• Title/Summary/Keyword: 통증사정

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Differences in Patients' and Family Caregivers' Ratings of Cancer Pain (암환자와 그 가족간호자가 지각하는 환자의 통증강도 차이)

  • Kim, Hyun-Sook;Yu, Su-Jeong;Kwon, Shin-Young;Park, Yeon-Hee
    • Journal of Hospice and Palliative Care
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    • v.11 no.1
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    • pp.42-50
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    • 2008
  • Purpose: Undertreatment of canter pain, especially due to the differences in the perception of pain between the patients and caregivers, is a well recognized problem. The purpose of this study were to determine if there exist differences in communication about pain intensity scores between patients and their family caregivers in Korea. Methods: A total of 127 patient-family caregiver dyads who have experienced canter pain participated in this study at a hospital in Seoul for six months. The data were obtained by fare to face interview with a structured questionnaire based on Brief Pain Inventory-Korean version and other previous researches. The clinical information for all patients was compiled by reviewing their medical records. Results: Patients' 'worst-pain for 24-hour' and 'right-now-pain' scores estimated by family caregivers were significantly higher than those by patient themselves. The degree of agreement between patients and family caregivers in the estimate of patients' 'worst-pain for 24-hour' intensity categories was 78.7% for 'severe pain', 40% for 'no pain', 27.5% for 'mild pain' and 22.9% for 'moderate pain'. In case of 'right-now-pain' intensity categories, the agreement was 50% for 'severe pain', 47.2% for mild pain, 46.3% for 'no pain', and 26.3% for 'moderate pain'. Conclusion: This study demonstrates that the degree of agreement between patients and family caregivers in the estimate of patients 'pain intensity categories was less than 50% except for 'severe pain'. The results indicate that Korean family caregivers tend to overestimate the canter pain intensity of their caring patients, especially, when a lancer patient has 'moderate' or 'mild pain'. Health Providers are advised to educate patient-family caregiver dyads to use a pain measurement scale to promote their agreement in pain Intensity stores. Further analyses and studies are needed to identify the factors and differences that influence their communication about pain intensity scores between patients and their family caregivers.

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Development of Detailed Clinical Models for Pain Assessment (통증 간호사정을 위한 임상내용모델 개발)

  • Min, Yul-Ha;Park, Hyeoun-Ae;Lee, Young-Ji;Kim, Young-Lan;Lee, Myung-Kyung
    • Perspectives in Nursing Science
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    • v.8 no.2
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    • pp.113-120
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    • 2011
  • Purpose: The aim of this study was to develop and validate Detailed Clinical Models (DCMs) for pain assessment in nursing. Methods: First, we identified the entities of pain assessment from ICNP. We identified the attributes and values of the attributes to describe the entities in more detail by reviewing the literature. Data types and optionalities of the attributes were defined. Second, we modeled the DCMs by linking an entity and its corresponding attributes with values and by specifying the data types and optionalities of the attributes. Finally, the DCMs were validated by a group of domain experts using a content validity index. Results: In total, 19 DCMs with 11 attributes for pain assessment were developed. The experts' evaluations showed that the DCMs were valid enough to represent pain related information of nursing assessment. Conclusion: The DCMs developed in this study can be used in electronic nursing records. The DCMs for pain can ensure the semantic interoperability of pain related information in electronic nursing records.

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A Study on the Preliminary Validation of a Postoperative Pain Measure for Parents for Children's Pain Assessment after Surgery (아동의 수술 후 통증사정을 위한 부모용 통증행동관찰척도의 타당성에 대한 연구)

