• Journal of Hospice and Palliative Care
• /
• v.16 no.3
• /
• pp.145-154
• /
• 2013

This study was performed to evaluate the existing pain assessment methods including the tools developed for use with nonverbal older adults with dementia, and to suggest recommendations to clinicians based on the evaluations. Computerized literature searches published after year 2000 using databases - Google scholar, RISS, KoreaMed, Medline, ScienceDirect, CINAHL - were done. Searching keywords were 'pain', 'pain assessment', and 'cognitive impairment/dementia'. The pain assessments for non-communicative dementia patients who are unable to self-report their pains are often made using the assessment tools relying on the observation of behavioral indicators or alternatively the strategy of surrogate reporting. While several tools in English version and only one in Korean are suggested for the pain assessments based on the observation of behavioral indicators, none are commonly used. In this review, we selectively evaluated those tools known to show relatively higher degree of validity and reliability for nonverbal older adults with dementia, namely, CNPI, DOLOPLUS 2, PACSLAC, PAINAD, and DS-DAT. It is hoped that the present review of selected tools for assessing pain in those vulnerable population and the general recommendations given be useful for clinicians in their palliative care practice. And future studies should focus on enriching the validation of the useful tools used to observe the nonverbal patient's behavioral indicators for pain in Korean.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.13 no.7
• /
• pp.3016-3022
• /
• 2012

The purpose of this study is to measure and evaluate the degree of the pain using tools such as faces, glasses, chips, and colors for 96 children in three general hospitals. The children preferred faces, glasses, chips and colors in order, and they preferred orange color for pain-free and black for intense pain. The pain score was significantly high with the children who did not have experience in hospital except colors tool in the difference by means of general characteristics(faces, glasses, chips; p<0.05). Faces, glasses, chips, colors tools are pain assessment tools which are easy simple to handle by children including family and medical personnel. We expect these tools will be used in many ways to assess pain according to a child's age in a clinical setting.

• Korean Journal of Adult Nursing
• /
• v.19 no.1
• /
• pp.66-77
• /
• 2007

Purpose: This study was performed to evaluate the effectiveness of a pain assessment education program developed for nurses. Methods: Research design of this study was nonequivalent control group quasi-experimental study. Subjects for this study were 56 nurses for control group, and 53 nurses for experimental group. The experimental group participated in pain assessment education program. Data were collected before and 6 months after the program and analyzed using the SPSS 12.0 program. Results: The results of this study were as follows: In pretest, there were no significant differences in general characteristics, knowledge of pain, attitude toward pain and pain assessment behaviors. In post test, the experimental group had significantly higher scores of pain knowledge scores and pain assessment behaviors than control group. However, attitude toward pain remained unchanged. Conclusion: According to the results, pain assessment education program was effective in improving pain knowledge and pain assessment behavior.

• Research in Community and Public Health Nursing
• /
• v.21 no.3
• /
• pp.311-320
• /
• 2010

Purpose: The aim of this study was to investigate the status of visiting nurses assessment and management of chronic musculoskeletal pain in older adults. Methods: The subjects of this study were 285 visiting nurses working at 24 public health centers located in Seoul, Gyeonggi-do, and Gangwon-do. Data were collected using a structured questionnaire from June to July, 2008. The SPSS/WIN 13.0 program was used for data analysis. Results: Of the visiting nurses, 195 (77.4%) reported lack of pain education for nurses. The education of exercise (83.3%) was used most frequently by nurses as a pain intervention. Barriers to effective pain management were inadequate pain management guidelines and lack of pain education for nurses. Conclusion: It is necessary to develop evidence-based nursing interventions for pain management and to develop systematic educational programs for visiting nurses management of chronic musculoskeletal pain.

