• Title/Summary/Keyword: 암성통증

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Factors Affecting Nurses' Pain Management for Cancer Patients: Personal and Hospital Institution Aspects (간호사의 암성 통증관리 수행정도와 관련요인: 개인 및 병원 기관 요인)

  • Song, Ho Jung;Kim, Gwang Suk
    • Journal of Korean Clinical Nursing Research
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    • v.16 no.3
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    • pp.25-37
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    • 2010
  • Purpose: The purpose of this study was to examine potential factors related to the management of cancer pain, that is, hospital institutional factors as well as personal aspects of nurses. Methods: This study was a descriptive research study in which 229 RNs working in 2 tertiary medical institutions in Seoul and 4 secondary medical institutions in Seoul, Incheon and Gyeonggi were surveyed. Results: It was found that nurses' knowledge about pain intervention, their working division and their knowledge about the use of analgesics had different effects on their pharmacologic interventions. These 3 variables explained 14.5% of the variance regarding pharmacologic interventions. On the other hand, nurses' knowledge about pain interventions and nursing organization were variables affecting non-pharmacologic interventions by the nurses. These two variables explained 22.1% of the variance regarding non-pharmacologic interventions by the nurses. Conclusion: The findings indicate that nursing organization, one of hospital institutional factors, had significant effects on non-pharmacologic interventions. Therefore, to increase effective pain management by nurses, an organizational system should be established such as placement of nurse practitioners, improvement of nurses' autonomy in pain management, and development and distribution of standardized guidelines.

Totally Implanted Port System for Terminal Cancer Pain; Problems and Complications (말기 암성통증을 위한 Totally Implanted Port System; 문제점과 합병증)

  • Hong, Kee-Hyek
    • The Korean Journal of Pain
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    • v.5 no.1
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    • pp.23-28
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    • 1992
  • The use of epidural narcotics to treat cancer pain was first described by Behar et al in 1979. More recently, a variety of implantable INDSs have been described for long-term intraspinal narcotic administration. Especially, among these systems INDS typeIII which is designed by Poletti et al is relatively low cost and less risk of infection, therefore this system has been widely accepted but the clinical experience is insufficient yet. 1, Problems, 1) thorough education of patients and care-givers about this system the method of drug delivery and the situations could be happen in using this system. 2) high cost of continuous drug delivery system 3) legal problems about morphine carry-out in the case of bolus infusion by syringe 1. Complications; 1) by morphine; Significant respiratory depression was not found in all 21cases. other morphine-related complications were occurred occasionally but improved within a few days by appropriate treatment. 2) by system, Blockage or leakage of catheter was occurred in 2cases and wound infection was occurred in 2cases and so reimplantation was done.

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Neurolytic Splanchnic Nerve Block for the Treatment of Upper Abdominal Pain (상복부 암성통증 환자관리에 있어서 내장신경통 차단술의 임상적 고찰)

  • Yoon, Young-Joon;Jin, Sang-Ho
    • The Korean Journal of Pain
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    • v.2 no.2
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    • pp.181-188
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    • 1989
  • Neurolytic splanchnic nerve block is an effective method for the relief of pain of upper abdominal cancer. Nine cases of intractable upper abdominal cancer pain were treated by splanchnic nerve block with absolute alcohol (25 ml) at the pain clinic of Kangdong Sacred Heart Hospital, Hallym University, during a 19 month period from March, 1988 to September, 1989. The group included six patients with stomach cancer, two patients with pancreatic cancer, and one patient with hepatobiliary cancer. We used fluoroscopy in all cases of alcohol spianchnic nerve block to determine both, the position of the needle tip, and the spread of the neurolytic solution. Of the 9 patients, 6 patients had excellent pain relief, and 3 patients who had combined upper abdominal and lower back pain had relieved upper abdominal pain only, but remaining lower back pain. Of the 9 patients', 5 patients had excellent pain relief through the patients remaining life (1-2 months) in which follow up was possible.

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The Celiac Plexus Block and the Lumbar Sympathetic Ganglion block for the Upper and Lower Abdominal Cancer Pain -7 cases- (상하복부 암성통증에 대한 복강신경총 및 요부교감신경절 차단 -7예 보고-)

  • Gill, Hyun-Jue;Yoon, Duck-Mi;Oh, Hung-Kun;Ree, Ye-Chul
    • The Korean Journal of Pain
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    • v.1 no.2
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    • pp.171-176
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    • 1988
  • It is well known that the celiac plexus block is specially useful for relieve intractable upper abdominal pain caused by upper abdominal visceral malignancy or upper abdominal metastasis from distant organs. But in cases of lower abdominal or pelvic metastasis from upper abdominal malignancy, the lower abdominal intractable pain is remained after the successful celiac plexus block. We have reported 7 cases of celiac plexus block combined with lumbar sympathetic ganglion block, among the 305 cases of the celiac plexus block from 1968 to Nov. 1987, performed in patients with lower abdominal or back pain due to carcinomatosis of lower abdominal metastatic malignancy, that their results were excellent for pain relief.

