• 제목/요약/키워드: 완화의료

검색결과 907건 처리시간 0.028초

The Effect of Stellate Ganglion Block on Breast Cancer-Related Infectious Lymphedema (유방암 감염성 림프부종 환자에서 성상신경절 블록이 미치는 영향)

  • Lee, Youn Young;Park, Hahck Soo;Lee, Yeon Sil;Yoo, Seung Hee;Lee, Heeseung;Kim, Won Joong
    • Journal of Hospice and Palliative Care
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    • 제21권4호
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    • pp.158-162
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    • 2018
  • Breast cancer related lymphedema (BCRL) is one of the most intractable complications after surgery. Patients suffer from physical impairment, as well as psychological depression. Moreover, a recent study revealed that cellulitis significantly increased the risk of BCRL, and cellulitis has been suggested as a risk factor of BCRL development. We describe a patient treated with stellate ganglion blocks (SGBs) without steroid for relief of symptoms and reduction of the arm circumference of breast cancer-related infectious lymphedema in a month. We measured the arm circumference at four locations; 10 cm and 5 cm above and below the elbow crease, numeric rating scale (NRS) score, lymphedema and breast cancer questionnaire (LBCQ) score on every visit to the pain clinic. A serial decrease of the arm circumference and pain score were observed after second injection. In the middle of the process, cellulitis recurred, we performed successive SGBs to treat infectious lymphedema. The patient was satisfied with the relieved pain and swelling, especially with improved shoulder range of motion as it contributes to better quality of life. This case describes the effects of SGB for infectious BCRL patients. SGB could be an alternative or ancillary treatment for infectious BCRL patients.

Effects of periodic breast massage on the cyclical mastalgia of fertile women before their menstrual period (유방 마사지가 가임기 여성의 월경 전 주기적 유방통 완화에 미치는 효과)

  • Kang, Kyoung Ae;Lee, Ji A;Hur, Myung-Haeng
    • Journal of the Korea Convergence Society
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    • 제13권3호
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    • pp.353-362
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    • 2022
  • This study was a randomized controlled trial to examine the effects of breast massage applied to women of childbearing age with cyclic mastagia on breast pain, breast hardness, nipple extensibility, breast size, and breast blood circulation. The study participants were 54 women with cyclic mastalgia who were recruited from Medical Center C, Women's Hospital M, department stores located in City D, and Internet cafes. The experimental treatment was to apply breast massage for a total of 30 minutes, 15 minutes each to the left and right breasts during the period of cyclic mastalgia. After experimental treatment, breast pain (F=49.16, p<.001), breast hardness (Rt t=8.93, p<.001; Lt t=-10.34, p<.001), nipple extensibility (Rt t=3.58, p<.001 ; Lt t=4.66, p<.001), breast size (Rt F=60.59, p<.001; Lt F=51.05, p<.001) and breast blood circulation (Rt t=-1.30, p=.201; Lt t=-2.82, p=.007) were significantly different between the two groups. In conclusion, breast massage performed in this study was effective in relieving breast pain, relieving breast hardness, and improving breast blood circulation in participants with cyclic mastalgia.

Effect of Vertically Rising Pressure Providing Spinal Canal Segment Motion on Symptom Relief in Patients with Parkinson's Disease (척추관 분절운동을 제공하는 수직 상승 압력이 파킨슨병 환자의 증상 완화에 미치는 영향)

  • Do-Hyun, Ahn;Hyeun-Woo, Choi;Kyung-Mi, Jung;Na-Young, Kim;Jong-Min, Lee
    • Journal of the Korean Society of Radiology
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    • 제16권6호
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    • pp.787-797
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    • 2022
  • The purpose of this study was to confirm the reduction of pain and symptom relief of Parkinson's disease by vertically stimulating the spine through the application of a mechanical bed capable of thermal and massage stimulation. For this purpose, after confirming the segmental motion of the spine due to the use of a medical combination stimulation bed for Parkinson's disease patients, VAS, ODI, gait ability, and spiral drawing tests were performed, and the relationship between the variables was identified. In the 10-day visual analog scale and evaluation of low back pain dysfunction, the average trend of decreasing after bed use was confirmed. For walking ability, a decrease in the moving time and an increase in the moving distance were observed. In the spiral drawing test, the mean test time after using bed was significantly lower than before. As a result, it suggested the possibility of using it as an auxiliary method for recovery and pain relief of Parkinson's disease patients due to spinal segmental movement with mechanical heating and massage. However, this study is a preliminary study, and there is a small number of subjects, so additional research is needed that considers the number and condition of future subjects in detail.

