• Journal of Hospice and Palliative Care
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• v.12 no.4
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• pp.177-193
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• 2009

The assessment of patient status in palliative medicine is essential for determining treatments and for clinical outcomes. The objective of assessment tools is to raise the quality of care for individual patients and their families. There are a number of tools available to assess pain, non-pain symptoms and quality of life. The tools are either uni-dimensional or multi-dimensional measures. Unfortunately, however, no single tool is recommended to be a superior to others in symptoms or quality of life assessment. Therefore, to select an appropriate assessment tool, one should consider the time frame and unique characteristics of tools depending on purpose and setting. The combination of prognostic index is highly recommended in prognostication, and web-based prognostic tools are available. Recently, a new objective prognostic score has been constructed through multicenter study in Korea. It does not include clinicalestimates of survival, but includes new objective prognostic factors, therefore, anyone can easily use it. For beginners in palliative medicine, relatively easy-to-use tools would be convenient. We recommend Eastern Cooperative Oncology Group performance status to assess functional status, numeric rating scale for pain assessment and the Korean version of brief pain inventory for initial pain assessment. Asking directly with numeric rating scale or the Korean version of MD Anderson Symptom Inventory would be desirable to assess various symptoms together. We think that European Organization Research and Treatment Quality of Life Questionnaire Core 15 for Palliative Care is good to assess the quality of life, while Objective Prognostic Score is convenient as prognostic index for beginners.

• Journal of Oral Medicine and Pain
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• v.38 no.2
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• pp.161-174
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• 2013

This study was designed to evaluate the pain control effect by morphine injection to masticatory muscle pain patients. Patients with masticatory muscle pain visited the Department of Oral Medicine, Kyung Hee University Dental Hospital were recruited to this study and diagnosed by RDC/TMD. Experimental group were divided into four group; saline injection group (n=10), lidocaine injection group (n=10), morphine 1.5 mg injection group (n=10) and morphine 3 mg injection group (n=10). Evaluation list was the subjective pain evaluation(visual analogue scale, Mc Gill pain questionnaire, pain drawing) and the objective pain evaluation(pressure pain threshold, pressure pain tolerance) and evaluation time was injection before, after 1 hour, 24 hour, 48 hour and then it was analyzed statistically. The results were as follows : 1. The subjective pain evaluation were significantly different statistically in morphine 3 mg group after 48 hour. (VAS: p<0.01, MGQ: p<0.001, PD: p<0.05) 2. The objective pain evaluation were significantly different statistically in morphine 1.5 mg group after 1 hour. (PPT: p<0.01, PPTol: p<0.05) 3. The morphine 3 mg group were more significantly different than lidocaine group and morphine 1.5 mg group statistically in the McGill pain questionnaire evaluation. (1h: p<0.01, 24h: p<0.01, 48h: p<0.001) Therefore, it was revealed that the morphine 3 mg injection was effective to pain control for masticatory muscle pain patients within 48 hours and more effect than lidocaine injection.

• The Korean Journal of Pain
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• v.8 no.1
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• pp.1-7
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• 1995

효율적인 술후 통증치료를 위해서는 통증치료의 방법과 환자관리면을 동시에 고려하여야 한다. 방법은 상술한 바와 갈이 술후 통증기전에 부합되는 방법들이 예방적으로 적용되어야 하고 아울러 환자 개개인에 맞는 지속적인 균형제통이 시행되어야 한다. 그리고 환자관리면에서는 환자의 통증을 자주 평가하고 그에 동반된 처치 및 간호업무가 수반되어야 한다. 그러므로 술후 통증관리는 진통제에 대한 전문지식을 갖춘 의료인이 적합한 제통방법을 지속적으로 시행하여야 하는데 그러기 위해서는 효율적인 조직체제가 필요하다. 구미각국에서는 여러해 전부터 술후 통증관리가 통증관리센터란 체제하에서 효과적인 급성 통증치료실로 운영되어져 왔으며 현재는 병원의 중심센타로 확립된 실정이다. 우리나라도 국민의료보험이 도입된지 17년이 지났고 환자 위주의 병원환경이 마련되어야 한다는 데에는 대다수의 국민들로부터 공감대가 형성된 현시점에서 이제는 통증관리센터가 설립되어야 한다고 생각된다. 이러한 제안이 기정사실화 되기까지는 많은 논의와 임상결과에 대한 자료들이 있어야 하겠지만 무엇보다도 마취과 의사들의 술후통증관리에 대한 지속적인 관심과 연구가 뒷바침되어야 할 것으로 생각된다.

• Journal of Oral Medicine and Pain
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• v.35 no.2
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• pp.135-147
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• 2010

