Marie O'Brien - Academia.edu (original) (raw)

Papers by Marie O'Brien

Research paper thumbnail of Trance-forming Pain: The Power of Hypnotic Relief

Pain Management Nursing, Apr 1, 2022

Research paper thumbnail of Pain Coping Skills Training: A Nurse Practitioner Delivered Telehealth Intervention to Enhance Self-Efficacy

Pain Management Nursing, Apr 1, 2022

Research paper thumbnail of Pain coping skills training un-locks patient-centered pain care during the COVID- 19 lockdown

Pain Management Nursing, 2021

Background: In 2020, the COVID-19 virus sparked a crisis constituting a nationwide public health ... more Background: In 2020, the COVID-19 virus sparked a crisis constituting a nationwide public health emergency that rapidly altered the provision of healthcare services for all Americans. Infectious disease mitigation led to widespread lockdowns of perceived nonessential services, programs, and non-emergent healthcare interventions. This lockdown exacerbated the public health dyad of uncontrolled pain and the opioid epidemic, which was already in a crisis state. Current literature supports the management of uncontrolled pain with a biopsychosocial approach, empowering patients to explore self-care to enhance activities of daily living. Pain Coping Skills Training (PCST) delivers real-life strategies that improve quality of life and strengthen self-efficacy. Self-efficacy has been identified as a patient outcome measure that demonstrates improved patient-perceived function and quality of life despite pain intensity. Studies have shown that nurse practitioners (APRN) are well-positioned to provide PCST to chronic pain sufferers. Methods: A pretest-posttest design was utilized for this project to enhance pain self-efficacy through an APRN-led community-based intervention. Intervention: Community-dwelling adults treated in a specialty pain management practice were selfselected to participate in a 6-week telehealth delivered PCST Program. This APRN delivered program presented basic pain education and a broad range of evidence-based nonpharmacologic pain management self-care tools. The primary outcome was improved Pain Self-efficacy measured with the pain self-efficacy questionnaire (PSEQ), with secondary outcomes of improved perceived pain intensity and function measured with the pain, enjoyment, and general activity (PEG) scale tracked weekly. Results: Baseline PSEQ and weekly PEG scores were obtained and compared to scores after the program. Collateral data points included confidence in using complementary and alternative nonpharmacologic interventions, satisfaction with the program, and a qualitative patient statement regarding pre-and postintervention participation. Conclusions: This project concluded that a Nurse Practitioner delivered PCST program via telehealth technology could provide community-dwelling adults with an intervention that improves pain self-efficacy, enhances self-reported PEG measures, and meets the social distancing requirements that continue to impact patients during the COVID-19 pandemic.

Research paper thumbnail of Expanding access to nurse-managed medication for opioid use disorder

Nursing Outlook, 2021

BACKGROUND Advanced practice registered nurses (APRNs) are increasingly caring for individuals wi... more BACKGROUND Advanced practice registered nurses (APRNs) are increasingly caring for individuals with opioid use disorder. Advances have been made to increase APRN education, outreach, and prescribing privileges, but as demand for medication for opioid use disorder (MOUD) grows, evidence suggests that policy and care barriers inhibit the ability of APRNs to support MOUD. PURPOSE This paper highlights the significant challenges of expanding access to buprenorphine prescribing by APRNs. RESULTS Barriers and recommendations were derived from the culmination of literature review, expert consensus discussions among a diverse stakeholder panel including patient representatives, and feedback from community webinars with care providers. DISCUSSION We provide an overview of existing care barriers, promising practices, and proposed recommendations to enhance the care of individuals and communities with opioid use disorder.

Research paper thumbnail of Validation of the Critical-Care Pain Observation Tool in Adult Critically Ill Patients

Dimensions of Critical Care Nursing, 2014

Effective management of pain begins with accurate assessment of its presence and severity, which ... more Effective management of pain begins with accurate assessment of its presence and severity, which is difficult in critically ill patients. The Critical-Care Pain Observation Tool (CPOT) was developed to evaluate behaviors associated with pain and validated primarily with cardiac surgical patients. The purpose of this study was to examine reliability and validity of the CPOT in a general population of adult, critically ill patients. Using a sample of 75 patients from critical care units of a community hospital, pain was evaluated at 3 times (prerepositioning, during repositioning, and postrepositioning) by 2 evaluators, using 3 different pain scales: CPOT; Faces, Legs, Activity, Cry, and Consolability (FLACC) scale; and Pain Intensity Numeric Rating Scale. Results indicated that reliability and validity of the CPOT were acceptable. Interrater reliability was supported by strong intraclass correlations (ranging from 0.74 to 0.91). For criterion-related validity, significant associations were found between CPOT scores and both FLACC (0.87-0.92) and Pain Intensity Numeric Rating Scale (0.50-0.69) scores. Discriminant validity was supported by significantly higher scores during repositioning (mean, 1.85) versus at rest (pre mean, 0.60; post mean, 0.65). The CPOT is an acceptable behavioral pain assessment scale for use in the general critical care patient population and is more appropriate for use with adults than the FLACC.