Lifting Shadows off the End-of-Life Care: Hopes and Beliefs on Video Decision Support Tools for Advance Care Planning

  • Jeong, Heon-Jae;Yoon, Hyeyeon
    • Journal of Hospice and Palliative Care
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    • 제19권1호
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    • pp.1-4
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    • 2016
  • As advance care planning is taking center stage in the field of end-of-life care, various tools have been developed to aid in the often emotional and difficult decision-making process. Video decision support tools are one of the most promising means of assistance, of which the modus operandi is to provide more comprehensive and precise information of medical procedures to patients and their families, allowing them to make better informed decisions. Despite such value, some are concerned about its potential negative impact. For example, video footages of some procedures may be shocking and unpalatable to non-medical professionals, and patients and families may refuse the procedures. One approach to soften the sometimes unpleasant visual of medical procedures is to show less aggressive or more relaxing scenes. Yet another potential issue is that the objectivity of video decision support tools might be vulnerable to the very stakeholders who were involved in the development. Some might argue that having multiple stakeholders may function as checks and balances and provide collective wisdom, but we should provide more systematic guarantee on the objectivity of the visual decision aids. Because the decision of the modality of an individual's death is the last and most significant choice in one's life, no party should exert their influence on such a delicate decision. With carefully designed video decision support tools, our patients will live the last moments of their lives with dignity, as they deserve.

Predicting Life Span for Terminal Colon Cancer using Clinical Symptoms (말기 대장암환자에서 중상을 통한 예후 측정 및 증상조절)

  • Lee, Do-Haeng;Choi, Youn-Seon;Hong, Myung-Ho;Kim, Jun-Suk;Lee, Kyung-Jin;Kim, Young-Soo
    • Journal of Hospice and Palliative Care
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    • 제2권2호
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    • pp.138-143
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    • 1999
  • Accurately estimating survival times in terminal cancer patients is very difficult for palliative care clinicians. But a reasonably accurate estimate of survival would permit the medical team to : Plan the ideal therapeutic strategy between overtreatment and too early discontinuation of specific therapy. Answer any questions asked by the patient or family. Organize adequate assistance for the patient concerned. Decide on the eligibility of the patient for clinical trials and whether to begin a treatment, the effects of which will not be immediate. This case was a 79 year-old male patient with colon cancer. He complained of dry mouth, anorexia, weight loss and showed KPS $40{\sim}50$ on admission day. 40 days later he died. To improve patient/family quality of life, it is necessary to improve the ability to estimate accurately a patient's length of survival.

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Factors Affecting the End-of Life Care Competency of Tertiary Hospital Nurses

  • Jeong, Da-In;Eun, Young
    • Journal of Hospice and Palliative Care
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    • 제23권3호
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    • pp.139-150
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    • 2020
  • Purpose: The purpose of this study was to investigate the levels of end-of-life care competency; knowledge, attitudes, and experiences regarding advance directives; perceptions of good death; and end-of-life care obstacles and supportive behaviors among tertiary care nurses. Methods: The participants were 150 nurses at a tertiary hospital in Jinju, Korea. The data collected using a questionnaire were analyzed using descriptive statistics, the t-test, analysis of variance, Pearson correlation coefficients, and stepwise multiple regression in SPSS for Windows version 24.0. Results: The mean (±SD) score of end-of-life care competency was 3.63 (±0.53) on a 5-point scale. A significant difference in end-of-life care competency was found according to whether nurses had experienced the death of a family member or acquaintance (P=0.029). According to stepwise multiple regression analysis, the factors affecting end-of-life care competency were the frequency of end-of-life care supportive behaviors (β=0.38, P<0.001), experience with advance directives (β=0.29, P<0.001), and marriage (β=0.15, P=0.039). This model had an explanatory power of 27.9% (F=18.87, P<0.001). Conclusion: In order to improve nurses' end-of-life care competency, it is important to strengthen end-of-life care supportive behaviors by exposing nurses to those behaviors and providing frequent experience with advance directives.

