Pain Clinics Operation Evaluation in Greek National Health System

Introduction: Palliative care is considered to be the active integrated (complete) care for people to address problems associated with life-threatening illness. Of particular importance are the control of pain, of other symptoms and of psychological, social and spiritual problems, with a focus on achieving the best possible quality of life for patients and their families. Aim: In the context of the project entitled: Development of a quality model in health education, self-care and rehabilitation of patients with, an evaluation of the quality of services provided by the staff of Pain Clinics (PC) in NHS hospitals, was done. Method: A census study was done, by sending 61 electronic questionnaires to respective Pain Clinics. Forty seven PC responded (77% response rate), of which 26 were in Athens / Thessaloniki and 21 in the Regions. The study took place in the time period of November and December months of 2011. The managers of the PC evaluated the quality of service with the use of 13 evaluation criteria, based on the conclusions of previous surveys of patients, in 5 degrees of Likert scale. The reliability test was performed by the Cronbach method and Alpha coefficient was calculated at 0.902. Results: The multi-factorial analysis of 13 quality criteria showed 3 main factors: a) Care Support, b) Patient Empowerment and c) Psychological Support. Excellent ratings were given to courtesy (75%), understanding (71.1%) and the instructions for taking medications (68.9%). To a smaller percentage, excellent ratings were given to psychological family support (26.7%), empowering of the patient in the management of physical health problems (22.2%), psychosocial health (20%) and the time for the completion of the relevant administrative procedures (20.5%). The managers of the PC recognize the importance of all the 8 methods of work that were proposed to them, most notably the following: 24 state the evaluation of patient satisfaction (57.1%), 21 the setting of targets for the provided services (51 2%) and 20 the implementation of certified procedures (48.8%). Finally it was found that certified procedures are being implemented in only one PC in the Regions, whereas in urban areas 7 PC (p ≤ 0.05) apply them. Conclusions: Although the contribution of the Pain Clinics to the services provided by the National Health System is extremely important, there is a need for multidisciplinary holistic approach to the problems of patients in the dimensions of physical, mental and social health, and developing networks with Primary Health Care services.