Abstract
Purpose
Persons with advanced cancers experience high rates of pain. Nursing interventions
for pain, which are tailored to the individual patient, may support motivation to
engage in self-management and should include setting of realistic functional goals.
For patients with advanced cancer, functional pain goals include personally important
activities, measurable across clinical encounters. However, limited evidence exists
regarding nursing assessment of functional pain goals. To address this gap, we piloted
use of a motivational interviewing intervention. Motivational interviewing is a clinical
technique for clarifying goals and related impediments, such as cognitive and emotional
factors underlying pain management behaviors.
Design
Pilot feasibility testing.
Methods
Palliative care patients with cancer-related pain completed up to four intervention
sessions, the Pain Self-Efficacy Questionnaire, and an author-developed acceptability
questionnaire. Feasibility success was determined by 60% of participants completing
at least two interventions. Fidelity to the intervention was assessed using the Motivational
Interviewing Skills for Healthcare Encounters tool.
Results
Sixty-seven percent completed two interventions. Participants reported that interventions
were helpful, worthwhile, and recommended. Mean pain self-efficacy scores (0-60 possible)
rose from 31.5 (SD = 11.2) at intervention 1 to 35.5 (SD = 13) after intervention
4. Intervention fidelity was maintained.
Conclusions
Participants were willing to engage in multiple motivational interviewing conversations
focused on pain management behaviors related to functional goals. Based on these findings
about motivational interviewing for functional goals and patient willingness to set
them, these conversations may have a place in clinical care as an element of pain
assessment and intervention tailoring.
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Article info
Publication history
Published online: May 04, 2021
Accepted:
March 11,
2021
Received in revised form:
March 7,
2021
Received:
September 27,
2020
Identification
Copyright
© 2021 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.