  • Shin, Hee-Sun;Jung, Yeon-Yi
    • Journal of Korean Academy of Nursing
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    • v.30 no.4
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    • pp.847-856
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    • 2000
  • Parents are primary care taker for the children and have an important role for the assessment and managent of children's pain following surgery. The purpose of the present study was to examine the validity and clinical utilization of the Postoperative Pain Measure for Parents (PPMP) developed by Chambers et al. Subjects were 52 children aged 4-12 years admitted for tonsillectomy and other minor surgery and their mothers. Faces Pain Scale, State Anxiety, and Postoperative Pain Measure for Parents were used. The data were collected by two research assistant on the operation day and 1st day after surgery at hospital during the period of July 20 to August 28, 1998. The results are as follows: 1. Eta correlation coefficient between 15 items of PPMP and child rated pain were calculated. Correlation coefficients were more than .2 for both day. 2. Internal consistency for PPMP were .82 and .83. 3. The scores of the PPMP were 10.73 (SD=3.71) and 9.27(SD=4.07) on the operation day and 1st day after surgery and there was no significant difference between two days(p=.056) On the other hand, there was a significant difference on the child rated pain by Faces Pain Scale between operation day and 1st day after surgery(p=.001). 4. The correlation(Spearman Rho) between PPMP and child rated pain were .40(p=.003) and .56(p=.000). The score of the PPMP and the children's state anxiety were highly correlated on the operation day and 1st day after surgery (.60, .52, p=.000). 5. Partial correlation between PPMP and child rated pain except state anxiety were .18(p=.23) and .48(p=.001) on the opration day and 1st day after surgery. 6. Using a cut-off score 10 out of 15, the measure showed excellent sensitivity (>80%) and moderate specificity (46.15%, 60% ). This study provides preliminary evidence for the use of the PPMP as a valid pain assessment tool with children between the ages of 4-12 years following surgery. It is suggested to explore the validity with a different subjects with other surgery and to examine the validity for infant and younger children.

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Validity, Reliability and Efficiency of Pain Self-report Scale in Elderly with Dementia (치매노인의 통증사정에 대한 자가보고 도구의 타당도, 신뢰도 및 효율성 검증)

  • Ryoo, Eon-Na;Park, Kyung-Sook
    • Korean Journal of Adult Nursing
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    • v.23 no.2
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    • pp.111-122
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    • 2011
  • Purpose: The aim on this study was to establish the validity, reliability and efficiency of a Pain Self-Report Scale for elderly with dementia and compare these results with an observational pain rating scale. Methods: Study subjects were 136 elderly with dementia who were residents in a nursing home, geriatric hospital, or day care center. The subject's pain was measured by five self-report scales and observational scale. DS-DAT (discomfort scale-dementia of the Alzheimer's type) was used for pain behavior observational measure. Cognitive state was assessed using the MMSE (Mini-Mental State Examination). Results: Observational rating correlated moderately with self-report (r=.225~.585, p<.05) and tended to underestimate pain intensity. Test-retest reliability was high for all five self-report scales, and the correlation between these scales was very strong (r=.735~.856, p<.05). Comprehension rate of VDS (verbal descriptor scale) was 88.3%, and NRS (numeric rating scale) 69.9%, FPS (face pain scale) 66.9%, HVAS (horizontal visual analog scale) and VVAS (vertical visual analog scale) 65.4%. Conclusion: Nurses should not apply observational scales routinely in demented patients as many of these are capable of reporting their own pain. Self-report, the highest standard of pain measurement can be reliably performed in a large proportion of demented elderly.

Job Analysis for Role Identification of General Hospice Palliative Nurse (호스피스 완화 간호사 역할규명을 위한 직무분석)