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Intraspinal Neurolytic Block for the Treatment of Cancer Pain (암성통증에 대한 척추내 신경 파괴제요법)

  • Choe, Huhn;Choe, Hyun-Kyu;Kim, Dong-Chan;Han, Young-Jin
    • The Korean Journal of Pain
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    • v.4 no.1
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    • pp.31-36
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    • 1991
  • Intraspinal alcohol or phenol administration has been used for the treatment of intractable pain due to terminal cancer. It has been alleged to produce good pain relief with minimal complication if performed carefully. We analysed 35 patients who received epidural or subarachnoid neurolytic block out of 83 patients with malignancy who were referrecl to our pain clinic. Most of the patients needed additional treatment modalities including epidural catheterization or systemic narcotic administration. The incidence of complication was high, especially when the neurolytic agents were administered in the lumbar region. This suggest that intraspinal neurolytic block is unreliable and unsafe, although it may temporarily reduce the analgesic requirement.

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Effects of a Tailored Education and Coaching Program to Enhance Care of Cancer-related Pain (맞춤형 암성통증관리 개별교육 및 코칭의 효과)

  • Kim, Hye Jin;Kim, Young Mee;Kim, Hee Jin
    • Journal of muscle and joint health
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    • v.27 no.1
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    • pp.12-21
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    • 2020
  • Purpose: The study was to develop a tailored education and coaching program (TECP) for cancer patients, and to identify the effects of TECP on pain severity, daily living impairment, barriers on pain management, self-efficacy, and pain management satisfaction. Methods: A randomized controlled trial was used. Patients referred to an oncology nurse specialist from oncologists for pain management were randomly assigned to TECP (25) or usual education program (UEP, 22). The intervention was offered by educating the method of taking opioid medication, managing opioid-induced side effects, reducing pain misconceptions and enhancing self-efficacy for communicating with a medical team on cancer pain severity, and pain-related impairment. Patients completed questionnaires before the education program and on the next visit 3~4 weeks later. Data were analyzed by SPSS 19.0 program using percentage, frequency, mean, standard deviation, x2 test and independent t-test. Results: At all levels, pain severity improved significantly in the experimental group-worst pain (8.16 to 3.80, p<.001), average pain (6.16 to 2.52 p=.008), and least pain (3.32 to 0.96, p=.038)-but not in the control group. Pain management satisfaction also showed significant differences (t=2.93, p=.005) between experimental (4.70±0.49) and control (4.17±0.73) groups. Interference with daily living, barriers to managing cancer pain, and self-efficacy for managing pain improved in both groups but there were no significant differences. Conclusion: The findings suggest that TECP should be considered for outpatients who need cancer pain management.

Implication and Evaluation of Pain Monitoring Program for Oncology Nurses (암 병동 간호사를 위한 통증모니터링 프로그램 개발 및 효과)

  • Kim, Yeon-Hee;Gong, Sung-Hwa;Choi, Jin-Sun;Jung, Ji-Young;Jun, Myung-Hee
    • The Journal of Korean Academic Society of Nursing Education
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    • v.12 no.2
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    • pp.196-204
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    • 2006
  • Purpose: This study was purposed to identify the effect of pain monitoring program for improving the knowledge, attitude and assessment ability of cancer pain in oncology nurses. Methods: In this study pain monitoring program was developed based on the literature, and constructed it with various teaching method including several group lectures, workshop, focus group and implementation at the clinical practices. In order to test the effect of this program, contrast group, pretest-post test quasi-experimental design was designed. 46 oncology nurses randomly assigned to either control or experimental group. The tool used are 32 item scale for the evaluation of the nurses' knowledge, attitude toward pain modified by Kim(1997), which was originally developed by McCaffery and Ferrel(1995). Results: The pain monitoring program for the oncology nurses was statistically significant for improving the level of the knowledge about and attitude toward pain management, and pain assessment behavior. Conclusion: More sensitive multiple measurement tool for the attitude toward pain management needs to be developed. Nurses need more knowledge and effective attitude toward cancer pain management. Pain monitoring program in this study is effective to improve the quality of pain management.

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Two Cases of Opioid-Induced Hyperalgesia in Cancer Patients Treated with Opioids for Pain Management (아편유사제를 사용한 암환자에서 발생한 통각과민 2례)

  • Hong, Sukchul;Kwon, Jung Hye;Han, Su Jung
    • Journal of Hospice and Palliative Care
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    • v.22 no.2
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    • pp.100-104
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    • 2019
  • Opioids are important drugs for the management of severe cancer pain without a ceiling effect. However, opioid administration leads to dose-limiting complications including drowsiness, hallucinations, delirium, respiratory depression, cognitive impairment, seizure, myoclonus, and hyperalgesia. Opioid-induced hyperalgesia (OIH) is a paradoxical phenomenon as opioid exposure increases pain sensitivity. Reducing or stopping opioids, opioid rotation, or co-administration of N-methyl-D-aspartate (NMDA) antagonists have been suggested for the management of OIH. In this study, we report two clinical cases of successful management of OIH in cancer pain patients that were treated with opioids.