1. Discuss the psychological factors associated with pain and, at least, one psychosocial intervention used to treat pain.

Psychological factors related to pain disorder get viewed to play a significant role in the onset, seriousness, exacerbation or maintenance of the pain. Psychological assessment assists in understanding patient’s experience of pain together with any associated pain behavior such as grimacing, postural changes and expressions of face. It also assists in identifying coping strategies that get used by the patient and whether they result in a positive outcome such as distraction and staying busy or adverse outcome such as catastrophising and limitation of activity. The diagnosis of pain disorder with psychological factors gets made when the patient’s reaction is out of proportion to the physical condition and when deficits in psychosocial functioning occur.

The psychological factors associated with pain include (Turk & Gatchel, 2013).

Cognitions: Fear about paralysis and despondency can result in elevated levels of pain.
Emotion: High levels of pain get associated with fear, anxiety, general stress and depression. High levels of these aspects compel individuals to seek medical treatment for the pain.
Behavior: Pain gets associated with low self-esteem as well as marked avoidance
Attention: Giving a particular pain lot of attention can result in elevated intensity.
Interpretation: Pain gets assessed differently by different patients, for instance, an individual who suffered a heart attack may ignore a muscle twitch in the chest.
Expectations: The type of expectation an individual has towards a particular pain may affect the feedback received from pain receptors.
Context: The time when pain is occurring determines the pain felt by a person, for instance, a patient who has got injected with anesthesia in a theater surgery procedure may not feel the pain until later.
Coping approaches: Different approaches get used to minimize pain. They include biofeedback, visualization, positive affirmations, and distraction.
Cognitive-Behavioral Therapy for Pain Management
This psychosocial treatment process involves several phases. The first step in treatment is pain education, where a patient gets explained about pain, how the role of own response towards pain influences pain experience and coping strategies in pain control. The second step involves in one or more coping skills for pain management. The therapist provides an educational rationale, basic instruction as well as guided practice and feedback got each strategy taught. The third step involves home practice with the skills learned from the therapist. The last step of treatment involves assisting patients to establish a program for maintaining their skills practice after the completion of training and for overcoming setbacks and relapses in the coping strategies.

2. Pick two of the five theoretical models of coping with chronic illness and describe in detail. What adherence interventions would be effective in the two models you choose?

Self-Regulation Model
It is a theoretical model of goal-directed behavior that gets applied to understanding people’s ability to cope with the chronic disorder. In this model, the human behavior gets influenced by objectives through which individuals seek to develop particular desired conditions in their lives. Patients use the self-realization process to strive to achieve certain goals. This model gets based on the assumption that patients experience stress when they get hindrances towards achieving their goals and dealing with stress gets conceptualized as efforts at self-regulation based on that adversity. Suffering from a chronic illness is stressful to the extent that it gets viewed to prevent a patient’s goals and their ability to deal successfully with the disease get determined by their capacity to reassess the goals (Suls, Davidson & Kaplan, 2010).

Self-Determination Model
It is a theoretical model based on a broader theory of human motivation and behavior referred to as self-determination theory. The theory assumes that humans have three natural psychological needs namely, autonomy, competence, and relatedness to others and when these needs get met; persons usually experience improved self-motivation, development, and well-being. The theory recognizes that behavioral and affective factors of coping with chronic diseases such as diabetes and hypertension get facilitated by self-management. According to this model, people’s motivations for autonomy and competence are vital in successfully coping with chronic illnesses. Autonomy motivation occurs when individuals experience volition and choice in their illness-related behaviors, whereas competence occurs when patient’s feel that they can control important disease-related outcomes.

Introduction
The fact that it is critical to keep the body extremely hydrated at all times goes without any debate. However, which is the best water to consume? Traditionally, tap water had been the norm in many offices, homes, and schools. However, bottled water has become popular with the increased notion that the water is purer and cleaner than tap water. On the other hand, bottle water can be contaminated thus leaving tap water as the best alternative. The decision to consume tap or bottled water is a personal choice that is supported by numerous factors. Tap water is, however, a better alternative than bottled water as even most of the bottled water are collected from taps and not springs or glaciers.

