Pain Reduction: Self-Management and Peer Mentorship

Managing pain is a crucial step in improving patient outcomes and the overall quality of care. However, because of individual perceptions of pain, the process of addressing it needs to be introduced. Patient independence should be viewed as an important step in improving the efficacy of pain alleviation.

Background and Significance of Problem

Pain is a symptom of a range of diseases and, therefore, a common occurrence among patients. Ranging from mild, tolerable, and localized to agonizing, pain may cause significant discomfort and even distress to patients, jeopardizing the opportunities or their recovery and impeding the treatment process. Therefore, appropriate tools for managing pain that will provide patients with independence and give them control over the process must be introduced into the context of contemporary healthcare services. Peer mentoring and self-management, in turn, are viewed as possible frameworks for reducing the negative experiences. Therefore, by contributing to the assessment of the identified strategies’ efficacy, one will be able to create a better environment for patients, thus, contributing to their faster recovery. Herein lies the significance of the problem.

Statement of the Problem and Purpose of the Study

Studies show that there have been significant problems in pain alleviation in healthcare (Joshi & Col, 2014). Particularly, the traditional approach to managing pain in patients, i.e., the provision of medications, has a deleterious effect. To be more specific, continuous use of pain management medications, especially opioids, leads to the development of chemical dependency in patients, as well as the reduction in the efficacy of the medication (Moayedi & Davis, 2013). Furthermore, traditional pain medications trigger severe side effects in patients, such as nausea, sleep disorders, anxiety, headache, etc. (Joshi & Col, 2014). Therefore, the incorporation of an alternative approach toward managing pain in patients has required Peer mentoring and self-management as the means of providing the patients with an opportunity to gain control over their experience should be viewed as a reasonable substitute.

Summary of the Evidence for the Proposed Study

The issue of pain management is essential for the improvement of patients’ well-being (Makris, Abrams, Gurland, & Reid, 2015). According to the U.S. Department of Health and Human Services, the pain has a greater toll on the U.S. patients than both cancer and heart disease (National Health Institute, 2013). Pain sufferers require the approach that will enable them to control their experiences and, therefore, explore the opportunities for reducing pain (Corbett et al., 2014).

At present, pain management strategies are restricted primarily to using opioid injections as the means of providing patients with a modicum of relief (Barr et al., 2013). Seeing that regular use of opioids triggers the development of resistance toward the drug and, thus, reduces its effect, a gradual increase in the amount of medicine is required (Fonseca, Ramos, Lopes, Mendes, & Parreira, 2017). Therefore, an alternative approach to pain alleviation must be introduced to reduce the negative effects of the current strategy (Andersen et al., 2017).

It should be noted that the identified strategies, particularly the use of self-management, have not been tested extensively yet. Therefore, there is not enough evidence about the effects that they have on patients’ well-being (Tse, Yeung, Lee, & Ng, 2015). Some researchers admit that self-management alone does not work as effectively as expected, particularly in alleviating pain among patients with diabetes (Joshi & Col, 2014). However, it is assumed that, when coupled with peer mentorship, which allows guiding the target population to successful self-management, the identified approach will have a significant effect on addressing the issue of painful experiences successfully.

Nevertheless, the concept of using peer mentorship as the means of introducing patients to self-management of pain can be deemed as a very promising idea. According to a recent study, the focus on the exploration of patients’ experiences gives patients a tighter control over their pain levels, therefore, encouraging them to increase their pain threshold significantly (Doyle, Lennox, & Bell, 2013). Therefore, it would be a reasonable idea to promote the concept of self-management among patients by using peer mentorship as the essential tool for helping the target population develop the required skills (Hapidou, Mollica, & Culig, 2016).

Furthermore, appropriate peer mentorship is bound to promote clinical education and, therefore, compel patients to acquire the relevant knowledge and skills (Rosenau, Lisella, Lorelli, & Nowell, 2015). By focusing on patients’ experiences, one will also be able to reinforce the idea of patient independence and, thus, introduce the target population to the idea of self-control, self-management, and self-cognition. Consequently, patients will be able to handle their painful experiences efficiently.

Research Question, Hypothesis, and Variables with Operational Definitions

Research Question

To what extent does the use of peer mentorship and self-management as the tools for pain alleviation work compare to other techniques used in addressing chronic pain in patients?

Hypothesis A

A combination of peer mentorship and self-management promoted by it coupled with a smaller dose of pain alleviation drugs (e.g., opioids) than usually prescribed, has a more profound impact on addressing the instances of chronic pain in patients as opposed to the regular intake of opioids.

Null hypothesis

The incorporation of peer mentorship and self-management program combined with a smaller intake of drugs into the process of addressing chronic pain in patients does not have any tangible effect on managing pain compared to the traditional usage of opioids.

