Research Project Proposal
Chronic pain remains a reason for the increased consumption of healthcare resources. Raffaeli et al. (2021) define chronic pain as a complex health condition affecting individual and community wellness. To promote individual and community health, managing chronic pain is necessary. Notwithstanding, traditional issues, such as insufficient management, persist, jeopardizing quality improvement efforts in chronic care: Research Project Proposal.
It is necessary that all stakeholders involved in managing chronic pain recognize it as a health problem and understand its impact on wellness. This research explores the effects of poorly managed chronic pain on the health of adults.
Background and Significance of the Problem
Chronic pain is a major healthcare concern worldwide. It is one of the most commonly encountered complaints in healthcare. Its high prevalence and the increasing rate of pain-causing and pain-related illnesses make it a burden to healthcare systems across the globe. It is also a leading cause of disability and a reason for consuming over-the-counter pain medications.
In the US, chronic pain affects up to 25% of adult populations. It has also and has been implicated in the opioid epidemic, increased hospitalizations, and preventable deaths (Cohen et al., 2021). Addressing this is, thus, important.
Comprehensive management of chronic pain continues to integrate pharmacological and non-pharmacological interventions. Pharmacotherapy is often warranted where other measures fail to produce the required analgesia. Combining both is more effective and safer in the overall treatment of chronic pain. However, traditional problems, such as poor access to chronic pain care, persist.
This has resulted in insufficient management of chronic pain and subsequent sequelae associated with the pain. As Fekede et al. (2023) report, poor management of chronic pain results in increasing need for opioid use, individual and community suffering, increased cost of care, and preventable deaths. All stakeholders involved in managing chronic pain should, therefore, be proactive in ensuring chronic pain is treated adequately.
Statement of the Problem and Purpose of the Study
Problem Statement
In as much as multiple modalities against chronic pain exist, reports of insufficient management of chronic pain persists, resulting in considerable patient suffering, a growing need for hospitalization, increased cost of healthcare and opioid use, and preventable mortalities (Fekede et al., 2023). Inadequate management of pain results when adequate analgesia is not attained. It has a negative impact on the physical and mental wellness of individuals, warranting its address.
Purpose Statement
The purpose of this research is to explore the impact of inadequate chronic pain management on the quality of life and mental wellness of adults within the community setting. Qualitative methodologies will be used to elucidate the perceived effects of chronic pain on physical and psychological wellness. This will help enhance stakeholders’ understanding of how unmanaged and poorly managed chronic pain affects well-being.
Literature Review
There is a literature consensus on how chronic pain impacts community health and wellness. According to Cohen et al. (2021), chronic pain results in morbidity, a high mortality risk, and debilitation globally. It is also a common cause of healthcare seeking for many adults and has been associated with the increased need for medications, especially opioid medications, and elevated cost of healthcare. This reinforces the need to address it.
The multipronged approach to managing chronic pain continues to integrate pharmacological and non-pharmacological measures. Both are effective in ensuring optimal analgesia and improving the quality of life of individuals and communities. According to Saleh (2023), pharmacotherapy and alternative modalities, such as cold application and exercise, are superior in managing chronic pain when used adjunctively than when applied as sole agents. Healthcare providers should, therefore, prioritize a diversified approach to managing chronic pain.
In as much as multiple modalities against chronic pain exist, reports of insufficient management of chronic pain persist. According to Fekede et al. (2023), poorly or insufficiently managed chronic pain remains a global concern. Insufficient management of chronic pain manifests in instances where the pain is diagnosed inaccurately, wrong dosing of patients, and when the patients are reluctant to seek therapy, among others. Undertreatment often becomes apparent in such cases, with consequent persistence of pain and deterioration in the quality of life of the affected persons.
Inadequate management of pain produces profound effects on all components of the healthcare system. According to Alzghoul et al. (2022), insufficiently managed chronic pain is a reason for a deteriorating quality of life. It also results in an escalating cost of care, as individuals have to visit the hospital regularly. Likewise, poor management of chronic pain is directly correlated with a growing need for opioid use and subsequent opioid misuse.
Ellis et al. (2021) explain the link between poorly managed chronic pain and opioid misuse. Inadequate management of chronic pain results in over-reliance on opioid medications. Many of the patients using opioid analgesics proceed to develop an addiction, perpetuating the opioid crisis.
Research Questions, Hypothesis, and Variables with Operational Definition
Research Question
The research question that will be used in the study is: How does insufficient management of chronic pain impact the physical and mental wellness of adults with chronic pain?
