Nursing Service Management Model for Enhancing Quality of Life and Safety of Patients in the Pain Clinic

Abstract

Purposes: To examine the, develop a nursing service management model, evaluate the effectiveness of the developed model and assess patient and nurse satisfaction with the developed nursing service model (IPNC-Model).

Study design: Research and Development (R&D).

Materials and Methods: This R&D study was conducted in three phases. Phase 1 involved studying the situation and analyzing problems through in-depth interviews with 10–15 chronic pain patients and 10–15 multidisciplinary healthcare providers. Phase 2 focused on model development and content validity verification by 5 experts. Phase 3 evaluated the model's effectiveness using a quasi-experimental design with 40 participants, divided into an experimental group (n=20) who received care under the developed IPNC-Model, and a control group (n=20) who received conventional nursing care. The instruments included the developed model (IPNC-Model), WHOQOL-BREF (Thai Version), a patient safety record form, and satisfaction questionnaires. The instruments yielded an IOC of 0.90–1.00 and a Cronbach's alpha coefficient of 0.90. Data were analyzed using descriptive statistics, independent t-test, paired t-test, and Fisher's Exact test.

Main findings: Situation analysis showed that the existing service did not comprehensively assess patients' emotional and psychological dimensions, lacked standardized assessment and clear communication guidelines, and had no systematic post-medication safety surveillance. Based on these findings, the developed model (IPNC-Model) consists of four main components: 1) holistic assessment, 2) pain management system, 3) safety surveillance, and 4) self-care promotion, with excellent content validity (S-CVI/Ave = 0.98). Post-intervention, the experimental group had significantly lower pain levels compared to the control group in maximum pain (p=.003), average pain (p=.009), and current pain (p=.013). The experimental group also scored significantly higher in the perception of nursing services and safety, self-care knowledge, and service satisfaction (p<.001). Zero safety incidents were reported in the experimental group. Regarding personnel satisfaction, nurses reported the highest level of satisfaction with the model (Mean = 24.12 out of 25, SD. = 0.99).

Conclusion and recommendations: The developed IPNC-Model is highly effective in reducing pain while enhancing patient safety, self-care knowledge, and satisfaction within the pain clinic. This model can serve as a prototype for the future development and standardization of nursing service systems.