Effect of applying a structured intervention to facilitate coping in patients experiencing low back pain. Insights gained through application of Mishel's theory of uncertainty in illness.
Title
Effect of applying a structured intervention to facilitate coping in patients experiencing low back pain. Insights gained through application of Mishel's theory of uncertainty in illness.
Creator
Arvelo, Sarah
Description
Arvelo, Sarah
The exploration of coping in a group of patients with chronic low back pain was conducted in a Midwestern pain clinic for the purpose of understanding how patients continued to cope with chronic low back pain after a reduction of opioid medication. Those on previously high dose opioids i.e. above 50 morphine equivalents per day, as identified through Center for Disease Control Guidelines for the Management of Chronic Pain, were included in this study. A quasi-experimental design using a mixed method approach was employed and was guided by Merle Mishel’s Theory of Uncertainty in Illness. A structured intervention was applied to all participants after they self-selected coping strategies to manage their pain, i.e. exercise, mindfulness, supplements, etc. Pain level, function, coping strategies, barriers, coping efficacy were evaluated at the beginning of the study and then at each visit over a 2-month period. Mishel’s theoretical concepts defining the trajectory of chronic disease were integral in understanding the pain experience. In a sample of 20, three groups were clearly defined revealing characteristics that could give guidance to early identification of those patients with chronic pain that may struggle. Findings guided the development of an adapted framework further defining the pain experience outlined by Mishel. The new model demonstrates not only the path to adaptation and maladaptation but also the path of those that struggle and are at risk for maladaptation. This information can inform practice change and further research to better identify risk factors and tailor interventions to addressing identified coping deficits.
The exploration of coping in a group of patients with chronic low back pain was conducted in a Midwestern pain clinic for the purpose of understanding how patients continued to cope with chronic low back pain after a reduction of opioid medication. Those on previously high dose opioids i.e. above 50 morphine equivalents per day, as identified through Center for Disease Control Guidelines for the Management of Chronic Pain, were included in this study. A quasi-experimental design using a mixed method approach was employed and was guided by Merle Mishel’s Theory of Uncertainty in Illness. A structured intervention was applied to all participants after they self-selected coping strategies to manage their pain, i.e. exercise, mindfulness, supplements, etc. Pain level, function, coping strategies, barriers, coping efficacy were evaluated at the beginning of the study and then at each visit over a 2-month period. Mishel’s theoretical concepts defining the trajectory of chronic disease were integral in understanding the pain experience. In a sample of 20, three groups were clearly defined revealing characteristics that could give guidance to early identification of those patients with chronic pain that may struggle. Findings guided the development of an adapted framework further defining the pain experience outlined by Mishel. The new model demonstrates not only the path to adaptation and maladaptation but also the path of those that struggle and are at risk for maladaptation. This information can inform practice change and further research to better identify risk factors and tailor interventions to addressing identified coping deficits.
Date
2020
Publisher
Alverno College
Extent
238 pages
Language
English
Format
PDF
Type
Text
DNP Project
Subject
Chronic low back pain
Uncertatintiy, coping
Theory of uncertatinty in illness
Pain--Treatment
Backache
Opioids
Rights
These materials may be used by individuals and libraries for personal use, research, teaching (including distribution to classes), or for any fair use as defined by U.S. Copyright Law.
Collection
Citation
Arvelo, Sarah, “Effect of applying a structured intervention to facilitate coping in patients experiencing low back pain. Insights gained through application of Mishel's theory of uncertainty in illness.,” Alverno College Library Digital Commons, accessed April 30, 2024, https://alverno.omeka.net/items/show/222.