Strategies for Implementing Nursing Activities for Chronic Pain Management in Primary Care: Integrated Findings from a Sequential Mixed-Methods Study.

BACKGROUND

Chronic pain (CP) affects one in five Canadians, representing a major public health issue. Its economic burden is estimated between CAD $38.3-$40.4 billion annually. Despite its prevalence, integration of nursing activities in CP management within primary care remains limited, indicating a need for strategies that facilitate effective implementation.

AIM: Determine implementation strategies to promote the integration of nursing activities in CP management in primary care, considering nursing practice realities and patient needs.

METHODS

A sequential explanatory mixed-methods study (QUAN→qual) was conducted in collaboration with two patient partners. A Delphi study captured prioritized nursing activities for CP management, while qualitative focus groups explored nurses' barriers and facilitators in CP management. Findings were integrated through a joint display comparing quantitative and qualitative results following Fetters' (2019) recommendations, in order to identify implementation strategies.

RESULTS

Findings indicated a substantial gap between prioritized nursing activities for CP management and current practice, highlighting that nursing involvement remains at an early stage of implementation. Two key orientations emerge: (1) Strengthening nurses' capacities to integrate CP-related activities by providing appropriate tools, training, and clinical guidance, (2) Mobilizing other healthcare system interest-holders (patients living with CP, healthcare providers, and managers) to support adoption of new nursing activities and create an environment conducive to change.

CONCLUSION

The study underscores the importance of implementation strategies to foster the adoption of nursing activities in CP management. These strategies provide an implementation blueprint for maximizing nurses' contribution to CP management in primary care through full deployment of their competencies.