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University of San Diego

Doctor of Nursing Practice Final Manuscripts

Chronic pain

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Enhancing Chronic Pain Management: Motivational Interview Among Lower Back Patients –Phase Ii, Valerie Gates, Melissa Hines-Antico May 2020

Enhancing Chronic Pain Management: Motivational Interview Among Lower Back Patients –Phase Ii, Valerie Gates, Melissa Hines-Antico

Doctor of Nursing Practice Final Manuscripts

Purpose: Chronic low back pain in adults is difficult to manage and can lead to clinical, psychological, and social consequences. Providers often have restricted clinic time that prevents patient education regarding self-care and non-pharmacological therapies.

Design: This nurse practitioner-led, evidence-based project incorporates monthly telephone calls to improve patient pain, enhance quality of life, decrease opioid usage, increase physical activity, and promote the utilization of non-pharmacological multimodal therapies.

Methods: Implementing a monthly telephone call utilizing motivational interviewing and a 5 A’s guided questionnaire assisted in providing individualized treatment plans. Data outcomes include pain scores, quality of life scores, number of opioid …


Optimizing Chronic Pain Management: Self-Care Utilization Among Veterans With Post-Traumatic Stress Disorder, Paul Krug, Anamarie J. Lazo, Joseph Burkard, David Bittleman May 2018

Optimizing Chronic Pain Management: Self-Care Utilization Among Veterans With Post-Traumatic Stress Disorder, Paul Krug, Anamarie J. Lazo, Joseph Burkard, David Bittleman

Doctor of Nursing Practice Final Manuscripts

Purpose: To implement a chronic pain management regimen that utilizes a self-care approach, integrating all dimensions of the biopsychosocial model to optimally treat the complex needs of younger Veterans with comorbid PTSD and chronic pain. The project aims to provide more insight and knowledge on safer chronic pain management among Veterans, reflected by improvement in patient’s pain level, quality of life, and depression scale.

Design: The project was implemented at the ASPIRE Center, a domiciliary residential rehabilitation treatment program for Veterans who suffer from PTSD and traumatic brain injury. The 5A’s behavior change model was utilized during clinic …


Improving Quality Of Life In Veterans With Chronic Pain Through Patient Engagement, Linda Nyagaya May 2018

Improving Quality Of Life In Veterans With Chronic Pain Through Patient Engagement, Linda Nyagaya

Doctor of Nursing Practice Final Manuscripts

Background: Various psychosocial factors affect follow up care among veterans with chronic pain. Engaging veterans by giving them the choice to decide contact modality for after clinic visit increases likelihood of successfully reaching patient and adherence to recommended pain management.

Purpose: To engage veterans through self-determined effective communication method: telephone, email or Myhealthevet for follow up care. The intervention aims to improve chronic pain self-care by assessing number of medications used for pain, numeric pain rating and quality of life score.

Framework/EBP Model: The Iowa Model and 5A’s will guide implementation and assessment of this project. Patients will self-determine the …


Supporting Self-Care In Veterans With Chronic Pain: Nurse Practitioner-Led Telephone Follow-Up, Marissa A. Munsayac Bsn, Rn, Dnp(S) May 2017

Supporting Self-Care In Veterans With Chronic Pain: Nurse Practitioner-Led Telephone Follow-Up, Marissa A. Munsayac Bsn, Rn, Dnp(S)

Doctor of Nursing Practice Final Manuscripts

Background
Veterans are disproportionately affected by chronic pain. Conventional pain management lacks emphasis on self-care and relies heavily on prescription opioids. Primary care providers (PCP) are able to educate veterans on self-care management; however, frequent follow-up is needed to improve overall pain and quality of life.

Objective
To implement a Nurse Practitioner (NP) telephone follow-up guided by the 5A’s framework among veterans with chronic pain in a primary care setting. This pilot evidence-based project (EBP) aimed to improve follow-up of self-care management in order to decrease pain, increase quality of life, and decrease pain medication use.

Materials & Methods
The …


Supporting Self-Management In Veterans With Chronic Pain: A Policy Perspective, Erin W. Lind May 2015

Supporting Self-Management In Veterans With Chronic Pain: A Policy Perspective, Erin W. Lind

Doctor of Nursing Practice Final Manuscripts

The purpose of the project was to do an evidence-based review of the effectiveness of promoting self-care on pain levels and quality of life among veterans with chronic pain at a national level. A review of current chronic pain management policies for veterans in southern California was also conducted. Active self-management initiatives permit more diverse, patient-centered treatment, promote self-management, and are relatively safe and cost-effective. Our results have confirmed that chronic pain is on the forefront of priorities for the Veterans Health Administration (VHA) due to an increasing rate of both chronic pain and opioid overdoses.