Enhancing Self-management for Adults With Functional Abdominal Pain: A Registered Nurse-Led Cognitive-Behavioral Therapy Approach

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Abstract

Chronic disease accounts for three-quarters of today's medical expenditures. Functional abdominal pain (FAP) syndrome and associated gastrointestinal symptoms affect 0.5% to 2% of North Americans. Persons with FAP routinely seek healthcare, with little resolution of symptoms, despite high costs. National reports advocate for innovative redesign of ambulatory care services. Cognitive-behavioral therapy (CBT) is a low-cost, effective self-management approach. The objective of this study was to implement a registered nurse-led CBT approach to enhance self-management and satisfaction with care for adults with functional gastrointestinal disorder (FGID). We conducted a pre- and postintervention group comparison study in an outpatient gastroenterology subspecialty clinic within a large medical center. Twelve patients (seen May to July 2015) received nurse-led education about the pain phenomenon and CBT techniques to self-manage pain and associated symptoms of FAP. Methods and effectiveness of CBT for promoting self-management of chronic pain symptoms were reviewed. Subsequently, we conducted a project that incorporated nurse-led CBT into standard practice. Pre- and post-CBT questionnaire data showed patients had improved symptoms, well-being, and satisfaction. Registered nurses practicing at the highest level of their scope of practice within ambulatory care service models can enhance care management by educating, coaching, and counseling to improve self-care for patients with FGID.

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