Unleashing the Potential of Primary Care Nurses in Chronic Pain Management: A Delphi Study to Identify Priority...

Chronic pain (CP) is a major cause of global disability, with patients often reporting inadequate access to primary care. Relevant primary care nursing activities for CP management are poorly defined, limiting the effective use of nurses' competencies in managing chronic diseases. This study aimed to identify and prioritize nursing activities for CP management. A three-round Delphi study was conducted among primary care nurses and individuals experiencing pain for over 3 months in Québec, Canada. In the first round, participants identified important nursing activities for CP management through open-ended questions. In the following two rounds, these activities were rated for importance using a 9-point Likert scale. Activities rated 7, 8, or 9 by ≥75% of participants were considered priority activities. A total of 48 nurses and 122 patients participated (n = 170) in the process. From 47 nursing activities derived from 1,167 narrative suggestions in the first round, 41 were prioritized by ≥75% of participants in the final round. These activities were categorized into four domains: global assessment (n = 15, 36.6% of all activities), care management (n = 10, 24.4%), health promotion (n = 7, 17.1%), and interprofessional collaboration (n = 9, 22.0%). The top three activities were: assessing dimensions of pain experience, screening for mood disorder symptoms, and establishing a therapeutic alliance with an empathic approach. Nurses and persons with lived experience identified a shared set of nursing activities for management of CP, aligning with usual care practices for chronic disease patients. These findings could inform clinical guidance on CP management and enhance the role of nurses in primary care settings.