Date of Award

8-2020

Document Type

Thesis

Degree Name

Doctor of Nursing Practice (DNP)

Department

Nursing (Graduate)

First Advisor

Kristen Slabaugh

Abstract

Background: Many patients receive treatment for chronic pain from a primary care provider. There is a known relationship between sleep and pain perception, making sleep an important factor to assess in patients with chronic pain. Unlike in specialist pain management settings, sleep is not routinely assessed in the primary care setting, resulting in missed treatment opportunities and suboptimal chronic pain management. Objective: To assess the sleep quality of patients with chronic pain in the primary care setting through the use of the Pittsburgh Sleep Quality Index (PSQI) questionnaire during the patient intake process. Methods: Patients meeting inclusion criteria received a PSQI while waiting to see a provider at chronic care visits. The primary care provider was alerted to the result, and patients who were identified as having poor sleep quality scoring > 5 on the PSQI had the opportunity to receive further assessment and treatment from the provider. Results: Sample data scores revealed 77.7% (n = 7) of patients with chronic pain had global PSQI greater than 5, which is indicative of impaired sleep quality (M = 13, SD = 5.24). All patients (n = 9) received educational handouts from their providers concerning sleep hygiene. The number of patients with an insomnia diagnosis (n = 7) and the number of patients receiving prescribed medication for insomnia (n = 2) did not change after the screening implementation. Conclusion: Implementation of a sleep assessment tool such as the PSQI did not support the increased identification of an insomnia diagnosis or increased management of insomnia with medication in the primary care setting.

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