• The Korean Journal of Pain
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• v.10 no.1
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• pp.117-120
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• 1997

Cancer is a devastating disease, and the treatment of related pain is an extremely challenging task. Providing adequate analgesia while avoiding unnecessary drug effects often requires a polypharmacologic approach in cancer pain management. A 36-year old woman with breast cancer metastatic to the axial skeleton and bilateral hip joints was admitted to hemato-oncology service with complaints of intractable abdominal and hip pain. Despite rapidly increasing doses of intravenous morphine up to 350 mg per day; transdermal fentanyl; midazolam; ketorolac; lorazepam; dexamethasone, the patient continued to describe her pain as 10 of 10, refusing all surgical/diagnostic interventions not directly related to pain control. She did, however, consent to lumbar epidural catheter placement. The patient was sedated with titrating doses of propofol to assist with positioning. Even though the procedure was not successful due to significant thoracolumbar scoliosis, the patient admitted feeling better than she has in months during attempted placement. After continuous infusion of propofol was initiated at subhypnotic dose, the patient's analgesic demand was drastically reduced and described her pain as "1 to 3" of "10". Approximately 96 hours after the propofol infusion was started, the patient expired comfortably. There had been no change in her medical regimen during fecal 48 hours. In the case described, propofol was extremely advantageous as an adjuvant in the management of cancer related pain.

• Asian Oncology Nursing
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• v.9 no.2
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• pp.104-113
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• 2009

Purpose: The aim of this study was to investigate pain management knowledge and attitude in cancer patients and their family caregivers. Methods: The subjects were 52 hospitalized cancer patients and 52 their family caregivers in a hematooncologic unit in one general hospital. Data were collected via self-reported questionnaires and interviews in 2008. Results: 46.2% of the patient participants reported pain and 50% of them were taking opioid analgesics. Levels of knowledge about cancer pain and its management in both patient and caregiver participants were low, whereas, the scores of knowledge of the caregivers were significantly higher than that of the patients. The attitudes toward cancer pain were not significantly different between patients and caregivers. Both cancer patients and caregivers had some misconcepts in using opioid analgesics and about cancer pain. Patients' and caregivers' level of knowledge about cancer pain and its mangement demonstrated positive correlation. Conclusion: Education about cancer pain and its management should target both cancer patients and their family caregivers. Also the education should focus on intervening the misconceptions that patients and their caregivers have regarding cancer pain and its management.

• The Korean Journal of Pain
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• v.7 no.1
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• pp.1-12
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• 1994

• Journal of muscle and joint health
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• v.27 no.1
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• pp.12-21
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• 2020

Purpose: The study was to develop a tailored education and coaching program (TECP) for cancer patients, and to identify the effects of TECP on pain severity, daily living impairment, barriers on pain management, self-efficacy, and pain management satisfaction. Methods: A randomized controlled trial was used. Patients referred to an oncology nurse specialist from oncologists for pain management were randomly assigned to TECP (25) or usual education program (UEP, 22). The intervention was offered by educating the method of taking opioid medication, managing opioid-induced side effects, reducing pain misconceptions and enhancing self-efficacy for communicating with a medical team on cancer pain severity, and pain-related impairment. Patients completed questionnaires before the education program and on the next visit 3~4 weeks later. Data were analyzed by SPSS 19.0 program using percentage, frequency, mean, standard deviation, x² test and independent t-test. Results: At all levels, pain severity improved significantly in the experimental group-worst pain (8.16 to 3.80, p<.001), average pain (6.16 to 2.52 p=.008), and least pain (3.32 to 0.96, p=.038)-but not in the control group. Pain management satisfaction also showed significant differences (t=2.93, p=.005) between experimental (4.70±0.49) and control (4.17±0.73) groups. Interference with daily living, barriers to managing cancer pain, and self-efficacy for managing pain improved in both groups but there were no significant differences. Conclusion: The findings suggest that TECP should be considered for outpatients who need cancer pain management.

