A patient who is being counseled for somatoform pain disorder states he believes his pain is the result of an undiagnosed injury.He adds that he cannot adhere to his plan for care involving performing his own activities of daily living,walking 20 minutes daily,and using pain medication only at bedtime.He states he feels "like a baby" because his wife and children must provide so much care for him.The nurse understands that it is most important to assess:

Question

Quizplus · Accepted Answer

Secondary gains reinforce maladaptive behavior and should be assessed in all cases where maladaptive behavior continues for an extended period of time despite efforts and opportunities to change.Here,the patient's dependency needs may be being met through care from his family,who do not realize that their caring for him is extending his somatic concerns.Mood is not suggested as an important element based on the data here,and although it should always be assessed in any psychiatric disorder,it is less likely to be contributing to his somatic focus than are secondary gains.The same is true of cognitive style,memory,and identity.

A Patient Who Is Being Counseled for Somatoform Pain Disorder