Functional and Organizational Model of Prevention of Chronic Pain Associated with Combat Trauma

According to the numerous studies, chronic pain (CP) is not only an individual problem for the patient, but also a significant burden on healthcare systems. The study of the impact of demographic and clinical characteristics and military history factors on the development of CP after discharge from military service is of considerable interest. The objective: to highlight a functional and organizational model for the comprehensive prevention of CP associated with combat trauma based on the results of a study of CP problems in Ukraine. Materials and methods. The following methods were used in the study: bibliosemantic, structural-logical analysis, and descriptive modelling. The methodological basis of the study was a systematic approach and the results of a sociological survey conducted from March 19 to May 9, 2025, among military patients with injuries and limb amputations. Data collection was carried out using two methods: face-to-face interviews and self-administered questionnaires. The margin of error does not exceed 3.1% (excluding the design effect). A total of 1,015 respondents were surveyed. To assess the direction and strength of the relationship between quantitative and qualitative (ordinal) variables, non-parametric Spearman’s rank-order correlation coefficient (ρ) was used. The ρ coefficient ranges from –1 to +1, where values close to ± 1 indicate a strong monotonic relationship, and values close to 0 indicate its absence. The threshold value of the probability level of all calculated features was taken as α < 0.05 (p < 0.05) with an indication of the exact value of the confidence level p. Results. The article highlights the problems of CP not only of a medical nature, but also of a socio-economic issue. Taking into account innovative international practices in the prevention of CP in patients with combat trauma, the results of our own study of CP problems in Ukraine, we have developed a functional and organizational model of comprehensive prevention of CP in patients with combat trauma using a systems approach. The prerequisites for the development of the model were: untimely pain relief for patients after injury, failure to comply with the stages of pain relief therapy from the moment of injury to specialized treatment conditions, imperfect technologies of pain relief therapy in inpatient conditions and the lack of a systematic approach to the rehabilitation of patients at the stage of primary medical care. The intersectoral approach to the implementation of the specified measures of the model will contribute to improving the quality of life of war veterans. Conclusions. The developed functional and organizational model of comprehensive prevention of CP in patients with combat trauma allows to implement the effective measures for the prevention of CP associated with combat trauma. This is achieved through the political commitment of the state and the improvement of the regulatory and legal support of the proposed organizational and treatment technologies: timeliness, stages, adequacy of multimodal pain relief and rehabilitation using an intersectoral approach for patients with combat trauma.