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Effectiveness of Hand Massage Combined with Analgesics on Pain Control in Patients with Terminal Cancer

진통제와 병용한 손 마사지가 말기 암환자의 암성통증 조절에 미치는 효과

  • Lee, Yunmi (National Health Insurance Service Ilsan Hospital) ;
  • Yoon, Hosoon (National Health Insurance Service Ilsan Hospital) ;
  • Lee, Sungwoon (National Health Insurance Service Ilsan Hospital) ;
  • Kim, Young Mi (National Health Insurance Service Ilsan Hospital)
  • 이윤미 (국민건강보험 일산병원) ;
  • 윤호순 (국민건강보험 일산병원) ;
  • 이성운 (국민건강보험 일산병원) ;
  • 김영미 (국민건강보험 일산병원)
  • Received : 2016.02.16
  • Accepted : 2016.11.19
  • Published : 2016.12.01

Abstract

Purpose: This study examined the effectiveness of a hand massage combined with analgesics on pain control in hospice patients with terminal cancer. Methods: This study is a quasi-experimental study with a single group time series design. The study included 25 terminal cancer patients who were admitted to a hospice ward. Each patient's pain level was measured after analgesics use only (control group). When patients complained of pain again, the pain level was assessed after administering a combination of hand massage and analgesics (experimental group). As for the experimental treatment, the participants were provided with oil hand massage on each hand for 5 minutes. Results: The experimental group and the control group showed no significant differences in the changes of pain score (F=0.74, P=0.3939). Conclusion: Although the pain level of the experimental group did not significantly improve compared with the control group, their pain levels tended to be low to begin with. Thus, a complementary utility value of hand massage cannot be completely excluded in terminal cancer patients. Since the pain level significantly changed according to the dosage of analgesic, nurses need more education and research on analgesic drug therapy for terminal cancer patients.

목적: 호스피스 완화의료 병동에 입원한 말기 암환자가 통증을 호소할 때 진통제만 투여한 경우와 손 마사지를 병행했을 경우 통증감소의 효과를 비교한다. 방법: 단일군 시계열 설계 유사실험 연구로서 호스피스 완화의료병동에 입원한 25명의 환자를 대상으로 통증을 호소할 때 진통제를 투여하고 5분, 10분, 20분, 2시간 후에 각각 통증 점수를 측정하였고, 동일한 대상자가 다시 통증을 호소할 때, 진통제를 투여한 후 손 마사지를 병행하여 동일한 방식으로 통증점수를 측정하였다. 결과: 진통제만 투여한 군과 진통제를 투여한 후 손 마사지를 병행한 군간의 통증정도는 유의한 차이가 없었다. 그러나 두군 모두 시간이 흐름에 따라 통증정도가 유의하게 감소하였다. 결론: 손 마사지를 시행한 실험군이 대조군보다 통계적으로 유의하지는 않으나 통증정도가 낮은 경향이 있으므로 말기 암환자에게 손 마사지의 보완적 활용가치를 완전히 배제할 수는 없으며, 진통제 사용량에 따른 통증의 차이도 확인 되었으므로 간호사들은 말기 암환자를 위한 진통제 약물요법에 대하여 더 많은 교육과 연구가 요구된다.