  • Kim, Boon-Han;Choe, Sang-Ok;Chung, Bok-Yae;Yoo, Yang-Sook;Kim, Hyun-Sook;Kang, Kyung-Ah;Yu, Su-Jeong;Jung, Yun
    • Journal of Hospice and Palliative Care
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    • v.13 no.1
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    • pp.13-23
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    • 2010
  • Purpose: This study was to identify the role of general hospice palliative nurse through job analysis (duties, task, and task elements). Methods: The sample consisted of 136 nurses or professors who were performing duties related to hospice care areas in Korea. A survey method was used, and the questionnaire included frequencies, criticality, and difficulties of task elements in job description by the DACUM method. Descriptive statistics were performed by using SPSS WIN 17.0. Results: The job description of general hospice palliative nurse was identified 8 duties, 36 tasks, and 137 task elements. As for the 8 duties, the average scores of frequency, criticality, and difficulty were 2.94, 3.66, and 2.80, respectively. The role of ‘pain assessment’ was the most important task element among frequency and criticality. The lowest score at the frequency and criticality were ‘manage public finance’ and ‘collect datum through diagnostic test & lab', respectively. Furthermore, the role of 'identify spiritual needs of patients and family' was the most difficult task, whereas the role of 'manage documents and information' was the least. Conclusion: In this study, we could recognize the reality of general hospice palliative nurse's performances. For general hospice palliative nurse, therefore, concrete practice guide lines of psychosocial and spiritual care, communication skills, and bereavement care with qualifying system are critically needed.

Performance of Evidence-based Pain Assessment and Management Guidelines among Medical-Surgical Nurses (내·외과 간호사의 근거기반 통증사정 및 관리 가이드라인 수행도)

  • Kim, Heui Lyang;Song, Chi Eun;So, Hyang Sook
    • Korean Journal of Adult Nursing
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    • v.28 no.5
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    • pp.546-558
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    • 2016
  • Purpose: This study aimed at the effectiveness to investigate the performance of evidence-based pain assessment and management guidelines. Methods: Participants were 140 nurses at the med-surgical units. Data were collected in early July, 2014 using Registered Nurses Association of Ontario (RNAO) guideline (2007) revised and validated by Hong and Lee (2012) and analyzed by descriptive statistics, t-test, ANOVA using SPSS/WIN18.0. Results: The score of performance of pain assessment guideline was higher than the score of pain management. Categories with high score were pain screening, parameter of pain assessment, documentation, assessment of opioids side-effects, and record of pain caused intervention. Categories with low score were comprehensive pain assessment, multidisciplinary communication, establishing a plan for pain management, consultation and education for patients and their families, and education for nurse. Non-pharmacological management was the lowest one. Conclusion: Assessing and managing pain is a complex phenomenon. It might be useful if institutions host training programs to ensure that nurse are better able to understand and implement pain assessment and management. Since non-pharmacological management is less likely to be used by nurses it may be helpful to include these methods in a training program.

A Case of Seminal Vesicle Cyst Accompanied with Ipsilateral Renal Agenesis in an Infant (영아에서 발견된 동측 신무형성증과 동반된 정낭낭종 1례)

  • Yun, Jin-Sang;Chang, Sun-Jung;Lee, Jun-Ho
    • Childhood Kidney Diseases
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    • v.13 no.2
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    • pp.252-255
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    • 2009
  • Seminal vesicle cysts have been rarely detected. Most of them are caused congenitally, and two-thirds of them are accompanied with ipsilateral renal agenesis or dysplasia. They are usually present with dysuria, urinary frequency, perineal pain, epididymitis, pain after ejaculation, scrotal pain or infertility in the second to fourth decade of patient's life. Occasionally cysts are palpable by digital rectal examination, but radiologic imaging study is necessary to diagnose. We report a case of an infant with seminal vesicle cyst accompanied with ipsilateral renal agenesis detected incidentally in postnatal sonogram. The infant's right side of kidney was diagnosed as antenatally multicystic dysplastic kidney.

Factors Influencing Quality of Life in the Community Dwelling Vulnerable Older women with Chronic Joint Pain (만성 관절통증이 있는 취약계층 재가 여성노인의 삶의 질에 영향을 미치는 요인)

