• Title/Summary/Keyword: 통증 관리

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The Approaches to Postoperative Pain Management (술후 통증관리의 접근)

  • Song, Sun-Ok
    • 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.

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Pain Management Knowledge, Attitudes, and Performance of Nurses in Long-Term Care Hospitals (요양병원 간호사의 통증관리에 대한 지식, 태도, 수행정도)

  • Cho, Hyeonju;Kwon, So-Hi
    • Journal of Hospice and Palliative Care
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    • v.19 no.4
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    • pp.322-330
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    • 2016
  • Purpose: This study investigated long-term care hospital nurses' knowledge and practice of pain management and their attitudes towards the job with an ultimate aim to provide fundamental information for development of a pain education program. Methods: A cross-sectional survey was carried out with 120 nurses from four long-term care hospitals. Nurses' knowledge of and attitudes towards pain management was measured using a tool developed by Watt-Watson. To examine their pain management practice, an instrument was developed based on the pain management guidelines used by the long-term care settings. Results: For pain management knowledge, the participants gave an average of 26.2 (${\pm}13.10$) correct answers out of 40 questions. The most frequently missed question was one about subjectivity of pain, "Patients' physiological and behavioral reactions to pain hint at the presence and intensity of pain" (89.2%), and 56.7% of the nurses believed that increasing tolerance for a narcotic analgesic means addiction. Regarding attitudes towards and practice of pain management, 80.2% of the nurses used placebos to patients who complain about pain often. Conclusion: This study revealed poor level of pain management knowledge of and attitude among long-term care hospital nurses. This might negatively affect their pain management practice. From the educational perspective, nurses should be provided with education on pain management education with emphasis on the nature of pain and misuse of placebo drugs.

Pain and Factors Influencing Its Management in Patients with Terminal Cancer (말기 암환자의 통증 및 통증관리에 영향을 미치는 요인)

  • Yun, Young-Ho;Heo, Dae-Seog;Kim, Hong-Soo;Ou, Sang-Woo;Yoo, Tai-Woo;Kim, You-Young;Huh, Bong-Yul
    • 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.

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Management of Postoperative Pain (술후 통증관리)

  • Jeong, Chang-Young
    • The Korean Journal of Pain
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    • v.4 no.2
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    • pp.100-105
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    • 1991
  • 술후 통증관리를 위해 많은 새로운 약물과 기술이 도입되고 특히 최근에는 intraspinal narcotics나 PCA방법의 많은 발달에 의해 많은 발전을 가져왔다. 그러나 통증자체가 신체적으로 정신적으로 여러 가지 복합적인 인자가 개제되어 있기때문에 사용되는 약물의 임상약리의 이해와 계속적인 새로운 기술의 개발이 적절한 통증관리의 방침을 수립할 수 있을 것이다.

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Analysis of Postoperative Pain Management Knowledge and Attitudes in Nursing Students for Promotion of Life Care (라이프케어 증진을 위한 간호대학생의 수술 후 통증관리의 지식과 태도 분석)

  • Lee, Eun-Hee;Lee, Hye-Jin
    • Journal of Korea Entertainment Industry Association
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    • v.14 no.2
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    • pp.187-194
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    • 2020
  • This study is a descriptive cross-sectional study to identify the perception of post-operative pain management by nursing college students. The study involved 171 nursing college students with clinical practice experience. The data collection was made using structured questionnaires from March to June 2019. The results showed 65.1 percent general knowledge, 58.0 percent knowledge of analgesics and 81.9 percent attitude toward pain management. Pain knowledge and attitude were higher for pain training and men. The general knowledge score for pain showed a positive correlation between knowledge of analgesics, attitudes to pain management. We hope that the results of this study will be used to develop a postoperative pain management program by showing the need for systematic training programs for nursing college students and continuous training for postoperative pain management.

Patient Satisfaction with Cancer Pain Management (암성통증관리 만족도)