Body

People with a preference for bottled water believe that the water is purer than tap water. Water manufacturing companies have been able to convince their consumers that their water is collected from pure an unpolluted areas such as spring water and glaciers. Therefore, water from the glaciers and springs is purer than tap water since tap water has to pass through underground pipes and systems thus increasing the risk of contamination (Brebbia, 2015). For instance, the risk of having traces of lead in tap water increases if the water system has aging pipes. Unfortunately, the perception of pure and unpolluted water cannot be validated as unscrupulous water manufacturers can also label and packaged tap water and deceive consumers that the water is pure.

The preference for bottled water over tap water also arises due to the taste. A majority of people who consume bottled water argue that the water tastes better than tap water. Bottled water passes through a series of purification processes thus the minimal risk of experiencing tastes and odors. In contrast, tap water is in an almost natural form thus the risk of experiencing an “earthy” taste. Moreover, there is a risk of rusting of the water pipes thus increasing the occurrence of a “taste” in the water. Bottled water is processed and tested before it is released to the consumers. A guarantee of quality is therefore assured.

The preference for bottled over tap water has also been due to concerns over the safety of the tapped water. A majority of community water systems fail to meet the standards of the safe drinking water Act thus increased the risk of exposure to unsafe water. Moreover, there are concerns that tap water may be more at risk of exposure to germs than bottled water. Water running from taps comes through an underground water system thus the risk of contamination especially in the case of breakages (Gleick, 2010).

On the other hand, proponents of tap water argue that bottled water is an unnecessary expense. Water is a basic necessity for survival thus there is no need for the commodity to be expensive and unaffordable to many consumers. The cost of bottled water is high as the manufacturers have to factor in production and transportation costs. Some manufacturers also strive to make quick profits thus over price their bottled water. In contrast, the cost of tap water is quite low thus making the crucial commodity affordable and accessible to everyone.

Tap water is also a better alternative to bottled water because it has the least negative impact. For bottled water, the manufacturers have to mass produce bottles. Therefore, millions of plastic bottles are then released to the consumers. Without a proper recycling system, the millions of plastic bottles end up as non-biodegradable waste which subsequently increases pollution. Moreover, the production of the plastic bottled also involves the burning of oil which results in the emission of carbon dioxide that in turn affects the ecological system. Water bottles are made from polyethylene terephthalate (PET) that releases toxic chemicals including ethylene oxide and benzene (Vesilind, & DiStefano, 2006). In contrast, tap water does not pollute the environment since the water is available directly from the taps and faucets.

Personally, I know tap water is a better option that bottled water. The fact that water is from a bottle does not make it safer. The bottled water could have fetched at a tap and sealed as bottled water thus exposing the drinker to a higher risk of contamination than tap water. Tap water is monitored and regulated for contamination thus ensuring minimal risk to drinkers. The water is also readily available to all and thus can be provided in schools in limitless and affordable supplies. In contrast, bottled water is unnecessarily expensive, yet tap water is just a fraction of that cost (Mackey, & Boulos, 2004). It is true that there are concerns over the quality of tap water and the risk of contamination. However, tap water can be monitored and tested regularly to ensure they are up to the expected standards.

Conclusion

Water is an essential health commodity that is critical for survival. The question of whether to consume bottled or tap water lies on factors related to the risk of contamination, the cost of the water and the sustainability of the water. Bottled water manufacturers promise their consumers that their bottled water is from springs and or glaciers thus it is bottled at its purest form. The reality, however, is that most bottled water comes from tap water; thus manufacturers dupe consumers with false advertisements. Bottled water is also unnecessarily expensive, yet tap water is affordable and accessible to many. Tap water also guarantees the sustainability of the environment as the production of the water does not undergo numerous process. In contrast, bottled water results to millions of plastic bottles that are non-degradable and choke the environment.

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