Keywords

References

  1. Ministry of Health & Welfare. Cancer Pain Management Guideline. 4th ed. [Internet]. Sejong:Ministry of Health & Welfare;2010. [cited 2016 Apr]. Available from: http://www.cancer.go.kr/2010/05/27/Cancer_Pain_management_guideline(Dr).PDF.
  2. KSHPC [Internet]. Seoul: Korean Society for Hospice and Palliative; 2001 [cited 2016 Nov 16]. Available from http://www.hospicecare.or.kr.
  3. Gordon DB, Dahl J, Phillips P, Frandsen J, Cowley C, Foster RL, et al. The use of "as-needed" range orders for opioid analgesics in the management of acute pain: a consensus statement of the American Society for Pain Management Nursing and the American Pain Society. Pain Manag Nurs 2004;5:53-8. https://doi.org/10.1016/j.pmn.2004.04.001
  4. American Pain Society. Principles of analgesic use in the treatment of acute pain and cancer pain. 6th ed. Glenview, IL:American Pain Society;2008.
  5. Lee WH. Total pain of patient with terminal cancer. Korean J Hosp Palliat Care 2000;3:60-73.
  6. Chang SY. Effects of aroma hand massage on pain, state anxiety and depression in hospice patients with terminal cancer. J Korean Acad Nurs 2008;38:493-502. https://doi.org/10.4040/jkan.2008.38.4.493
  7. Choi SY. Pain management and pain knowledge of nurses. Asian Oncology Nursing 2004;4:82-90.
  8. Lee HS, Park SH, Chung YS, Lee BY, Kwon SH. Evaluation of a community-based cancer patient management program: collaboration between a hospice center and Public health centers. Korean J Hosp Palliat Care 2010;13:216-24.
  9. Kim HK, Lee HS, Hwang KH, Yoo YS, Lee SM. Positive and negative determinants for pain management in both cancer patients and their nurses. J Korean Acad Fundament Nurs 2006;13:68-75.
  10. Christiaens G. Independent nursing interventions for pain management. Home Health Care Manage Pract 2003;15:212-4. https://doi.org/10.1177/1084822302250688
  11. Chang SB, Chu SH, Kim YI, Yun SH. The effects of aroma inhalation on sleep and fatigue in night shift nurses. Korean J Adult Nurs 2008;20:941-9.
  12. Oh JJ. The effect of hand-massage on the relaxation of dementia patients. J Korean Acad Nurs 2000;30:825-35. https://doi.org/10.4040/jkan.2000.30.4.825
  13. MacKenzie M, Zed PJ, Ensom MH. Opioid pharmacokineticspharmacodynamics:clinical implications in acute pain management in trauma. Ann Pharmacother 2016;50:209-18. https://doi.org/10.1177/1060028015625659
  14. UpToDate: Hydromorphone: Drug information [Internet]. Waltham, MA : UpToDate, Inc.; c2016. [cited 2016 Apr 12]. Available from: http://www.uptodate.com/contents/hydromorphone-druginformation?source=search_result&search=hydromorphone+drug+information&selectedTitle=1%7E115.
  15. Cho KS. The effect of a hand massage program on anxiety and immune function in clients with cataract surgery under local anesthesia. J Korean Acad Nurs 1999;29:97-106. https://doi.org/10.4040/jkan.1999.29.1.97
  16. Oh HJ, Park JS. Effects of hand massage and hand holding on the anxiety in patients with local infiltration anesthesia. J Korean Acad Nurs 2004;34:924-33. https://doi.org/10.4040/jkan.2004.34.6.924
  17. Kim MJ, Nam ES, Paik SI. The effect of aromatherapy on pain, depression, and life satisfaction of arthritis patients. J Korean Acad Nurs 2005;35:186-94. https://doi.org/10.4040/jkan.2005.35.1.186
  18. Sung MH, Lee SA, Sim JS. The effects of aromatherapy hands massage on the preoperative anxiety of stomach cancer patients. Korean J Adult Nurs 2006;18:709-17.
  19. Wilkinson SM, Love SB, Westcombe AM, Gambles MA, Burgess CC, Cargill A, et al. Effectiveness of aromatherapy massage in the management of anxiety and depression in patients with cancer: a multicenter randomized controlled trial. J Clin Oncol 2007;25:532-9. https://doi.org/10.1200/JCO.2006.08.9987
  20. Lee E, Kim KS. The effects of aroma hand massage on anxiety and sleep in cancer patients during hospitalization. Perspect Nurs Sci 2011;8:42-53.
  21. Min YC, Oh PJ. A meta-analysis of intervention studies on cancer pain. J Korean Oncol Nurs 2011;11:83-92. https://doi.org/10.5388/jkon.2011.11.1.83
  22. Jo KH, Park AR, Lee JJ. Effects of integrated palliative care intervention on quality of life in terminal cancer patients : A meta-analysis. Korean J Hosp Palliat Care 2015;18:136-47. https://doi.org/10.14475/kjhpc.2015.18.2.136
  23. Kong BH. Merleau-ponty's phenomenology of body and the experience of illness in nursing. Res Philosop Phenomenol 2009;40:57-81.
  24. Kim YJ, Chung SH, Suh IS. The effect of hand massage on discomfort in patients following percutaneous coronary intervention. Korean J Adult Nurs 2008;20:452-60.