Content Analysis of the Meaning of Spiritual Care as Perceived by Nursing Students

  • Shin, Sun-Hwa;Kim, Hyeon-Young;Woo, Hee-Yeong;Lee, Myung-Nam;Kim, Ye-Jean
    • Journal of Hospice and Palliative Care
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    • 제23권3호
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    • pp.151-161
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    • 2020
  • Purpose: This study aimed to describe the meaning of spiritual care as perceived by nursing students. Methods: This study used a descriptive research design, and the participants were 126 fourth-year nursing students from three nursing colleges. Data were collected from August to September 2019, and were analyzed using the content analysis method. Results: Four themes of spiritual care with 15 sub-themes were extracted from the content analysis: 1) "promoting spiritual well-being" (sub-themes: "providing religious help", "caring for the patient as a spiritual being", and "presupposing human dignity regardless of religion"); 2) "taking place in actual nursing practice" (representative sub-themes: "considering the perspective of the patient", "reducing suffering"); 3) "caring for the multifaceted needs of human beings" (representative sub-themes: "providing physical, mental, and spiritual care", "caring for both the mental and physical health of the patient"), and 4) "growing together" (sub-themes: "positively affecting patient well-being", "beginning with the nurse's self-transcendence"). Conclusion: These results suggest that nursing students consider spiritual care to be a highly positive and practical form of nursing care. However, because few students have been exposed to religion and spirituality, more systematic training should be provided.

Herpes Zoster Ophthalmicus in a Patient with Malignant Lymphoma (악성림프종 환자에서 발생한 안부 대상포진)

  • Lee, Jun-Hak;Kim, Hyung-Tae;Park, Jun-Beom;Park, Sang-Cheol;Kwon, Young-Eun
    • Journal of Hospice and Palliative Care
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    • 제8권1호
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    • pp.52-56
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    • 2005
  • Herpes zoster (HZ) is an acute infection of the unilateral sensory dermatome caused by varicella-zoster virus (VZV) and is characterized by vesicular eruption and unilateral pain along the involved dermatome. Although the pathogenesis of HZ is incompletely understood, it is thought that when cell-mediated immunity falls below a critical level, dormant VZV within cells of the sensory ganglia are allowed to replicate and infect the host with the resultant clinical presentation of HZ. It has been associated with immunosuppressed states, such as advanced age, leukemia, lymphoma, chemotherapy and/or radiation treatment. We present a case of a 62-year-old female patient with malignant lymphoma suffering herpes zoster ophthalmicus who did not respond to conventional treatment, and in whom the application of various nerve blocks and patient-controlled analgesia produced moderate pain relief. The patient died twenty days later due to cardiopulmonary failure.

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The Comparison of Hospice Care by Nurse, Volunteer and Minister (말기 암환자 호스피스 케어의 사례 - 간호사, 자원봉사자, 목회자의 케어 사례 비교 -)

  • Kim, Boon-Han
    • Journal of Hospice and Palliative Care
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    • 제2권1호
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    • pp.46-53
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    • 1999
  • The purpose of this case study is to explore the difference of hospice care and the efficiency of hospice education, by comparing the care of the nurse, the volunteer and the minister who have been trained by the Hospice Education Program. The index of common hospice care delivered by cases is that 1) the physical problems (pain, physical discomfort, incontinece, nausea, vomiting etc.) 2) the family problems(family support, change of family function, inefficiency, preparing the death of family) 3) the psychiatric problems(grief and sadness of death, anxiety, fear, helplessness). The case of volunteer and minister is different with the hospice care by nurse, because it is some what related to Christian's base. The index of care by the volunteer and minister is pertaining to social support and spiritual support for family and dying patient. In conclusion, for the wholistic hospice care, we need the hospice caregiver who have diverse background and expert in knowledge of various dimension. For that, it is necessary to build and develop hospice education program as a team apprach, which indudes a systematic expertizing items for care in consideration of caregiver's background.

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A Study on the Flow Control Based Estimated Receiving Capacity on the Video Conference System (화상회의 시스템에서 수신능력 예측을 이용한 흐름제어에 관한 연구)

  • 김상진;남지승
    • Journal of Korea Multimedia Society
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    • 제6권3호
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    • pp.488-495
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    • 2003
  • With the development of networks, multimedia communication has expanded its application field. From the remote control for household electric appliances to medicine, games, video conferencing and multimedia chatting, multimedia communication is being used in all parts of our lives. This multimedia communication requires the transmission of a lot of data at high speed. But if the transmission rate of the communication network exceeds the processing speed of being used in the high speed network environment, a bottleneck occurs in each node and deteriorates the performance of the network. This is the main reason for the slow speed of data transmission and packet loss. In this paper, considering the client's processing performance, reception performance was predicted and the way of flow control was shown. The computing performance of relevant Processor and its performance was estimated through the actual implementation.

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