Date of Award

Spring 5-31-2019

Document Type

Doctor of Nursing Practice Final Manuscript

Degree Name

Doctor of Nursing Practice

Department

Nursing

First Advisor

Joseph Burkard DNSc CRNA

Abstract

Purpose: Untreated chronic pain is a nationwide epidemic affect individual physically, psychologically, and financially. Low back pain is the most common subset of chronic pain. Restricted clinic time and a focus on procedural/prescriptive methods for managing pain prohibits patient education regarding self-care, and formation of a relationship with the provider.

Design: Article review yielded 20 articles that supported the use of motivational interviewing for chronic pain in lower back pain patients. They were evaluated for their strength of evidence on a scale of 1-6. One article was ranked level I as a meta-analysis, and six were ranked as level II which is randomized control trials.

Methods: Implementation of monthly telephone follow-ups, guided by the 5A’s framework to strengthen self-motivated behavior modifications, develop patient-centered outcomes, and outline systematic follow-up care plans. Data collection utilized standardized rating scales and questionnaires. The process proceeded for six months concluding with program evaluation.

Results: The average pain score improved from 4.6 down to 3.8 (-0.8) almost a 1-point decrease. The average QOL score had the most dramatic increase from 4.6 to 6 (+1.4). No improvement in pain medication usage.

Conclusion: Timely utilization of evidence-based interventions for chronic back pain can improve patient-provider interaction and promote self-care by addressing quality of life issues, decreasing patient pain scores and limiting importance of opioid medications.

Clinical Implications: Promotion of self-care behaviors encourages provider backed safety and holistic collaboration.

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