Development of pain management model for end stage of cancer patients Yangsisurach district, Mahasarakham province.

Abstract

     The objective of this action research was to study the development and evaluation of a pain management model for terminal cancer patients in Yangsisurach District from September 2022 to October 2023. There were 2 groups of participants: 1) The group that jointly developed the model, consisting of a multidisciplinary team in the hospital/subdistrict health promotion hospital, village health volunteers, and CG in the community, totaling 43 people; 2) 20 terminal cancer patients and their families. The research steps studied the problems and situations from reviewing the incidence, brainstorming, reviewing medical records, and observing care. After that, the data was analyzed to lead to the development of the model, which was used for improvement in the cycle, and evaluation. The research instruments included a pain level assessment form, a home visit record form by a multidisciplinary team, a nursing practice observation form, and a patient and relative satisfaction assessment form, which was adapted from the nursing office's assessment form. Qualitative data analysis used content analysis. Quantitative data by number, mean, and percentage.
     Results of the study: A pain management model for terminal cancer patients Yangisurach District is P-A-I-N Model consisting of 1) Pain & Performance: Assessment of pain and ability to help both staff and family caregivers. There is a clear determination, monitoring and follow-up of pain assessment guidelines. 2) Assurance of guidelines: There are guidelines, pain management manuals. 3) Information & Communication: Recording pain score data, effective communication, developing a link for pain assessment, having PCWN between agencies and home caregivers to link data and short clips of medication administration. 4) Net Work: Strong network with participation of multidisciplinary teams and caregivers in the community. It was found that the pain score of terminal cancer patients from severe level after receiving management for 48 hours was reduced by 50 percent, and patients and families were highly satisfied with pain management (Mean = 4.50, SD 2.84). The community service network was satisfied with the assessment using the link to assess PPS score. Village health volunteers and CG had more skills and confidence in pain care.