  • Lee, So-Woo;Kim, Si-Young;Hong, Young-Seon;Kim, Eun-Kyung;Kim, Hyun-Sook
    • Journal of Hospice and Palliative Care
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    • v.6 no.1
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    • pp.22-33
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    • 2003
  • Purpose : The purpose of this study was to evaluate the present status of patients' satisfaction and the reasons for any satisfaction or dissatisfaction in cancer pain management Methods : A cross-sectional survey was used to obtain the feedback about pain management. The results of the survey were collected from 59 in- or out-patient who had cancer treatment at two of the teaching hospitals in Seoul from July, 2002 to November, 2002. The data was obtained by a structured questionnaire based on the American Cancer Society Patient Outcome Questionnaire(APS-POQ) and other previous research. The clinical information for all patients were compiled by reviewing their medical records. Resuts : 1) The subjects' mean score of the worst pain was 6.77, the average pain score was 3.80, and the pain score after management was 2.93 for the past 24 hours. The mean score of total pain interference was $25.03{\pm}12.82$. Many of the subjects had false beliefs about pain such as 'the experience of pain is a sign that the illness has gotten worse', 'pain medicine should be 'saved' in case the pain gets worse' and 'people get addicted to pain medicine easily'. 2) 66.1% of the subjects were properly medicated with analgesics. 33.9% of the subjects reported use of various methods in controlling pain other than the prescribed medication. Only 33.9% of the subjects had a chance to be educated about pain management by doctors or nurses. 3) The mean score of patients' satisfaction with pain management was $4.19{\pm}1.14$. 72.9% of the subjects answered 'satisfied' with pain management. The reasons for dissatisfaction were 'the pain was not relieved even after the pain management', 'I was not quickly and promptly treated when I complained of pain', 'doctors and nurses didn't pay much attention to my complaints of pain.', and 'there was no appropriate information given on the methods of administration, effect duration and side effects of pain medicine.' The reasons for satisfaction were: 'the pain was relieved after the pain management.', 'doctors and nurses quickly and promptly controlled my pain.', 'doctors and nurses paid enough attention to my complaints of pain.' and 'trust in my physician'. 4) In pain severity or pain interference, no significant difference was found between the satisfied group and dissatisfied group. On the belief 'good patients avoid talking about pain', a significant difference was found between the satisfied group and dissatisfied group. Conclusions : The patients' satisfaction with cancer pain management has increased over the years but still about 30% of patients reported to be 'not satisfied' for various reasons. The results of this study suggest that patients' education should be done to improve satisfaction in the pain management program.

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A University Hospital Nurses' Knowledge and Attitude about Cancer Pain Management (일개 대학병원 간호사의 암성통증관리에 대한 지식과 태도)

  • Kim, Seon-Hwa;Park, Sang-Youn
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.13 no.1
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    • pp.254-263
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    • 2012
  • This study was performed to investigate a hospital nurses' knowledge and attitude about cancer pain management and to make use of base material for education. The research design was descriptive survey study, and the data were collected from 303 nurses who were working at a university hospital. A instrument study was the inventory consisting 107 questionnaires for cancer pain management. The data were analysed by SPSS WIN 18.0. The study showed that the percentage of correct answers for general knowledge about pain was 79.6%, for knowledge about cancer pain was 82.2%, for knowledge about analgesics use was 55.6%, for attitude about pain management was 65.2%, and the percentage of correct answers for each item was 70.7%. The knowledge about analgesics use was significant difference in age, education level, position, years of nursing practice, present place of working, years of present working place, pain education program experience, the attitude about pain management was significant difference in gender, education level and present place of working. Consequently it needs the persistent educational programs development and the clinical application to improve of nurses` knowledge and attitude about cancer pain management.

A Study on the Development of Case Management Program for Arthralgia in Customized Visiting Health Care (맞춤형 방문건강관리사업에서의 관절통증 사례관리 프로그램 개발 연구)