Theoretical Framework

When considering the problem of pain management, one must keep in mind that its nature is quite complicated. Therefore, it needs to be approached from several angles. The peer mentorship aspect of the intervention will be viewed through the lens of the Relational Theory (RT). By definition, the specified framework helps develop a deep insight into the relationships of the stakeholders involved in a certain process (Ray & Turkel, 2014). Therefore, RT will help define the intrinsic efficacy of peer mentorship.

To explore the opportunities for self-management and assess the experiences of the target population, one will have to consider using the Multidimensional Pain Theory (MPT). The suggested framework implies that the phenomenon under consideration should be analyzed as a complex concept and approached from several dimensions. As a result, a deep understanding of the problem can be developed, with the following creation of a relevant and efficient management approach. Particularly, how self-management can be promoted and executed in the clinical setting can be identified and researched critically (Jahanpeyma & Akbari, 2016).

Overview and Guiding Propositions(s) Described in Theory

RT helps explore the dynamic relationships between the elements or participants of a particular process (Ray & Turkel, 2014). The framework itself is rather basic; it suggests that the cooperation between the participants of the said process should be examined as the mode of communication in the course of which positive patient outcomes can be achieved (Ray & Turkel, 2014). As a result, the premises for designing an efficient intervention or evaluating the current one (i.e., peer mentorship, or nurse-patient and patient–patient interactions) can be built (Ray & Turkel, 2014).

MPT, in its turn, explores the phenomenon of pain, singling out the following components in it: “sensory-discriminative, affective-motivational, and cognitive-evaluative components” (Moayedi & Davis, 2013, p. 10) ones. Therefore, the authors of the framework suggest that the process of pain analysis should start with a deep understanding of the nature and implications of pain. As a result, profound strategies can be developed to alleviate pain in the target population.

Application of Theory to the Project’s Focus

RT will be used to explore the relationships between nurses and patients. Particularly, the peer mentorship approach, which will be deployed to promote successful pain management, will be considered through the lens of RT as the interaction between nurses and patients. Thus, the possible obstacles in implementing the program, as well as the existing opportunities, will be isolated (Ray & Turkel, 2014).

The MPT framework will serve as the means of studying how patients react to pain. The fact that different people have different pain tolerance levels may hamper the research process slightly. The MPT theory, however, will allow gaining a deeper insight into how pain is perceived and managed by patients. As a result, a more faithful assessment of the participants’ experiences can become a possibility (Moayedi & Davis, 2013).

Methodology

Sample/Setting

It is expected that the study will include 200 participants. The sample size, in turn, will be restricted to 120 people. As a result, all target groups will be represented successfully. The people suffering from chronic pain will be recruited to participate in the study.

Sampling Strategy

It is crucial to make sure that each participant should have an equal chance of participation. Thus, the use of random sampling should be deemed as the most appropriate one. Consequently, the relevant biases will be reduced successfully.

Research Design

A quasi-experimental design is suggested as the means of conducting the research. A randomized controlled trial will be carried out to determine the veracity of the hypothesis. Groups A (using peer mentoring and self-management) and B (the control group) will be represented during the study.

Extraneous Variables

Personal perception of pain is the key extraneous variable in the study. To control it successfully, one should create the same environment for all participants involved. E.g., all patients should receive the same medications.

Instruments

Numerical and verbal rating scales (NRS and VRS) will be used to measure the patients’ experiences (Dansie & Turk, 2013). The identified tools are generally considered reliable and valid since they provide consistent results (i.e., have high-reliability rates) and help address the subjectivity in patients’ responses to pain (i.e., have high validity levels) (Dansie & Turk, 2013). Furthermore, the test-retest framework will be used to correlate the results of the interventions and determine the reliability and validity of the instruments that will be developed in the course of the study (Dansie & Turk, 2013).

Description of the Intervention

Peer mentoring and self-management will be used as the key means of pain alleviation. The patients will be given detailed instructions regarding peer mentoring. Furthermore, independent pain management tools will be offered to the target population.

Data Collection Procedures

Surveys and interviews will be used to collect essential information. Furthermore, the rating scale mentioned above will be provided to the patients so that they could assess their experience accordingly.

Data Analysis Plans

Data Analysis for Demographic Variables: Plan

It will be crucial to determine the mean, the median, and the standard deviation between the demographic variables involved in the research. Thus, the unique characteristics of the target population will be identified, and the factors that will encourage or inhibit the promotion of the relevant strategies will be isolated successfully. The variables such as age, sex, ethnicity, etc., will be considered.

