Self-Management and Self-Management Support on Chronic Low Back Pain Patients in Primary Care

Friday, 26 July 2013: 10:15 AM

Jennifer Kawi, PhD, MSN, APN, FNP-BC
School of Nursing, Physiological Department, University of Nevada, Las Vegas, Las Vegas, NV

Learning Objective 1: The learner will verbalize understanding of the relationships of self-management, self-management support, and other pain-related variables in chronic low back pain.

Learning Objective 2: The learner will demonstrate understanding of chronic low back pain patientsí perceptions on their self-management, self-management support, and functional ability.


     This research study examined self-management (SM), self-management (SMS), and other pain-related variables on chronic low back pain (CLBP) in the primary care setting. Participant perceptions of their SM, SMS, and functional ability were also described. The Chronic Care Model served as the theoretical framework for this research.

     The World Health Organization described low back pain as the most common cause of disability afflicting large numbers of the population. In effect, SM has been strongly recommended as an essential skill to empower and engage patients to care for themselves appropriately. Worldwide, healthcare professionals are urged to provide adequate SMS to increase patient’s ability to self-manage. However, although these strategies have shown success in improving other chronic disease outcomes, current knowledge base are insufficient in the area of non-malignant CLBP. 


     Non-experimental, cross-sectional, descriptive design, using general linear modeling and qualitative content analysis addressed the study purposes. Data were collected from 120 participants in four primary care clinics using survey measures. 


     SMS was found to significantly influence SM and mental health. Participant-perceived overall health significantly influenced functional ability and pain intensity. Participants described taking medications, exercising, and making lifestyle changes as most common SM strategies. Prescribing medications, giving encouragement, and providing information were main participant-perceived SMS activities. Depression and anxiety were key responses to participant perceptions on functional ability.


     Study findings increase our understanding of the SM, SMS, and functional ability of CLBP patients with relevance to application in practice. There is great need to develop evidence-based SM and SMS programs specific to CLBP patients’ needs. Nurses play major roles in leading these initiatives globally. Study findings also reinforce the importance of psychologists and physical therapists’ collaboration in the complex care of CLBP. Longitudinal and experimental studies are recommended to evaluate SM and SMS programs that include physical therapy and psychological care components.