  • Lee, Moo-Sik
    • Proceedings of the KAIS Fall Conference
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    • 2009.12a
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    • pp.474-478
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    • 2009
  • 본 연구는 2008년 맞춤형 방문건강관리사업에 사용되고 있는 관절통증을 중심으로 한 사례관리를 수정 보안하여 우리나라 실정에 맞는 관절통증 사례관리 프로그램을 개발, 제안하며, 맞춤형 방문건강 관리사업의 활성화와 완성도를 높이는데 있다. 연구방법으로는 2007년 전국 12주 관절통증 사례관리 결과자료 분석하고, 전국 253개 보건소의 맞춤형 방문건강관리사업 인력에 대한 자료 분석과 전국 보건소 전문가 자문회의와 토론 결과를 통해 설문지를 수정 보완하여 2008년도 충청남도 관절통증 12주 사례관리를 실시하였다. 자료분석은 SPSS 12.0 통계 프로그램을 이용하여, p-value가 0.05 미만과 0.01미만인 경우를 통계적으로 유의한 것으로 판정하였으며, 전국자료는 빈도분석, wilcoxon 부호순위 검정과 McNemar's 검정을 실시하였으며, 12주의 관절통증 사례관리의 연구기간동안 수집된 자료를 1주와 8주간, 1주와 12주간, 8주와 12주간을 paired t-test 검정과 McNemar's 검정을 실시하여 유의성 평가를 실시하였다. 연구결과는 다음과 같다. 12주 기간 동안 사전 사례관리 방문간호사의 교육을 통한 사례관리 서비스의 강도의 조절 및 매주로 서비스의 횟수를 조절하여 사례관리를 실시한 결과 총 109개 항목에서 1주와 8주간에 유의한 항목은 TG(mg/dl)를 비롯한 51개 항목, 1주와 12주간에는 콜레스테롤(mg/dl)을 비롯한 53개 항목, 8주와 12주간에는 지난 48시간동안 관절통증 점수를 비롯한 3개 항목으로 유의한 차이를 볼 수 있었으며, 1주와 8주간은 유의하나 1주와 12주간은 유의하지 않게 나타나는 항목은 TG(mg/dl)를 비롯한 3개 항목, 1주와 8주간은 유의하지 않다가 1주와 12주간은 유의하게 나타나는 항목은 콜레스테롤(mg/dl)를 비롯한 6개 항목, 1주, 8주, 12주간의 모든 기간에서 유의한 항목은 지난 48 시간동안 관절통증 점수를 비롯한 3개 항목으로 조사되었다. 결론적으로 현재 우리나라에서 추진되고 있는 맞춤형 방문건강관리 사업의 사업지침에 대한 보완을 위해 관절통증사례관리 프로그램에 있어 중재 서비스 또는 프로그램의 기간은 12주간에서 8주간으로 조정 되어야 하며, 추가가 필요한 항목으로는 교육, 자기역량 강화, 운동처방, 물리치료, 약물치료, 대체요법, 식이, 영양, 생활지도 등이며, 어골도 분석을 위한 기본 틀 및 주요 구성요소를 제시 및 기여 요인 및 결정요인을 위한 논리적 모형 제시가 필요하며, 개선목표를 위한 유지증진 및 관리능력, 지기 관리 수행도 개선과 대상자별 맞춤형 사례관리를 위한 표준화된 행동 체크리스트 제작 보급 및 사례별 운동, 물리치료 지도 방법 계획 수립에 대한 인력 충원이 필요하다.

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Factors affecting nurse's pain management for patients with dementia (요양병원 간호사의 치매환자 통증관리 수행에 영향을 미치는 요인)

  • Ryu, Young-Seun;Park, Jeong-Sook
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.9
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    • pp.253-264
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    • 2016
  • The aim of this study was to investigate the factors influencing nurses' pain management in patients with dementia. A total of 197 nurses were recruited from 30 long-term care hospitals in B city. Data were collected from June 25 to July 15, 2016. Data analysis was performed using the SPSS 22.0 program, which included a t-test, ANOVA, Scheffe test, Pearson's correlation, and multiple regression analyses. The levels of knowledge were low with a score of 10.73 out of 18. The level of attitudes, self-efficacy, barriers and performance were 2.98, 3.34, 2.90, and 4.09, respectively. In addition, there were significant differences in the level of performance depending on the age (p=.046), long-term care (p=.009), and pain education (p=.004). The level of attitudes (r=.21, p=.006), self-efficacy (r=.51, p<.001) and performance were positively correlated with each other. A significant negative correlation was observed between the barriers and performance (r=-.16, p=.035). The meaningful variables that influence the performance were self-efficacy, long-term care, and pain education. These factors were responsible for 30.1%. Therefore, effective programs will be necessary to enhance pain management by improving the self-efficacy and knowledge of pain in dementia patients.

Knowledge and Performance of Cancer Pain Management of Nurses and Nurses' aides in Long-term Care Hospitals (요양병원 간호사와 간호조무사의 암성 통증관리에 대한 지식 및 수행)

  • Jeong, Sunjin;Kim, Kyeha
    • The Journal of the Korea Contents Association
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    • v.14 no.10
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    • pp.649-660
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    • 2014
  • The purpose of this study was to assess knowledge and performance of cancer pain management of nurses and nurses' aides in long-term care hospitals. Subjects were 84 nurses and 72 nurses' aides recruited from seven long-term care hospitals in Gwangju city and Jeonranam-do. SPSS/WIN 21.0 was used for data analysis by descriptive statistics, independent t-test, one-way ANOVA, Pearson's correlation coefficients, and stepwise multiple regression. The mean scores of knowledge of cancer pain management were 16.84, and the score for performance was 2.88. There were significant differences in the knowledge of cancer pain management according to education level, job, and cancer pain management guidelines. Significant differences in performance of cancer pain management were observed according to education level, job, number of beds, cognition of cancer pain management guidelines, and clinical practice guideline for cancer pain management. Knowledge, number of beds, and clinical practice guideline for cancer pain management affected in performance of cancer pain management. Education program for cancer pain management and clinical practice guideline for cancer pain management are needed to improve performance of cancer pain management of nurses and nurses' aides in long-term care hospitals.