Hypothesis: Research and Null
Research Hypothesis
Patients whose chronic pain is managed poorly or inadequately managed pain will experience a deterioration in their physical and mental health. A decline in physical health may be evidenced by poor quality of life, verbalization of ill health, complications associated with the pain, and increased hospitalizations. Chronic pain has also been associated with psychiatric manifestations, such as stress, emotional distress, and anxiety.
Null Hypothesis
Insufficient management of chronic pain does not have any impact on the physical and mental wellness of adults with chronic pain.
Variables
The physical and mental wellness of adults with chronic pain is the dependent variable in this research. Chronic pain management, on the other hand, is the independent variable. The overall wellness of the patients will be determined by their pain level (Fekede et al., 2023).
In this respect, poorly managed pain results in negative health outcomes and deterioration in the quality of life. Conversely, proper management improves the clinical and health outcomes of the patients.
Theoretical Framework
Overview and Guiding Propositions
The integrated pain care model serves as the theoretical foundation for this research. The model explains how social, psychological, and environmental factors all work together to cause chronic pain. According to these provisions, chronic pain goes beyond the symptoms and individual experiences.
It is a multifaceted and intricate constellation of interconnected factors. These factors contribute to impairments in physical, psychological, emotional, and social functioning (Hooten et al., 2024). This extensive integration of components warrants a comprehensive, multipronged approach to managing pain.
Chronic pain management in evidence-based care has traditionally integrated an all-in-one approach. Within the care environment, multidisciplinary healthcare teams, where different healthcare professionals unite to design pain-specific therapeutic care plans, remain the gold standards for managing chronic pain.
This strategy is superior as it has been associated with improved clinical and health outcomes for the patients. Kovačević et al. (2024) report that the interdisciplinary team approach to chronic pain management results in better pain remission, lowered need and consumption of opioid analgesics, reduced hospital visits, and improved quality of life. This underlines its significance.
Application of Theory to the Study Focus
The need to improve care for patients with chronic pain informs the proposed study. As Kovačević et al. (2024) report, adequate management of chronic pain improves the quality of life and wellness of individuals and communities. By exploring the impact of insufficient care on health and well-being, the study demonstrates and affirms the need for quality improvement in pain management.
Likewise, the study aligns with the provisions of the holistic approach to managing chronic pain as it explores the impact of pain on the psychological and physiologic wellness of individuals and communities. Findings from the study will reinforce the need to utilize integrated models in managing chronic pain.
Methodology
Sample/Setting
Persons included in the study must be aged 18 years and above. Likewise, they must have a history of chronic pain and be willing to provide any pain-related information. Persons younger than 18 years will be excluded from the study regardless of their pain management status. Likewise, those attached to a healthcare facility and who are routinely seeking care to address their pain will not participate in the study.
The expected sample size for the study is between 20 and 30. The sample will be drawn from participants who meet the inclusion criteria. This sample size is justifiable as there are many adults with poorly managed chronic pain across American societies (Fekede et al. , 2023). Likewise, the inclusion criteria are broad and may facilitate the entry of a large number of participants into the study.
The planned study will take place in a community setting. The primary focus of the research is chronic pain. Chronic pain remains a healthcare problem ingrained in many healthcare systems.
Apparent disparities in accessing healthcare coupled with negative attitudes and poor perception of chronic pain have significantly reduced the number of people seeking medical attention to treat their pain (Fekede et al., 2023). As a result, the number of people with chronic pain remains high.
Sampling Strategy
Convenience sampling is the strategy of choice for the study. In this technique, the selection of the study participants is based on their availability and willingness to take part in the study. In this respect, the persons included in the study will be those who meet the inclusion criteria and are ready and willing to participate. The convenience sampling strategy is better suited for the study as it eliminates barriers to participation that would otherwise reduce the sample size (Ahmed, 2024).
Research Design
Case study is the research design used in this research. This design enables the researcher to examine people or groups. Similarly, it incorporates a variety of data-gathering techniques, including observations and interviews (Priya, 2020). This makes the design more preferable in answering the research question and addressing the identified problem.
Extraneous Variables (Control Plan)
The manners of the investigators, the health literacy levels of those participating in the study, and the weather of the day are some extraneous variables in the research. These factors may influence individuals’ participation in the study. They may also inform how they understand and respond to the research question. It is, therefore, important that they are considered when conducting the study.
