Chronic pain and coping: a proposed role for nurses and nursing models.
OBJECTIVE
Activity of living based nurse models such as that proposed by Roper, Logan and Tierney are utilized commonly to rationalize, structure and guide practice. This paper proposes that their use, in the context of chronic pain, should be extended to incorporate the assessment of coping and its effect on disability.


BACKGROUND
As coping has been found to account for some of the variance in adaptation to chronic pain, generic models of coping and their utility in this context are considered. The need for reliable and valid means to assess coping are of paramount importance as this will facilitate and inform treatment and management of chronic pain. At the present time coping is most generally assessed using self report instruments which primarily focus on the number and type of strategies used to cope rather than their effectiveness in reducing disability and increasing function.


RESULTS
A classification system which categorizes chronic pain patients in terms of how they function in daily life as either adaptive copers, interpersonally distressed or dysfunctional is outlined. The similarities between this and a routine nursing assessment based on an activities of living model are highlighted.


CONCLUSIONS
It is proposed that the innovative use of nursing activity of living models could provide the framework for a pain clinic based assessment of coping that has greater utility for professionals and patients alike.
Richardson
C
C
Research Fellow in Pain Management, Centre for Research in Health Care, School of Health and Human Sciences, Liverpool John Moores University, Liverpool, UK. c.d.richardson@livjm.ac.uk
Poole
H
H
D000203:Activities of Daily Living; D000223:Adaptation, Psychological; D002908:Chronic Disease; D006233:Persons with Disabilities / Q000523:psychology; D006801:Humans; D007587:Job Description; D016294:Models, Nursing; D008960:Models, Psychological; D009723:Nurse-Patient Relations; D009730:Nursing Assessment / Q000379:methods* / Q000592:standards; D015403:Nursing Evaluation Research; D010146:Pain / Q000451:nursing* / Q000523:psychology*; D015203:Reproducibility of Results; D012380:Role; D012803:Sick Role; D013315:Stress, Psychological / Q000451:nursing / Q000517:prevention & control / Q000523:psychology