• Journal of Korean Academy of Nursing
• /
• v.42 no.1
• /
• pp.76-84
• /
• 2012

Purpose: The purpose of this methodological study was to examine the reliability and validity of a translated Korean version of the Critical Care Pain Observation Tool (CPOT) developed for assessment of pain in critically ill nonverbal patients. Methods: A cross-sectional study design was used. Data were collected from a convenience sample of 202 critically ill patients admitted to a university hospital. Upon establishment of content and translation equivalence between the English and Korean version of CPOT, psychometric properties were evaluated. Results: The interrater reliability was found to be acceptable with the weighted kappa coefficients of .81-.88. Significant high correlations between the CPOT and the Checklist of Nonverbal Pain Indicators were found indicating good concurrent validity (r=.72-.83, p<.001). Data showed the area under the ROC curve of 0.86 with a cut-off point of 1, which resulted in 76.9% sensitivity and 88.6% specificity. The mean score of CPOT during suctioning was significantly different from that of before (t= -14.16, p<.001) or 20 minutes after suctioning (t=16.31, p<.001). Conclusion: Results of this study suggest that the CPOT can be used as a reliable and valid measure to assess pain in critically ill nonverbal patients.

• Journal of Korean Academy of Nursing
• /
• v.35 no.7
• /
• pp.1401-1409
• /
• 2005

Purpose: Infants at neonatal intensive care units (NICU) are invariably exposed to various procedural and environmental stimuli. The study was performed to compare the pain responses in three NICU stimulants and to examine the clinical feasibility for NICU infants using CRIES, FLACC and PIPP. Method: In a correlational study, a total of 94 NICU stimulants including angio-catheter insertions, trunk-rubbings and loud noises, was observed for pain responses among 64 infants using CRIES, FLACC and PIPP. Results: A significant difference was identified among the mean scores in CRIES($F_{(2, 91)}$=47.847, p=.000), FLACC($F_{(2, 91)}$=41.249, p=.000) and PIPP($F_{(2. 91)}$=16.272, p=.000) to three stimulants. In a Post-hoc Scheff test, an angio-catheter insertion showed the highest scores in CRIES, FLACC and PIPP compared to the other two stimulations. A strong correlation was identified between CRIES and FLACC in all three stimulations(.817 < r < .945) while inconsistent findings were identified between PIPP and CRIES or FLACC. Conclusions: The results of the study support that CRIES and FLACC are reliable and clinically suitable pain measurements for NICU infants. Further studies are needed in data collection time-point as well as clinical feasibility on PIPP administration to assess pain response in infants, including premature infants.

• Korean Journal of Psychosomatic Medicine
• /
• v.21 no.2
• /
• pp.140-146
• /
• 2013

Objectives: We compared the characteristics of the pain threshold and pain experience between demented group and non-demented group. Methods: This study was part of Gangwon projects for early detection of dementia in 2010. We recruited 8302 local resident ages over 65 years old. Of theses, 1259 people who scored low MMSE were selected and 365 of them completed CERAD-K(Consortium to Establish a Registry for Alzheimer's disease). Finally, 90 in non-demented group and 57 in demented group(mild to moderate Alzheimer's disease) were analyzed. Pain threshold was experimentally measured by pressure algometer and we investigated the pain experience, by Brief pain inventory (BPI), a self-report test. Results: In the demographic characteristics, there are more female, higher ages, lower education in the demented group. There was no significant difference between the two groups in the pain threshold. On the BPI results, 'shoulder pain', 'the number of pain' and 'interference of working' were significantly more prevalent in non-demented group. However, there are no significant differences between the groups in the 'pain severity', 'prevalence of pain' and 'pain treatment'. Conclusions: Demented group report less pain experience but, still perceived pain. It support previous studies that patient with dementia have increased pain tolerance but preserved pain threshold. Thus, active pain assessment and treatment for patients with dementia is needed.

