken (1) and should reduce the sensation of pain by flooding the nervous system, reducing its ability to transmit pain signals to the spinal cord and brain. (1)
Other appropriate responses should also be credited.
For one of the treatments outlined in part (a):
Explain one weakness of this way for Becky to manage her pain.
Award 2 marks for an explanation of the weakness in the context of an alternative treatment for managing pain. Award 1 mark for a basic explanation of the weakness.
Weaknesses may include:
Acupuncture
- Bleeding or bruising at insertion site.
- Unsterilised needles may lead to infection.
- A needle may break and damage internal organs.
- Often not covered by national health/insurance and may need multiple sessions (cost and time).
TENS
- Not all types of pain are reduced.
- May cause burns if not used correctly.
- Can be difficult to find the correct placement for effective treatment.
Example:
The pain from the broken leg may improve using acupuncture but Becky may get other effects that cause pain from acupuncture. (1) For example, bleeding or bruising may occur at the insertion site. (1)
Other appropriate responses should also be credited.
2
Can credit a weakness of any treatment outlined in part (a) even if not 'alternative' treatment e.g. evaluates pain killers or psychological treatment.
Acupuncture - can be uncomfortable for patients - don't credit that it is painful.