You are the case manager for a 35-year-old man being seen at a primary care clinic for chronic low back pain

Question

When you meet with the patient, he says that he is having problems at work; in the past year he has been absent from work about once every 2 weeks, is short-tempered with other workers, feels tired all the time, and is worried about losing his job. You are developing this patient's plan of care. On what should the goals for the plan of care focus?
A) Increase the patient's pain tolerance in order to achieve psychosocial benefits.
B) Decrease the patient's need to work and increase his sleep to 8 hours per night.
C) Evaluate other work options to decrease the risk of depression and ineffective coping.
D) Decrease the time lost from work to increase the quality of interpersonal relationships and decrease anxiety.

Answer 1

Ans: D
Feedback:
Chronic pain may affect the patient's quality of life by interfering with work, interpersonal relationships, or sleep. Thus, the best set of goals would be to "decrease time lost from work to increase the quality of interpersonal relationships, and decrease anxiety." Increasing pain tolerance is an unrealistic and inappropriate goal; exercise could help, but would not be the focus of the plan of care. Decreasing the need to work does not address his pain. Evaluating other work options to decrease the risk of depression is a misdirected diagnosis.