Instruments
Questionnaires are the data collection tool that will be used in the proposed research. Questionnaires utilizes questions adopted from the phenomenon being investigated. In this case, the questions will be based on chronic pain management and interrogate how insufficient management of chronic pain impacts the physical and mental wellness of the participants. Instrument validity will be assured by aligning the questions with the stated research questions, problem statements, and purpose statements.
Test-to-test reliability of the tool will be ensured by administering the questions at varied times to different people under similar conditions. To guarantee the internal consistency of the tool, the overall findings will be evaluated against the response to each item interrogated. Internal consistency will be assured if there is a correlation between the response from each item asked during the interview and the overall findings.
Description of the Intervention
Interviewing will be used as the intervention during the data collection stage. In this regard, participants will be interviewed on their mental health and quality of life. Pre-determined questions based on the research question will be used as a guide to the interview process. Responses obtained from the participants will be analyzed and used to address the research question.
Data Collection Procedures
A video recording will be used to collect the participant responses. Body movements, such as facial expressions, will also be captured. The participants’ reactions will also be observed to identify any non-verbal cues that may provide insights into the suffering of the participants.
Data Analysis Plan
Data obtained will be analyzed through thematic analysis. Thematic analysis involves careful examination of the obtained data to identify recurring themes, extract information, and interpret them to arrive at meaningful conclusions. Thematic analysis will allow the determination of whether poor chronic pain management has an impact on the health of adult populations within community settings.
Ethical Issues
The proposed study involves human participants. The most likely ethical issues are those bordering on informed consent. Informed consent demonstrates compliance with the normative ethical principle of autonomy. It shows the researcher respects their participants and dignifies them.
For this reason, an informed consent form will be obtained from all participants. Before signing the consent form, they will be educated on the research process, including the implications of the study, the perceived risks, and how the findings may be beneficial to them. The consent form will detail the purpose of the research and the identifying details of the investigator. It will also list what is expected of the participants.
Limitations of the Proposed Study
The proposed study has some limitations. Foremost, the study is limited in its scope as it is focused on adult populations within community settings. While the prevalence of chronic pain is higher among the adult population, there are several reported cases of chronic pain among pediatric and adolescent populations. Likewise, the incidence of pain-causing illnesses such as cancer continues to rise within the younger populations.
The limited scope of the study may make generalizing it to the younger populations difficult. The small sample size used for the study may also make it difficult to generalize the results. Another limitation of the research borders on the study setting.
Whereas many cases of poorly managed chronic pain are found within the community, there are several cases of inadequate pain management in the hospital setting. This is mostly the case in resource-limited settings such as lower and middle-income countries. This makes generalization of the findings to these populations difficult.
Implications for Practice
Findings from the study will contribute to the growing knowledge of chronic pain management. The results will demonstrate the negative impacts of poor management of chronic pain on adults and affirm the need to ramp up efforts to address chronic pain. Likewise, findings will detail specific effects of chronic pain on health, informing potential areas to target in the resolve to improve the health of persons with chronic illnesses.
Caregivers, in this respect, may utilize the findings to design patient-specific interventions that help guarantee their wellness even as the chronic pain is being managed. The study may also identify factors that interplay in poor management of pain. This will also help tailor the care approaches to meet their individual needs.
Chronic pain remains a health concern. It has been implicated in increased morbidity and debilitation. Despite the abundance of more effective pain management interventions, inadequate management of chronic pain persists.
Understanding the impact of poorly managed chronic pain on individual and community wellness will help inform the need to address it. The proposed research explores the impacts of poorly managed pain on the physical and mental wellness of adults within the community. Findings will inform quality improvement in chronic pain care.