Research paper thumbnail of Trance-forming Pain: The Power of Hypnotic Relief

Pain Management Nursing, Apr 1, 2022

Research paper thumbnail of Pain Coping Skills Training: A Nurse Practitioner Delivered Telehealth Intervention to Enhance Self-Efficacy

Pain Management Nursing, Apr 1, 2022

Research paper thumbnail of Pain coping skills training un-locks patient-centered pain care during the COVID- 19 lockdown

Pain Management Nursing, 2021

Background: In 2020, the COVID-19 virus sparked a crisis constituting a nationwide public health ... more Background: In 2020, the COVID-19 virus sparked a crisis constituting a nationwide public health emergency that rapidly altered the provision of healthcare services for all Americans. Infectious disease mitigation led to widespread lockdowns of perceived nonessential services, programs, and non-emergent healthcare interventions. This lockdown exacerbated the public health dyad of uncontrolled pain and the opioid epidemic, which was already in a crisis state. Current literature supports the management of uncontrolled pain with a biopsychosocial approach, empowering patients to explore self-care to enhance activities of daily living. Pain Coping Skills Training (PCST) delivers real-life strategies that improve quality of life and strengthen self-efficacy. Self-efficacy has been identified as a patient outcome measure that demonstrates improved patient-perceived function and quality of life despite pain intensity. Studies have shown that nurse practitioners (APRN) are well-positioned to provide PCST to chronic pain sufferers. Methods: A pretest-posttest design was utilized for this project to enhance pain self-efficacy through an APRN-led community-based intervention. Intervention: Community-dwelling adults treated in a specialty pain management practice were selfselected to participate in a 6-week telehealth delivered PCST Program. This APRN delivered program presented basic pain education and a broad range of evidence-based nonpharmacologic pain management self-care tools. The primary outcome was improved Pain Self-efficacy measured with the pain self-efficacy questionnaire (PSEQ), with secondary outcomes of improved perceived pain intensity and function measured with the pain, enjoyment, and general activity (PEG) scale tracked weekly. Results: Baseline PSEQ and weekly PEG scores were obtained and compared to scores after the program. Collateral data points included confidence in using complementary and alternative nonpharmacologic interventions, satisfaction with the program, and a qualitative patient statement regarding pre-and postintervention participation. Conclusions: This project concluded that a Nurse Practitioner delivered PCST program via telehealth technology could provide community-dwelling adults with an intervention that improves pain self-efficacy, enhances self-reported PEG measures, and meets the social distancing requirements that continue to impact patients during the COVID-19 pandemic.

Research paper thumbnail of Expanding access to nurse-managed medication for opioid use disorder

Nursing Outlook, 2021

BACKGROUND Advanced practice registered nurses (APRNs) are increasingly caring for individuals wi... more BACKGROUND Advanced practice registered nurses (APRNs) are increasingly caring for individuals with opioid use disorder. Advances have been made to increase APRN education, outreach, and prescribing privileges, but as demand for medication for opioid use disorder (MOUD) grows, evidence suggests that policy and care barriers inhibit the ability of APRNs to support MOUD. PURPOSE This paper highlights the significant challenges of expanding access to buprenorphine prescribing by APRNs. RESULTS Barriers and recommendations were derived from the culmination of literature review, expert consensus discussions among a diverse stakeholder panel including patient representatives, and feedback from community webinars with care providers. DISCUSSION We provide an overview of existing care barriers, promising practices, and proposed recommendations to enhance the care of individuals and communities with opioid use disorder.

Research paper thumbnail of Validation of the Critical-Care Pain Observation Tool in Adult Critically Ill Patients

Dimensions of Critical Care Nursing, 2014

Effective management of pain begins with accurate assessment of its presence and severity, which ... more Effective management of pain begins with accurate assessment of its presence and severity, which is difficult in critically ill patients. The Critical-Care Pain Observation Tool (CPOT) was developed to evaluate behaviors associated with pain and validated primarily with cardiac surgical patients. The purpose of this study was to examine reliability and validity of the CPOT in a general population of adult, critically ill patients. Using a sample of 75 patients from critical care units of a community hospital, pain was evaluated at 3 times (prerepositioning, during repositioning, and postrepositioning) by 2 evaluators, using 3 different pain scales: CPOT; Faces, Legs, Activity, Cry, and Consolability (FLACC) scale; and Pain Intensity Numeric Rating Scale. Results indicated that reliability and validity of the CPOT were acceptable. Interrater reliability was supported by strong intraclass correlations (ranging from 0.74 to 0.91). For criterion-related validity, significant associations were found between CPOT scores and both FLACC (0.87-0.92) and Pain Intensity Numeric Rating Scale (0.50-0.69) scores. Discriminant validity was supported by significantly higher scores during repositioning (mean, 1.85) versus at rest (pre mean, 0.60; post mean, 0.65). The CPOT is an acceptable behavioral pain assessment scale for use in the general critical care patient population and is more appropriate for use with adults than the FLACC.