Developing a Home ward care Model for Post-Appendectomy Pain Management during the first 72 hours at Detudom Crown Prince Hospital

Abstract

This research and development study aimed to develop and evaluate an innovative home-based patient care model (Home Ward) for uncomplicated acute appendicitis patients by integrating transitional care principles with digital health technology. The study employed a research and development approach conducted between June 2025 and January 2026, progressing through four phases. The sample consisted of patients diagnosed with uncomplicated acute appendicitis who had a primary caregiver. Participants were divided into an experimental group and a control group of 30 individuals each, totalling 60 participants. The instruments used included a pain assessment scale and a self-pain management ability assessment, both of which yielded a Content Validity Index (CVI) of 0.97. Additional tools comprised the DMS Home Ward application and a Line Official Account. Data were analysed using descriptive statistics and an Independent t-test, with a statistical significance level set at 0.05

The developed care model consisted of three core components: a pre-discharge readiness assessment, caregiver skills training covering wound cleansing, wound splinting, and NSAIDs administration, and continuous 72-hour symptom monitoring conducted via Line Official Account and the DMS Home Ward application by a multidisciplinary team. Evaluation findings revealed that the experimental group received more comprehensive self-care instructions than the control group. Regarding pain levels during the first 24 hours, the experimental group reported a higher mean pain score than the control group (M = 6.00, SD = 1.438 vs. M = 4.33, SD = 0.959; t = 5.281, p < 0.001), with similar trends observed at 48 and 72 hours. Nevertheless, the experimental group demonstrated superior pain management ability, particularly through wound splinting, which reduced pain in as many as 93.33% of cases. This model offers patients and their families a viable alternative for post-appendectomy home care that meets safety and quality standards comparable to in-hospital care. It enhances patients' capacity for self-pain management and self-care while simultaneously reducing financial burdens and travel demands on caregivers.