In this study, the objective masticatory efficiency of two groups of temporomandibular disorder patients, pain and sound groups, was compared with that in a normal group using the MAI (mixing ability Index). The subjective chewing ability was evaluated using questionnaires, such as the Food Intake Ability Index (FIA) and Visual Analogue Scale (VAS). The Oral Health Impact Profile (OHIP)-49K of the patients was also examined to measure the oral health-related quality of life. The results were as follows: 1. The MAI, FIA and VAS in the pain group were significantly lower than in the normal and sound groups. This shows that the chewing efficiency of the pain group was lower than the normal and sound groups (P<0.05). However, there was no significant difference between the sound and normal groups. 2. The OHIP-49K for the oral health-related quality of life showed a significant increase in both the pain and sound groups compared with normal group. This means that the oral health-related quality of life was lower in both the pain and sound groups. 3. There was a correlation between the MAI, FIA and VAS (P<0.01) in all subjects (71 persons). The OHIP-49K was associated with the FIA and VAS. 4. There was a correlation between the FIA and VAS (P<0.05) in the sound group but no correlation in the other groups. 5. There was a correlation between the FIA and VAS in all groups. 6. The VAS was increased significantly in the pain group according to the level of pain reduction after treatment (P<0.05). However, there was no significant increase in the MAI, even though there was an improvement in masticatory efficiency. In addition, there was no difference in the FIA and OHIP-49K according to the level of pain reduction after treatment. In this study, it is believed that pain is a main factor decreasing the masticatory efficiency in patients with temporomandibular disorders. Moreover, TMJ sounds decrease the quality of life but do not decrease the masticatory efficiency. Therefore, it is important to control the pain in order to improve the masticatory efficiency in temporomandibular disorder patients. Moreover, managing both pain and sound can improve the quality of life.

• The Korean Journal of Pain
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• v.10 no.1
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• pp.1-4
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• 1997

• 한국호스피스완화의료학회:학술대회논문집
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• 2003.07a
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• pp.90-92
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• 2003

• Journal of Hospice and Palliative Care
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• v.6 no.1
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• pp.45-50
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• 2003

Purpose : This study was conducted to develop primary assessment tools to evaluate the relationship between symptom prevalence and symptom distress in cancer patients of Korea. Methods : A total of 196 patients diagnosed with cancer admitted in 5 general hospitals from January, 6 to January, 20 in 2003, were entered into the study. These patients were asked to complete the MSAS (Memorial symptom assessment scale). We classified these answers into prevalence and distress and then scored them according to grade and frequency. Results : The five most prevalent symptoms were lack of energy (82.1%), dry mouth (73.5%), pain (73.5%), itching (72.4%), and feeling drowsy (68.9%). Among 24 common prevalent symptoms, the ten most distress the symptoms were dry mouth (2.11), itching (2.07), pain (2.03), lack of energy (1.98), difficulty sleeping (1.96), worrying (1.94), "I don't look like myself" (1.91), constipation (1.88), and difficulty concentration (1.76). Conclusion : These 10 symptoms had high prevalence and distress in cancer patients of Korea. We suggest these symptoms to be applied in developing the primary assessment tool in cancer patients.

• The Journal of the Korea Contents Association
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• v.14 no.5
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• pp.458-467
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• 2014

Pain is one of the most common and painful symptoms that cancer patients suffer from. Pain seriously affects 30-50% of the patients at the early cancer diagnosis stage or who receive active anticancer treatments, 60-70% of the patients with progressive cancer, and 80-90% of the patients at the late stage of cancer. However, there is no systematic and easy pain control program for the cancer patients. In this study, an algorithm is proposed to provide quick pain relief service upon the occurrence of sudden pain, for the purpose of controlling the sudden pain that cancer operation survivors experience. In developing the algorithm, questionnaires, evaluation forms and National Comprehensive Cancer Network (NCCN) guideline were considered, and a trial service was provided to a group of 20 cancer patients for a month to evaluate the designed algorithm. The results of the trial service were examined by expert medical workers to evaluate the proposed algorithm, and a 90% compatibility decision was derived, which verified the effectiveness of the proposed algorithm. In the case of incompatibility decision, the management of the pain diary did not have compatible results. Therefore, the further study will additionally address the customized pain diary algorithm.

• Journal of Hospice and Palliative Care
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• v.1 no.1
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• pp.23-29
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• 1998

Purpose : Validity of WHO guideline of cancer pain management has been proven and many trials were done for resolution of inadequate management of cancer pain. We assessed the severity of pain in terminal cancer patients and patient's characteristics influencing inadequate pain management. Methods : This study was done on 100 patients who was confirmed as terminal in Seoul National University Hospital from lune 1997 to November. For getting the informations about dermographic and medical characteristics such as performance and metastasis, and drug-adjusted pain severity the patients, we reviewed the medical records and interview the patients. we assessed the adequacy of prescribed analgesics with WHO guidelines of pain management, and patient's characteristics influencing on adequacy of pain management. Results : 85.0 percent of cancer patient had pain when diagnosed as terminal cancer and 68% of patient had pain above moderate severity. 38.0 percent of those were given inadequate pain management and the greater pain severity, the less adequate(P<0.001). Sex, age, primary site of cancer, metastasis, symptoms such as depression and anxiety, and performance were not significant. Conclusion : Despite guidelines for pain management, many patients with terminal cancer received inadequate pan management. Their is a need for education about evaluation of pain and guidelines of pain management.

• Proceedings of the KAIS Fall Conference
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• 2010.11b
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• pp.1041-1043
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• 2010

만성 통증 환자의 우울증 및 삶의 질 저하에 대한 많은 보고가 있으며, 통증 조절을 위해 심리적 측면도 중요한 요소로 포함된다. 온열 수치료는 통증 조절을 위하여 가장 많이 시행되는 치료법 중의 하나이며 다양한 방법으로 임상에서 적용될 수 있다. 현재까지 전신 온열 수치료가 통증, 심리, 주관적인 삶의 질에 미치는 영향에 대하여 포괄적인 연구가 시행된 사례가 없으므로, 본 연구에서는 만성 통증 환자에게 제주도내 상수원을 이용한 온습포치료, 즉 통증 부위의 부분치료 또는 전신 온열 수치료를 시행한 후 통증의 정도, 정서, 주관적 삶의 질 평가 결과에 변화가 있는지 알아보기로 하였다.