Dissertation
Influence of motivation on successful opioid-tapering outcomes among individuals living with chronic pain: A Grounded Theory Study
University of Iowa
Doctor of Philosophy (PhD), University of Iowa
Summer 2020
DOI: 10.17077/etd.005585
Abstract
The purpose of this grounded theory study was to explore how motivation influenced successful opioid-tapering outcomes among individuals living with chronic pain. This study was informed by Ryan and Deci’s (2017) self-determination theory (SDT). Participants (N = 11) ranged in age from 22 to 74 years, and educational attainment ranged from some college to doctoral degrees. Based on the results of this study, the Motivational Outcomes Model (MOM) was developed. The MOM includes opioid-tapering decisions (i.e., self-initiated, shared, ambivalent); motivational process goals (i.e., attainment, avoidant, ambivalent); and perceptual opioid- tapering outcomes including successful (n = 7), successful-ambivalent (n = 3), and unsuccessful (n = 1). The emergent MOM was aligned with components of the SDT framework that informed the study in the following ways. Attainment goals (MOM) are comparable to intrinsic motivation (SDT), avoidant goals (MOM) are comparable to extrinsic motivation (SDT), and ambivalent goals (MOM) are comparable to amotivation (SDT). Results revealed that the participants used both attainment goals and avoidant goals to pursue successful outcomes. Ambivalent goals, although initially directionless, can also result in successful opioid-tapering outcomes. Notably, even though most participants used both attainment and avoidant goals, individuals who self-initiated their opioid-tapering decisions were motivated mostly through an internal or integrated perceived locus of causality. An intrinsic or integrated perceived locus of causality is comparable to intrinsic motivation because the individual holistically considers all factors and regulates decisions/goals from an internally aligned (autonomous) disposition. The MOM does not imply causality but demonstrates the complexities of achieving successful outcomes in opioid tapering. Implications and recommendations include expanding nonpharmacologic alternatives, developing interdisciplinary pain management care teams, and conducting thorough evaluations.
The purpose of this grounded theory study was to explore how motivation influenced successful opioid-tapering outcomes among individuals living with chronic pain. This study was informed by Ryan and Deci’s (2017) self-determination theory (SDT). Participants (N = 11) ranged in age from 22 to 74 years, and educational attainment ranged from some college to doctoral degrees. Based on the results of this study, the Motivational Outcomes Model (MOM) was developed. The MOM includes opioid-tapering decisions (i.e., self-initiated, shared, ambivalent); motivational process goals (i.e., attainment, avoidant, ambivalent); and perceptual opioid- tapering outcomes including successful (n = 7), successful-ambivalent (n = 3), and unsuccessful (n = 1). The emergent MOM was aligned with components of the SDT framework that informed the study in the following ways. Attainment goals (MOM) are comparable to intrinsic motivation (SDT), avoidant goals (MOM) are comparable to extrinsic motivation (SDT), and ambivalent goals (MOM) are comparable to amotivation (SDT). Results revealed that the participants used both attainment goals and avoidant goals to pursue successful outcomes. Ambivalent goals, although initially directionless, can also result in successful opioid-tapering outcomes. Notably, even though most participants used both attainment and avoidant goals, individuals who self-initiated their opioid-tapering decisions were motivated mostly through an internal or integrated perceived locus of causality. An intrinsic or integrated perceived locus of causality is comparable to intrinsic motivation because the individual holistically considers all factors and regulates decisions/goals from an internally aligned (autonomous) disposition. The MOM does not imply causality but demonstrates the complexities of achieving successful outcomes in opioid tapering. Implications and recommendations include expanding nonpharmacologic alternatives, developing interdisciplinary pain management care teams, and conducting thorough evaluations.
Keywords: chronic pain, opioid taperings, opioid use disorder, success, motivation, goals
Details
- Title: Subtitle
- Influence of motivation on successful opioid-tapering outcomes among individuals living with chronic pain: A Grounded Theory Study
- Creators
- Shamire J. Rothmiller
- Contributors
- John S. Wadsworth (Advisor)Jennifer Sanchez (Advisor)Katherine Hadlandsmyth (Committee Member)Noel Hernandez-Estrada (Committee Member)Ebonee Johnson (Committee Member)Heather Reisinger (Committee Member)
- Resource Type
- Dissertation
- Degree Awarded
- Doctor of Philosophy (PhD), University of Iowa
- Degree in
- Rehabilitation and Counselor Education
- Date degree season
- Summer 2020
- DOI
- 10.17077/etd.005585
- Publisher
- University of Iowa
- Number of pages
- xiv, 181 pages
- Copyright
- Copyright 2020 Shamire J. Rothmiller
- Language
- English
- Description illustrations
- color illustrations
- Description bibliographic
- Includes bibliographical references (page 141-159).
- Public Abstract (ETD)
The purpose of this grounded theory study was to explore how motivation influenced successful opioid-tapering outcomes among individuals living with chronic pain. This study was informed by Ryan and Deci’s (2017) self-determination theory (SDT). Participants (N = 11) ranged in age ranged from 22 to 74 years, and educational attainment ranged from some college to doctoral degrees. Based on the results of this study, the Motivational Outcomes Model (MOM) was developed. The MOM includes opioid-tapering decisions (i.e., self-initiated, shared, ambivalent); motivational process goals (i.e. attainment, avoidant, ambivalent); and perceptual opioid-tapering outcomes, including successful (n = 7), successful-ambivalent (n = 3), and unsuccessful (n = 1). The emergent MOM was aligned with components of the SDT framework that informed the study in the following ways. Attainment goals (MOM) are comparable to intrinsic motivation (SDT), avoidant goals (MOM) are comparable to extrinsic motivation (SDT), and ambivalent goals (MOM) are comparable to amotivation (SDT). Results revealed that the participants used both attainment goals and avoidant goals to pursue successful outcomes. Ambivalent goals, although initially directionless, can also result in successful opioid-tapering outcomes. Notably, even though most participants used both attainment and avoidant goals, individuals who self-initiated their opioid-tapering decisions were motivated mostly through an internal or integrated perceived locus of causality. An internal or integrated perceived of locus of causality is comparable to intrinsic motivation because the individual holistically considers all factors and regulates decisions/goals from an internally aligned (autonomous) disposition. The MOM does not imply causality but demonstrates the complexities of achieving successful outcomes in opioid tapering. Implications and recommendations include expanding
- Academic Unit
- Counselor Education
- Record Identifier
- 9983987896402771
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