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2019 | OriginalPaper | Hoofdstuk

6. Multifactoriële analyse in de medisch-specialistische revalidatie

Auteurs : Drs. J. L. Swaan, Dr. H. R. Schiphorst Preuper, Prof. dr. R. J. E. M. Smeets

Gepubliceerd in: Handboek pijnrevalidatie

Uitgeverij: Bohn Stafleu van Loghum

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Samenvatting

Als een patiënt met chronische pijn wordt verwezen naar de revalidatiearts dan kan er sprake zijn van laag complexe of hoog complexe problematiek. Interdisciplinaire behandeling in de medisch-specialistische revalidatie (MSR) is alleen geïndiceerd bij hoog-complexe problematiek. Bij de vaststelling van de mate van complexiteit van het pijnprobleem maakt de revalidatiearts gebruik van verwijsinformatie (correspondentie, eerder verrichte diagnostiek), neemt een uitgebreide anamnese af, eventueel gecombineerd met korte vragenlijsten, verricht lichamelijk onderzoek en laat zo nodig zelf aanvullende diagnostiek verrichten. Als er voldoende informatie is verzameld, begint het proces van analyse. Voor analyse wordt gebruik gemaakt van de zogenaamde ‘vlaggen’, waarbij de aanwezigheid van rode vlaggen kan wijzen op onderliggende (ernstige) somatische problematiek en de overige vlaggen (geel, oranje, blauw, zwart) te beschouwen zijn als prognostisch relevante factoren. Daarnaast wordt gebruik gemaakt van het exploreren van predisponerende, uitlokkende en onderhoudende factoren als hulpmiddel bij de analyse, waarbij met name de laatste van groot belang zijn voor het bepalen van mogelijke aangrijpingspunten van behandeling. Zo komt de revalidatiearts tot een indicatiestelling voor een interventie en aangrijpingspunten voor behandeling. In dit hoofdstuk worden de predisponerende, uitlokkende en onderhoudende factoren besproken. Onderhoudende factoren kunnen biomedisch, psychologisch en/of sociaal zijn en al deze worden factoren worden uitgebreid toegelicht. Er wordt speciaal aandacht geschonken aan de mogelijk negatieve beïnvloeding door medewerkers uit het (para en peri-)medische circuit.
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Metagegevens
Titel
Multifactoriële analyse in de medisch-specialistische revalidatie
Auteurs
Drs. J. L. Swaan
Dr. H. R. Schiphorst Preuper
Prof. dr. R. J. E. M. Smeets
Copyright
2019
Uitgeverij
Bohn Stafleu van Loghum
DOI
https://doi.org/10.1007/978-90-368-2230-5_6