Nurse-Led Motivational Interviewing for Setting Functional Cancer Pain Goals

Purpose: Persons with advanced cancers experience high rates of pain. Nursing interventions for pain, which are tailored to the individual patient, may support motivation to engage in self-management and should include setting of realistic functional goals. For patients with advanced cancer, functional pain goals include personally important activities, measurable across clinical encounters. However, limited ev-idence exists regarding nursing assessment of functional pain goals. To address this gap, we piloted use of a motivational interviewing intervention. Motivational interviewing is a clinical technique for clarify-ing goals and related impediments, such as cognitive and emotional factors underlying pain management behaviors. Design: Pilot feasibility testing. Methods: Palliative care patients with cancer-related pain completed up to four intervention sessions, the Pain Self-Efficacy Questionnaire, and an author-developed acceptability questionnaire. Feasibility success was determined by 60% of participants completing at least two interventions. Fidelity to the intervention was assessed using the Motivational Interviewing Skills for Healthcare Encounters tool. Results: Sixty-seven percent completed two interventions. Participants reported that interventions were helpful, worthwhile, and recommended. Mean pain self-efficacy scores (0-60 possible) rose from 31.5 (SD = 11.2) at intervention 1 to 35.5 (SD = 13) after intervention 4. Intervention fidelity was maintained. Conclusions: Participants were willing to engage in multiple motivational interviewing conversations fo-cused on pain management behaviors related to functional goals. Based on these findings about moti-vational interviewing for functional goals and patient willingness to set them, these conversations may have a place in clinical care as an element of pain assessment and intervention tailoring. (c) 2021 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.