  • Yoo, Jae-Soon;Ham, In-Suk
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.1
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    • pp.355-367
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    • 2018
  • The purpose of this study was to identify the predictors of the quality of life in community dwelling vulnerable older women with chronic joint pain. A cross-sectional study was conducted on 234 participants registered at a visiting health care service in the public health center of C-city. The structured questionnaire were used to collect data on the general characteristics, pain rating index, pain intensity, perceived health status, functional independence, sleep pattern, depression, and quality of life from February 16 to March 13, 2017. The data were analyzed using a t-test, ANOVA, Pearson's correlation coefficients, and hierarchical multiple regression analysis. The significant factors of the quality of life including general characteristics were depression (${\beta}=-.60$, p<.001), pain intensity scale (${\beta}=-.15$, p=.007), health insurance type (${\beta}=.15$, p=.001), perceived health status (${\beta}=.14$, p=.007), duration of pain (${\beta}=-.10$, p=.019), marital status (${\beta}=.10$, p=.024), and functional independence (${\beta}=.09$, p=.036). These factors accounted for 63.1% of the total variance in the quality of life. The findings suggest that a public healthcare program on managing depression is effective in improving the quality of life in community dwelling older women with chronic joint pain. Public health nurses should intervene in nursing care for economically vulnerable aged and pain management based on a precise assessment from the beginning of pain.

Reliability and Validity of a Korean Version of the Critical Care Pain Observation Tool (CPOT) for ICU Patients Unable to Self Report (자가보고 능력이 없는 중환자의 통증사정을 위한 한국어판 Critical Care Pain Observation Tool의 신뢰도와 타당도 검증)

  • Lee, Hee Og;Kim, Yeon Su;Lee, Chang Ok;Hur, Sung Yi;Kwon, In Gak
    • Journal of Korean Critical Care Nursing
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    • v.6 no.1
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    • pp.1-10
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    • 2013
  • Purpose: The purpose of this study was to examine the reliability and validity of a Korean version of the Critical Care Pain Observation Tool (CPOT) developed for assessment of pain in critically ill nonverbal patients. Methods: Data were collected from a convenience sample of 30 critically ill patients admitted to a medical ICU in a hospital. The CPOT was tested at before, during and 20 minutes after changing a position and suction. Upon establishment of content and translation equivalence between the English and Korean version of CPOT. Results: The interrater reliability was found to be acceptable with the kappa coefficients of .76-1. The construct validity of the pain scores were increased from 0.43 to 2.5 in changing a position (t=-8.60, p<.001)and 0.1 to 3.23 (t=-9.36, p<.001) in suctioning. The pain scores were decreased from 6.06 to 4.01 in changing a position (t=-10.19, p<.001) and 6.45 to 4.13 (t=-10.39, p<.001) in suctioning. The concurrent validity the correlations between pain scores and physiological indicators, and a increased in Heart rate before and after changing a position (r=.65, p<.001). Conclusion: The CPOT can be used as a reliable and valid measure to assess pain in critically ill nonverbal a medical ICU patients.

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Effects of pain, sleep and self-care behavior in patients underwent robotic minimally invasive cardiac surgeries (로봇을 이용한 심장수술이 환자의 통증, 수면 및 자가간호수행에 미치는 영향)

  • Park, Soohyun;Jang, Insil
    • Journal of Digital Convergence
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    • v.17 no.7
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    • pp.265-274
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    • 2019
  • The purpose of this study was to know the difference in pain, sleep, self-care behavior in patients performed by sternotomy and robotic minimally invasive cardiac surgeries. The participants were 64 patients with sternotomy and 64 patients with minimal thoracotomy in heart valve surgeries at a tertiary hospital in Seoul. Data were analyzed using descriptive statistics, ${\chi}^2$ test, paired t-test. with SPSS/WIN(22.0). The participants with minimally invasive thoracotomy felt severe pain than the patients with thoracotomy at post operation day 2 & 5. The severe pain site were the surgical site in both groups. The participants with sternotomy had better sleep than minimally invasive thoracotomy patients. Self-care behavior was higher in the minimally invasive thoracotomy group. Therefore, despite the many advantages of robotic surgery such as rapid recovery and shortening of length of stay in hospital, accurate pain assessment and application of differentiated protocols are needed for the management of pain in the patients with robotic minimally invasive cardiac surgeries. In addition, a structured education program intervention is needed to improve comfort by considering gender, age, and method of operation.