• The Korean Journal of Pain
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• v.3 no.1
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• pp.11-14
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• 1990

Thirty-two cancer patients were treated with various pain control methods. In those who had localized pain or more than 1 year life expectancy. The author preferred neurolytic blockade for whom had localized pain or had more than 1 year life-expectancy to epidural or intrathecal narcotics. The latter methods were saved as a last resort. Effective pain relief was achieved in over 80% of those treated. There were no serious complications. Of the 12 epidural or intrathecally implanted catheter with subcutaneous tunneling cases, successful pain management was possible throughout the remainder of life which was from 1 week to 6 months.

• The Korean Journal of Rehabilitation Nursing
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• v.3 no.1
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• pp.43-58
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• 2000

Pain management is a major issue in caring of cancer patients. Patients' concerns for reporting pain and taking analgesics are patient-related barriers to the management of cancer pain. Since such study has not been done at all in Korea, it is clearly needed to study on these problems. The purpose of this study is to attain basic data in order to improve cancer pain management in Korea. This is done by: 1) examining the extent of patients' concerns that might be barriers to the optimal pain management, and the extent of related factors (pain management hesitancy, adequacy of using analgesics, pain severity and pain interference); 2) identifying the relationship between patients' concerns and the related factors. The data has been collected from 180 cancer patients who were hospitalized in medical wards of one university hospital in Seoul, Korea during the period from November 1, 1997 to February 28, 1998. The data has been collected through interviews with (1) Barriers Questionnaire - Korean Version (BQ-K); (2) Hesitancy Experience Questionnaires (HQ); (3) Pain Management Index (PMI); (4) Brief Pain Inventory (BPI); and (5) Demographic Data. The data were analyzed by descriptive statistics and by t-test, One-way ANOVA, Pearson correlation using SPSSWIN program. The Results are as following: 1) The mean scores of Pain Management Concerns (PMC) by BQ-K were toward the moderate with a little high points(2.59). Most of the patients (99.4%) had some extent of concerns (over lout of maximum 5 points). Among the eight subscales of BQ-K, the Pain Management Concerns (PMC) about 'Fear of tolerance' was the highest (3.80) and 'Worry about side effects' was the least (1.40). 2) The extent of Pain Management Hesitancy (PMH) by HQ of wnom had pain on the day of the interview was a little higher than moderate score(5.53 out of maximum 10 points). 6.7% of the patients with experiencing pain used less adequate analgesics for the severity of pain than they were expected. 27.8% of them never used any analgesics at all. The mean score of pain severity by BPI was 16.59 (maximum: 40), and that of the interference with daily life by BPI was 32.03 (maximum: 70). 3) The patients who were older, less educated, and in low socio-economic status were likely to have more concerns. Pain Management Concerns (PMC) was positively correlated with Pain Management Hesitancy (PMH) (r=.75), pain severity (r=.44) and pain interference (r=.50). Those who were not using adequate analgesics had higher Pain Management Concerns (PMC) than did those who were using adequate analgesics (t=-5.42). The patients who had more Pain Management Concerns (PMC) tended to hesitate more to report pain and to use analgesics. They used more inadequate analgesics for the severity of pain and also had experienced more pain severity and interference with daily life. In conclusion, the patients' concerns for reporting pain and for using analgesics are major patient-related barriers to cancer pain management in Korea. The patients' concerns were correlated significantly with the level of the hesitancy experience, inadequate use of analgesics, the pain severity and the interference with daily life. Considering this, an educational program for cancer patients under the treatment with analgesics should be developed in order to solve these problems.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.15 no.2
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• pp.161-170
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• 2008

