Date of Conferral

2017

Degree

Doctor of Nursing Practice (DNP)

School

Nursing

Advisor

Deborah Lewis

Abstract

Chronic pain is a condition that impacts millions of men and women around the globe. It is a compelling disease that particularly impacts quality of life (QOL) for many veterans with undertreated or untreated pain. The focus of this systematic literature review was the appraisal of articles and clinical practice guidelines to better understand best-practice nonpharmacological strategies for management of chronic pain. Key words used in the literature search included chronic pain and veterans, complementary alternative medicine (yoga, tai chi, music therapy, acupuncture, and massage), and cognitive behavioral therapy (CBT). The articles included in the review were limited to those pertaining to adults over the age of 18 with non-cancer musculoskeletal chronic pain. The review excluded articles pertaining to patients reporting headache, cancer-related pain, fibromyalgia, mental health problems, or gynecological pain. Polit and Beck's levels of evidence were used to appraise each article. The Stetler model was used as the change model for this project. Thirty-six articles met the criteria and were included. Nine clinical practice guidelines were appraised. Four articles were pilot studies, 3 met the criteria for Evidence Levels V-VII, 3 met the criteria for Levels III-IV, 8 were Level II, and 18 were systematic reviews of randomized controlled trials (Level I). The analysis of evidence supported the use of yoga, CBT, acupuncture, and massage therapy as best-practice methods of personalized nonpharmacological pain management. This project is important for those who care for veterans and other adult chronic pain patients. Application of the findings may lead to changes in chronic pain management that will enhance social change and improve QOL for veterans and others living with untreated or undertreated chronic pain.

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