# PWR-059 — Pain self-management: learner worksheet Release: Revision 7T · Full Tutorial Edition Estimated time: Estimated 10 min reading; practical time is provider-set Difficulty: Intermediate Equipment: Basic stationery or digital tools — One valued, low-risk activity and a clear finish point.; Timer and provider-set starting duration or task amount.; Prescribed medication, mobility aids, supports and positioning aids unchanged.; Activity record for function, pain interference, effort and delayed response. Space: Desk / seated Automated structural checklist: 10 of 10 structural checks present Evidence quality/context: G4; Focused research depth Automated method-quality band: Comprehensive Method-rating basis: Structure coverage, instruction/check specificity, alternative distinctness, source troubleshooting, comparison depth and whether purpose/check fields are authored rather than derived. Editorial review: Pending manual editorial sign off ## Before you begin - [ ] I read the tutorial authority and stop conditions. - [ ] I have the required equipment/space or a declared accessible alternative. ## Canonical source context Pain self-management aims to improve life around pain without denying pain or promising a cure. The learner and clinician select one valued activity, set a repeatable starting dose, use planned pauses and recovery, record the delayed effect and adjust from function rather than turning the task into a pain contest. Target outcome: The learner completes one clinician-agreed activity dose with planned supports and reports pain interference, function, recovery time and adverse effects. ### Authority and setup conditions - The clinician checks red flags, diagnosis, medication and whether the selected activity is safe. - Choose an activity that can stop or pause without leaving a hazard. - Define the starting dose from recent repeatable ability, not the best day. - Agree urgent and non-urgent stop signs before starting. ### Required or supplied materials - One valued, low-risk activity and a clear finish point. - Timer and provider-set starting duration or task amount. - Prescribed medication, mobility aids, supports and positioning aids unchanged. - Activity record for function, pain interference, effort and delayed response. ## 1. Name the valued function Choose one concrete activity that matters, such as preparing part of a meal or walking to the garden chair. Why: A meaningful function prevents practice becoming a pain-tolerance test. Success check: The goal describes an action and finish point. Accessible alternative: Ask the qualified provider to adapt positioning, cue modality, pace, interface or rest while preserving this step’s declared check: “The goal describes an action and finish point.” If an adaptation changes the measured task or configuration, record it as a different configuration rather than an equivalent attempt. Alternative relationship: Conditional equivalence requires target and configuration check Learner notes: ________________________________________________________________________________ Completed: [ ] ## 2. Set a repeatable dose With the clinician, choose time, distance or steps below the level that has recently caused uncontrolled worsening. Why: A stable starting dose can be repeated and adjusted. Success check: Dose and rationale are written before activity. Accessible alternative: Ask the qualified provider to adapt positioning, cue modality, pace, interface or rest while preserving this step’s declared check: “Dose and rationale are written before activity.” If an adaptation changes the measured task or configuration, record it as a different configuration rather than an equivalent attempt. Alternative relationship: Conditional equivalence requires target and configuration check Learner notes: ________________________________________________________________________________ Completed: [ ] ## 3. Prepare supports Place aids, seat, water, tools and help so the task does not require last-minute strain. Why: Environment can reduce unnecessary pain load without invalidating the activity. Success check: All planned supports are present and recorded. Accessible alternative: Ask the qualified provider to adapt positioning, cue modality, pace, interface or rest while preserving this step’s declared check: “All planned supports are present and recorded.” If an adaptation changes the measured task or configuration, record it as a different configuration rather than an equivalent attempt. Alternative relationship: Conditional equivalence requires target and configuration check Learner notes: ________________________________________________________________________________ Completed: [ ] ## 4. Begin at an even pace Start without rushing to “get it over with”; use the planned sequence and normal breathing. Why: Boom-and-bust pacing often adds bursts of load that are hard to repeat. Success check: Speed and technique remain steady enough to stop safely. Accessible alternative: Ask the qualified provider to adapt positioning, cue modality, pace, interface or rest while preserving this step’s declared check: “Speed and technique remain steady enough to stop safely.” If an adaptation changes the measured task or configuration, record it as a different configuration rather than an equivalent attempt. Alternative relationship: Conditional equivalence requires target and configuration check Learner notes: ________________________________________________________________________________ Completed: [ ] ## 5. Pause on schedule Use the planned pause or task switch even if pain is temporarily low; apply the clinician-approved settling strategy. Why: Time-based pauses reduce decisions made only at peak pain. Success check: The pause occurs at the predeclared point. Accessible alternative: Ask the qualified provider to adapt positioning, cue modality, pace, interface or rest while preserving this step’s declared check: “The pause occurs at the predeclared point.” If an adaptation changes the measured task or configuration, record it as a different configuration rather than an equivalent attempt. Alternative relationship: Conditional equivalence requires target and configuration check Learner notes: ________________________________________________________________________________ Completed: [ ] ## 6. Stop at the declared finish End the dose instead of adding more because the day feels good or forcing completion because pain rose. Why: Keeping the dose stable reveals delayed response and repeatability. Success check: Actual dose matches the plan or the deviation is named. Accessible alternative: Ask the qualified provider to adapt positioning, cue modality, pace, interface or rest while preserving this step’s declared check: “Actual dose matches the plan or the deviation is named.” If an adaptation changes the measured task or configuration, record it as a different configuration rather than an equivalent attempt. Alternative relationship: Conditional equivalence requires target and configuration check Learner notes: ________________________________________________________________________________ Completed: [ ] ## 7. Record function and interference Record what was completed, assistance, pain interference, distress, effort and recovery actions—not pain intensity alone. Why: Self-management success can be better function even when pain remains. Success check: The record separates function, pain and assistance. Accessible alternative: Ask the qualified provider to adapt positioning, cue modality, pace, interface or rest while preserving this step’s declared check: “The record separates function, pain and assistance.” If an adaptation changes the measured task or configuration, record it as a different configuration rather than an equivalent attempt. Alternative relationship: Conditional equivalence requires target and configuration check Learner notes: ________________________________________________________________________________ Completed: [ ] ## 8. Check delayed response At the clinician-set later time, record symptom change and recovery duration, then adjust only one feature with the clinician. Why: Immediate tolerance can miss delayed worsening. Success check: Progression uses both immediate and delayed data. Accessible alternative: Ask the qualified provider to adapt positioning, cue modality, pace, interface or rest while preserving this step’s declared check: “Progression uses both immediate and delayed data.” If an adaptation changes the measured task or configuration, record it as a different configuration rather than an equivalent attempt. Alternative relationship: Conditional equivalence requires target and configuration check Learner notes: ________________________________________________________________________________ Completed: [ ] ## Reflection What changed? ________________________________________________________________________________ What remains difficult? ________________________________________________________________________________ What will I repeat, adapt, ask for help with, or stop? ________________________________________________________________________________ --- Completion of this worksheet demonstrates tutorial participation only. It does not establish capability, qualification, safety clearance, diagnosis, treatment or independent validation.