Purpose: The purpose of this study was to provide basic data for proper pain management. Method: Data were collected from 85 hospitalized patients with cancer pain. A retrospective chart review of level of pain, source of pain, verbal expression of pain, and pain management was done. The data were analyzed with the SPSS program. Results: The level of pain measured by NRS at the three time points was as follows Time 1 ($4.40{\pm}2.25$), Time 2 ($0.61{\pm}1.30$), Time 3 ($2.47{\pm}2.75$). The kinds of pain were somatic pain (51.8%), visceral pain (37.6%), neuropathic pain (12.9%). The analgesic amount measured by OME (oral morphine equivalent) was as follows: Time 1 ($70.85{\pm}69.65$), Time 2 ($91.61{\pm}89.20$), Time 3 ($96.71{\pm}94.25$). Degree of pain had significant differences according to type of cancer (F=-3.286, p= .002), cancer origin (F=2.906, p= .018), and metastasis (F=2.906, p= .018) at Time 2. Best control period had significant difference according to type of cancer (F=2.373, p= .023), and origin of cancer (F=2.466, p= .040) at Time 2 Conclusion: These finding will enable the application of nursing interventions for pain control in cancer patients, identification of kinds of nursing compared to priorities, and increased levels of comfort in cancer patients in clinical settings.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.13 no.1
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• pp.68-75
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• 2006

Purpose: This study was carried out to obtain basic data for developing effective pain management by identifying the positive and negative determinants for pain management in both cancer patients and their nurses. Method: The participants were 85 cancer patients and 78 nurses at C university hospital in Seoul. Data were collected from December 2004 to March 2005 using structured questionnaires. Results: The level of pain peaked at 5.02 when going into the hospital, and was then lowered to 2.08. The waiting time for analgesics was less than 30 minutes in 81.1% of the patients and for 68.2% answered that they reported their pain when the pain was no more endurable. Just over eighty percent (80.6%) of the patients were satisfied with the pain management. Only 10.3% of the nurses used a standardized tool for assessing patients, pain and 64.1% gave analgesics whenever patients complained of pain, while 19.2% did not when patients complained too frequently. Nurses who were unsatisfied with pain management accounted for 85.4% of the participants. Patients showed higher levels of barriers to pain management than nurses. Conclusion: There is a need to give cancer patients and nurses appropriate information on effective cancer pain management.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.17
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• pp.7453-7456
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• 2015

Background: Medical practitioners' attitudes have a significant impact on quality of care for cancer pain patients. This study was conducted to determine if being given a lecture concerning cancer pain and its management could improve the attitudes of medical students. Materials and Methods: A comparative study was conducted in 126 fifth-year medical students. Each student completed a pretest consisting of 3 questions about attitudes toward the optimal use of analgesics and 5 questions about attitudes toward prescribing opioids. Then they were given a 1.5-hour lecture, immediately following which they completed a post-test with the same questions. Results: Analysis with either comparison between groups or by matching, the post-test showed significantly more positive attitudes (p<0.05) of the medical students in all 3 questions about optimal use of analgesics and 4 out of 5 questions about prescription of opioids. The post-test results showed significantly more negative attitudes concerning the most appropriate stage for patients with severe pain to receive maximal doses of analgesics. Conclusions: Conservative attitudes, especially concerns about addiction, have been associated with a reluctance in many physicians to prescribe opioids. This study found that cancer pain education can help to improve medical student attitudes. However, fear of addiction and tolerance was still evident so emphasis of this particular issue during a lecture is essential. Providing appropriate information by means of a lecture can improve the attitudes of medical students regarding cancer pain management. However, more information should be given to lessen fear of addiction and tolerance.

• Journal of Hospice and Palliative Care
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• v.11 no.1
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• pp.51-54
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• 2008

Qualify of life is the main consideration in pain management and palliative care for patients with advanced cancer. Cancer pain is primarily relieved with pharmacological therapy including aretaminophen, nonsteroidal anti-inflammatory drugs, adjuvant analgesics, and opioids. In addition to pharmacological therapy, the neurolytic celiac plexus block is claimed to be an effective approach in management of advanced pancreatic cancer pain. We report our patient who has been treated for advanced cancer pain with multiple neurolytic blocks. The clinical result suggests that combined neurolytic blocks improved the quality of life of patient who had advanced ranter pain by reducing both the intensity of pain and opioid consumption, without serious complications.