Pain is a critical health problem, with over half of Americans suffering from chronic or recurrent pain. Many patients also experience comorbid depression. Although numerous self-management interventions have been implemented in an effort to improve pain outcomes, little attention has been devoted to the role of the provider of these services, typically a nurse care manager (NCM). Given the robust literature pointing to a link between physician-patient communication and patient outcomes, NCM-patient communication merits closer examination. Matthias and colleagues reported chronic pain patients' perceptions of the communication with NCMs in a pain self-management trial and patients' perceptions of the communication they experienced in primary care. Eighteen patients suffering from chronic musculoskeletal pain and depression participated in four focus groups designed to ascertain their perceptions of the intervention. A key emergent theme from these focus groups was the contrast in patients' perceptions of the communication with their primary care physicians versus with the NCMs. Patients reported feeling supported, encouraged, and listened to by their NCMs, whereas they tended to be dissatisfied with their primary care physicians, citing issues such as lack of continuity of care, poor listening skills, and under- or overprescribing of medication.

WHAT THE STUDY MAY MEAN TO YOU AS A HEALTH CARE PROVIDER: The results of this study underscore the importance of the NCM, particularly for patients with chronic conditions such as pain.

WHAT THE STUDY MAY MEAN TO YOU AS A PATIENT: The study showed that you are likely to communicate better with your nurse than with your physician. This trend could be altered through the teaching and performance of self-management skills. You should then be able to communicate equally with both nurses and other health care providers.

MS Matthias et al. Self-Management Support and Communication from Nurse Care Managers Compared with Primary Care Physicians: A Focus Group Study of Patients with Chronic Musculoskeletal Pain. Pain Management Nursing, 2010;11:26-34.