Data Analysis for Study Variables: Plan

Afterward, the correlation between the use of the suggested intervention (i.e., the combination of peer mentorship and self-management combined with a reduced amount of medications, and the usage of the traditional pain alleviation tools) will have to be identified. For this purpose, the data provided by the participants regarding their pain-related experiences will need to be quantified and compared using the t-test. Additionally, a scatter plot will have to be incorporated into the research is that tendencies in the effects of promoting the required strategies could be determined.

Ethical Issues

Ethical Considerations

All participants must be aware of the implications of the study. Therefore, informed consent must be retrieved from all people involved in the research. The letters of informed consent will be sent to the study participants so that they or their legal guardians should sign them (see Appendix A).

Plan to Protect Human Rights

To promote the welfare of all participants involved, one should make sure that the information retrieved from the participant should be classified. Therefore, a non-disclosure policy should be viewed as a crucial part of the project.

Limitation of Proposed Study

The fact that the sample is comparatively small and may not represent the target population fully can be viewed as the essential limitation of the research.

Implications for Practice

It is expected that the study outcomes will help develop a comprehensive approach toward pain management. While medications ill still be incorporated into the framework, the emphasis on self-management and peer mentorship will offer patients control over their experiences, thus encouraging them to develop a greater tolerance for pain. In other words, a significant improvement in the quality of nursing services and patient outcomes is expected.

References

Andersen, L. N., Juul-Kristensen, B., Sorensen, T. L., Herborg, L. G., Roessler, K. K., & Sogaard, K. (2017). Longer term follow-up on effects of tailored physical activity or chronic pain self-management programme on return-to-work. Journal of Rehabilitation Medicine, 48(10), 887-892. Web.

Barr, J., Fraser, I., Puntillo, K., Ely, E. W., Gelinas, C., Dasta, J. F., Davidson, J. E., …Jaeschke, R. (2013). Clinical practice guidelines for the management of pain, agitation, and delirium in adult patients in the Intensive Care Unit. Clinical care Medicine, 41(1), 263-306. Web.

Corbett, A., Husebo, B. S.,. Achterberg, W. P., Aarsland, D., Erdal, A., & Flo, E. (2014). The importance of pain management in older people with dementia. British Medical Bulletin, 111(1), 139–148. Web.

Dansie, E. J., & Turk, D. C. (2013). Assessment of patients with chronic pain. British Journal of Anaesthesia, 111(1), 19-25. Web.

Doyle, C., Lennox, L., & Bell, D. (2013). A systematic review of evidence on the links between patient experience and clinical safety and effectiveness. BMJ Open, 3(e001570), 1-19. Web.

Fonseca, C., Ramos, A., Lopes, M., Mendes, F., & Parreira, P. (2017). Control of pain and dyspnea in non-pharmacological interventions: Patients with oncologic disease in acute care. Journal of Cancer Science & Therapy, 9(1), 319-320. Web.

Hapidou, E. G., Mollica, K. V., & Culig, K. M. (2016). Accessibility of chronic pain treatment for individuals injured in a motor vehicle accident. Psychology and Cognitive Sciences – Open Journal, 2(1), 15-28. Web.

Jahanpeyma, P., & Akbari, M. (2016). The effect of Orem’s self-care education on interdialytic weight and blood pressure changes in hemodialysis patients. International Journal of Medical Research & Health Sciences, 5(7), 294-299. Web.

Joshi, P., & Col, N. (2014). Chronic pain self-management: An unmet need among people with diabetes. International Journal of Diabetes Research, 3(1), 1-2. Web.

Makris, U. M., Abrams, R. C., Gurland, B., & Reid, M. C. (2015). Management of persistent pain in the older patient A clinical review. JAMA, 312(8), 825-836. Web.

Moayedi, M., & Davis, K. D. (2013). Theories of pain: from specificity to gate control. Journal of Neurophysiology, 109(1), 5-12. Web.

National Health Institute. (2013). Pain management. Web.

Ray, M. A., & Turkel, M. C. (2014). Caring as emancipatory nursing praxis: The theory of relational caring complexity. Advances in Nursing Science, 37(2), 132–146. Web.

Rosenau, P. A., Lisella, R. F., Lorelli, T. L., & Nowell, L. C. (2015). Developing future nurse educators through peer mentoring. Nursing: Research and Reviews, 5(1), 15-21. Web.

Tse, M. M., Yeung, S. S. Y., Lee, P. H., & Ng, S. S. (2015). Peer-assisted pain management program for nursing home residents: Does it help to relieve chronic pain and enhance physical and psychological health? Journal of Gerontology & Geriatric Research, 3(3), 1-6. Web.

Appendix A: Informed Consent Letter

Informed Consent Letter.