Development of the Change Implementation Strategies Model Regarding Evidence-Based Chronic Wound Pain Management

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Boonyapat Shatpattananunt
Wongchan Petpichetchian
Luppana Kitrungrote


Abstract: Chronic wound pain has not been well managed in many countries around the world. Development of a change implementation strategies model within healthcare contexts is worth constructing in order to reduce suffering and to improve the quality of the life of patients with varying health problems, including chronic wound pain. This study’s purpose was to develop an evidence-based change implementation strategies model for nursing Thai patients with chronic wound pain. A mutual collaborative action research approach was employed with 20 nurses at a tertiary hospital in a northern region of Thailand who were involved in the change process guided by the Lewin’s Planned Change Model. This is a 3-step model of change consisting of unfreezing, moving, and refreezing. The Wound Pain Management Model involving chronic wound pain assessment and management, also supplied important content during the change process. The research process included two phases, firstly preparation, which explored the field and developed a tentative model, and secondly, the use of mutual collaborative action research which resulted in the refinement of the model to become the CLEVER Model.

Twelve strategies evolved during the study, and were executed in order for unfreezing, moving, and refreezing towards the change implementation of evidence-based chronic wound pain management. The acronym “CLEVER” represents the following factors that contributed to successful implementation of the Model: C-Context and Culture, L-Leader, E-Effective driving change, V-Voice, E-Empowerment, and R-Re-audit. The CLEVER Model was found to be beneficial in practice, and can be used to guide changing other evidence-based practices in nursing. However, it requires testing with other populations in Thailand.

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How to Cite
Shatpattananunt B, Petpichetchian W, Kitrungrote L. Development of the Change Implementation Strategies Model Regarding Evidence-Based Chronic Wound Pain Management. PRIJNR [Internet]. 2015 Nov. 18 [cited 2022 Oct. 5];19(4):359-72. Available from:
Original paper
Author Biography

Boonyapat Shatpattananunt, RN, PhD Candidate, Faculty of Nursing, Prince of Songkla University, Thailand



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