The Literature Review

Question Answered step-by-step The Literature Review: should give an overview of the previously available literature that addresses the research problem. It should show how the current study first into the existing framework of research or state how this research will fill a gap in what is currently known.1)           Is the review of literature relevant to the problem?2)           Is the review of literature well organized and put together in a manner that is easy to follow?3)           Does the review of literature conclude with a summary of the literature that leads to implications for the study? Self-Management Interventions Complementary and alternative medicine therapies may be used in addition to pharmacologic interventions to reduce chronic pain. The National Center for Complementary and Integrative Health (NCCIH) sorts complementary self-management approaches into 2 categories: mind and body therapies (e.g., yoga, meditation, exercise, acupuncture, relaxation techniques) and natural products (e.g., herbs, vitamins, minerals) (NCCIH, 2017). Rural residents may lack access to complementary self-management interventions (Hoffman, Meier, & Council, 2002), whereas pharmacologic interventions are readily available and better covered by insurance (IOM, 2011). A lack of current research exists on the use of complementary self-management interventions for chronic pain management among rural and nonrural residents. In a 2003 study, a significant relationship (c2 ¼ 19.72, p ¼ .001; n ¼ 595) was found between the use of complementary self-management approaches for pain management and type of community, with 82% of suburban, 77% of urban, and 58% of rural respondents reporting the use of these treatments (Vallerand, Fouladbakhsh, & Templin, 2003). Of the rural residents, 66% used prescription medications and 18% were taking an opioid analgesic (Vallerand, Fouladbakhsh, & Templin, 2004). The percentage of suburban and urban residents who used prescription medications and opioid analgesics was not reported. Findings from a 2008 survey of 463 patients with chronic nonmalignant pain who received primary care at 12 U S. academic medical centers in nonrural settings indicated that 52% of patients used complementary self-management approaches to manage their chronic pain (Rosenberg et al., 2008). No association was found between opioid use and self-management intervention usage. Chronic Pain Management in the Primary Care Setting At the patient level, facilitators of patients’ chronic pain management in the primary care setting include confidence in one’s self-management ability, relationship with their PCP, support from family and friends, and access to services (Lukewich, Mann, VanDenKerkhof, & Tranmer, 2015). Self-management interventions engage individuals to manage their chronic pain. Thus, self-management interventions are an important component of chronic pain management and promote patients to be active participants in their treatment rather than relying only on pharmacologic interventions, which are often opioid based (Boudreau et al., 2009; Olsen, Daumit, & Ford, 2006). At the community level, the use of complementary self-management interventions for chronic pain management by rural residents can be explained by the Chronic Care Model (Bodenheimer, Wagner, & Grumbach, 2002). The model is an organizational approach for providing high-quality chronic disease care in the primary care setting. Treating chronic pain has similarities to treating other chronic diseases that are managed in the community, health care system, and provider organization, such as a rural clinic (Bodenheimer et al., 2002). High-quality pain care that includes the use of self-management interventions is supported by 6 essential elements: (1) linkages between PCPs and community resources for selfmanagement interventions such as exercise classes, (2) a health care organization that views multimodal chronic pain management as a priority, (3) selfmanagement support that emphasizes the patient’s role in managing chronic pain and empowers patients to use self-management interventions, (4) a delivery system that defines the roles and tasks of team members for educating patients about pain intervention Rural vs. Nonrural Self-Management for Chronic Pain 9 options, (5) decision support for integration of evidence-based pain care in daily practice, and (6) clinical information systems for reminding providers about evidence-based care and providing feedback on the outcomes of using self-management interventions. These interrelated elements result in evidence-based interactions between an informed, empowered patient and a knowledgeable, proactive health care team (Bodenheimer et al., 2002). Therefore, the absence of elements of the Chronic Care Model in the rural setting such as resources, health insurance coverage for complementary self-management approaches, and relative lack of knowledge of evidence-based self-management interventions among PCPs may reduce the likelihood of patients using complementary self-management interventions. Study Objectives To determine if there is a difference in chronic pain management in the rural setting, the objective of this study was to compare the use of complementary selfmanagement interventions and opioid-based analgesics between rural and nonrural residents with chronic pain. Based on previous research findings, we believed that rural residents would report lower use of selfmanagement interventions and higher use of opioidbased analgesics than nonrural residents.  Health Science Science Nursing NUR 354 Share QuestionEmailCopy link Comments (0)