• Journal of Hospice and Palliative Care
• /
• v.2 no.1
• /
• pp.7-15
• /
• 1999

This survey was designed to evaluate knowledge and attitudes of physicians and nurses toward cancer pain management in South Korea and to compare physicians' knowledge and attitudes with nurses' Ninety-nine physicians and 152 nurses working at four major institutions in South Korea were included for the study. With the 30 items of the knowledge with true and false answers about cancer pain such as pain assessment(6 items), pharmacokinetics of opioids(8 items), analgesics classification(11 items), and drug administration(5 items), total score of knowledge answered by physicians was 21.40, which was not significantly higher than 20.87 answered by nurses. Rates of the correct answer were more than 70% in both physicians and nurses. Physicians were more knowledgeable in pharmacokinetics and analgesics classification than nurses, while nurses higher only in pain assessment than physicians. Since physicians and nurses could not effectively manage the cancer pain because of inappropriate knowledge, it is important to provide intensive education to physicians and nurses about cancer pain management.

• Journal of Korean Clinical Nursing Research
• /
• v.18 no.1
• /
• pp.136-148
• /
• 2012

Purpose: The purpose of this study was to develop a reliable and valid pain assessment tool suitable for critically ill patients with communication problem in Korean intensive care unit. Methods: This pain assessment tool, Critical Care Non-verbal Pain Scale (CNPS), was developed based on review of national and international researches. Data were collected from ten intensive care units at five major general hospitals in Seoul. Reliability and validity were tested during performance of position change and endotracheal suctioning. Pain was measured before, during, and 20 minutes after the two procedures. Results: Interrater reliability of the CNPS was analyzed by ICC (Intraclass correlation coefficients). ICC values were significant from .833 to .883. Significant correlation between the FPS (Face Pain Scale) scores and the CNPS scores verified concurrent validity of the CNPS. For position change, CNPS scores increased significantly between before and during (t=-23.399, p<.001) and decreased significantly between during and 20 minutes after (t=22.760, p<.001). For endotracheal suctioning, CNPS scores increased significantly between before and during (t=-29.064, p<.001) and significantly decreased between during and 20 minutes after (t=28.194, p<.001), verifying construct validity of the CNPS. Conclusion: Results indicate that the CNPS can be used to assess pain of critically ill patients who have communication problem.

• Child Health Nursing Research
• /
• v.5 no.3
• /
• pp.262-280
• /
• 1999

This study was Performed to understand Pediatric Pain management status and nurses' knowledge and attitudes toward it. In addition. it aimed to provide basic data in order to establish effective nursing intervention strategies by confirming the barriers of effective pain management in practice. The subjects were 195 nurses working in pediatric units(general pediatric unit. oncology unit, neonatal unit. neonatal ICU, Pediatric ICU) of 8 university hospitals and one general hospital. Data was collected by the questionnaire from the 3rd of August to the 20th of September in 1999. The instrument developed by Sanna(1999) to measure nurses' knowledge and their attitudes and the other tool by Cleeland(1984) to evaluate barriers in effective Pain management was used. Results of this study are summarized as follows 1. Most nurses learn about the pain management knowledges from through regular curriculum of nursing school(62.0%) And almost nurses(90.8%) don't used to utilize pain assessment tool, but the 'Faces Rating Scale' is the most frequently used by nurses. 2. The use of pain medication(65.6%) is most frequently taken by nurses as pain management and is followed by massage (55.9%) , distraction(27.7%). 3. Nurses' knowledge level is moderate (Mn=3.07). Nurses don't seem to understand pediatric Physical development (Mn = 2.86), psychological development(Mn=2.94) well, meanwhile they seem relatively Quite knowledgeable about the way pain emerges. 4. Nurses' attitudes toward pain is based on behavioral and physiological responses to Pain. They believe 'changes in behavior are a way of assessing pain in child' and 'acute pain increases the number of respiration' Nurses are ready to accept pediatric pain, but are not positive in adopting pain intervention in practice. 5. The barriers of effective pain management are inadequate assessment of pain and pain relief(81.5%), ineffective incorporation among health professionals(80%), and lack of equipment or skills(80.0%).