References
Ahmed, S. K. (2024). How to choose a sampling technique and determine sample size for research: A simplified guide for researchers. Oral Oncology Reports, 12, 100662. https://doi.org/10.1016/j.oor.2024.100662
Alzghoul, B. I., Al Humoud, S., & Abdullah, N. A. (2022). Patient-related barriers to effective pain management: A cross-sectional survey of Jordanian nurses. The Open Public Health Journal, 15(1). https://doi.org/10.2174/18749445-v15-e2207270
Cohen, S. P., Vase, L., & Hooten, W. M. (2021). Chronic pain: An update on burden, best practices, and new advances. The Lancet, 397(10289), 2082–2097. https://doi.org/10.1016/s0140-6736(21)00393-7
Ellis, M. S., Kasper, Z., & Cicero, T. (2021). Assessment of chronic pain management in the treatment of opioid use disorder: Gaps in care and implications for treatment outcomes. The Journal of Pain, 22(4), 432–439. https://doi.org/10.1016/j.jpain.2020.10.005
Fekede, L., Temesgen, W. A., Gedamu, H., Kindie, S., Bekele, T. G., Abebaw, A., Baymot, A., & Difer, M. (2023). Nurses’ pain management practices for admitted patients at the comprehensive specialized hospitals and its associated factors, a multi-center study. BMC Nursing, 22(1). https://doi.org/10.1186/s12912-023-01528-x
Hooten, W., Backonja, M., Williams, K., Sturgeon, J., Gross, J., Borodianski, S., Wang, V., Tuan, W.-J., Zgierska, A., Moeller-Bertram, T., & Kriegel, M. (2024). Integrated pain care models and the importance of aligning stakeholder values. PAIN Reports, 9(3). https://doi.org/10.1097/pr9.0000000000001160
Kovačević, I., Pavić, J., Filipović, B., Ozimec Vulinec, Š., Ilić, B., & Petek, D. (2024). Integrated approach to chronic pain—the role of psychosocial factors and multidisciplinary treatment: A narrative review. International Journal of Environmental Research and Public Health, 21(9), 1135. https://doi.org/10.3390/ijerph21091135
Priya, A. (2020). Case study methodology of qualitative research: Key attributes and navigating the conundrums in its application. Sociological Bulletin, 70(1), 94–110. https://doi.org/10.1177/0038022920970318
Raffaeli, W., Tenti, M., Corraro, A., Malafoglia, V., Ilari, S., Balzani, E., & Bonci, A. (2021). Chronic pain: What does it mean? A review on the use of the term chronic pain in clinical practice. Journal of Pain Research, Volume 14, 827–835. https://doi.org/10.2147/jpr.s303186
Saleh, A. M. (2023). Nurses’ assessment and management practices of pain among intensive care patients in King Khalid Hospital, Kharj, Riyadh. Heliyon, 9(9). https://doi.org/10.1016/j.heliyon.2023.e19986
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Question 
Week 10 Project
Instructions
Overview/Description:
The final project for NSG6101 consists of the development of a novel research proposal specific to your role specialization. The project must include
an intervention appropriate to nursing practice and consistent with your MSN role option. An alternative to the above includes the selection of a specialty organization to focus research proposals based on the priorities of that organization.
Examples of these organizations could include (but are not limited to): Sigma Theta Tau International, American Nurses’ Foundation, Oncology Nursing Society, Association of Nurses in AIDS Care, American Psychiatric Nursing Association, American Association of Critical Care Nurses, National Association of Pediatric Nurse Associates and Practitioners, National League For Nursing, etc.
Throughout this course you have been developing various sections of the research proposal. This week you will assemble the final proposal (addressing
faculty feedback).
This paper is to be developed in APA format/style using the required template and not to exceed 8–10 pages (excluding title
page/references/appendices).
Research Project Proposal
Criteria:
Introduction
• Background and Significance of Problem
• Statement of the Problem and Purpose of the Study
Literature Review
•Summary of the Evidence for the Proposed Study
Research Question, Hypothesis, and Variables with Operational Definitions
Theoretical Framework
• Overview and Guiding Propositions(s) Described in Theory
• Application of Theory to Your Study’s/Project’s Focus
Methodology
• Sample/Setting: Number and criteria for inclusion and description of place in which data will be collected.
• Sampling Strategy
• Research Design: Type (e.g., Quasi–Experimental), description, and rationale for selection.
• Extraneous Variables (and plan for how controlled).
• Instruments: Description, validity, and reliability estimates, which have been performed (on a pre–established measure). Include plans for testing validity and reliability of generating your own instrument(s).
• Description of the Intervention
• Data Collection Procedures
• Data Analysis Plans
o Describe plan for data analysis for demographic variables (descriptive statistical tests),
o Describe plan for data analysis o^ study variables (descriptive and inferential statistical tests).
Ethical Issues
• Describe ethical considerations and your plan to protect human rights.
Limitation of Proposed Study
Implications for Practice
References
Appendices
• Informed Consent Letter
o Procedure section is clear, described in detail, specific, and all inclusive. Written in lay language (as documented by reading level score).
Includes risks and benefits relevant to study. Address assent (if applicable).