Journal of Korean Academy of Fundamentals of Nursing
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v.7
no.3
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pp.415-428
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2000
The purpose of this study was to identify side effects of the vesicant chemotherapy. The study was designed to be a descriptive survey. The subjects of this study were 88 patients with various types of cancer, primary lung cancer(25.0%), advanced gastric cancer(25.0%), breast cancer(20.5%), etc. The mean age was 44.8 years old(range: 16-68). The questionnaire was completed by nurses of the outpatient unit and chemotherapy ward, and intravenous nurse specialist. The results of the study were as follows: 1) Chemotherapy was administered with a 23G scalp needle and 24G insyte. Injection site was dorsum of hands(64.7%), cephalic vein(19.3%). Successful rate for the first attempt was 88.6%. The first & second cycle chemotherapy was 29.5% each.. Mainly used drugs were Navelbine(34.1%), Adriamycin(20.5%). 2) Venous Problems after chemotherapy were pain(13.6%) incurred by venous, mainly due to the administration of Navelbine; redness at the inravenous site(12.5%) and itching sense 2.3% Non-venous problems were nausea (18.2%), dullness(14.8%), vomiting(8.0%), facial flushing(6.8%), anxiety(5.7%). Subjective discomforts after chemotherapy were generalized arm pain at the injection side(14.8%), dizziness(6.8%), weakness(5.7%) and general bodyache(5.7%). Systemic anaphylactic reaction and extravasation did not occur. 3) Non-venous problem after chemotherapy were nausea, vomiting & anorexia. Frequency of chemotherapy related to side effects were itching, facial flushing, and nausea(p< .05). Day of chemotherapy related to side effects were nausea & vomiting(p< .05). Site of chemotherapy related to side effects were redness(p< .05). Frequency of venipuncture related to side effects were redness(p< .05). Conclusively, cancer chemotherapy patients have had some venous problem. They need appropriate venous access devices for chemotherapy. And other non-venous problem will be managed appropriately. Further research was required to identify the rate of venous complication or side effects of vesicant chemotherapy.
Objective : Primary treatment of spinal metastasis has been external beam radiotherapy. Recent advance of technology enables radiosurgery to be extended to extracranial lesions. The purpose of this study was to determine the clinical effectiveness and safety of stereotactic radiosurgery using Cyberknife in spinal metastasis. Methods : From June, 2002 to December, 2007, 129 patients with 167 spinal metastases were treated with Cyberknife. Most of the patients (94%) presented with pain and nine patients suffered from motor deficits. Twelve patients were asymptomatic. Fifty-three patients (32%) had previous radiation therapy. Using Cyberknife, 16-39 Gy in 1-5 fractions were delivered to spinal metastatic lesions. Radiation dose was not different regarding the tumor pathology or tumor volume. Results : After six months follow-up, patient evaluation was possible in 108 lesions. Among them, significant pain relief was seen in 98 lesions (91%). Radiological data were obtained in 83 lesions. The mass size was decreased or stable in 75 lesions and increased in eight lesions. Radiological control failure cases were hepatocellular carcinoma (5 cases), lung cancer (1 case), breast cancer (1 case) and renal cell carcinoma (1 case). Treatment-related radiation injury was not detected. Conclusion : Cyberknife radiosurgery is clinically effective and safe for spinal metastases. It is true even in previously irradiated patients. Compared to conventional radiation therapy, Cyberknife shows higher pain control rate and its treatment process is more convenient for patients. Thus, it can be regarded as a primary treatment modality for spinal metastases.
Purpose: Pain management is often needlessly suboptimal. Health care professionals are seldom trained in pain management, may not realize the importance of pain management or recognize that a patient is in pain, and may fear prescribing opioid medications. Noting that one of the problems related to health care professionals is poor assessment of pain, we studied a trend of pain severity and satisfaction with pain controls after using TTS-fentanyl in order to determine whether a regular pain assessment was effective for controlling cancer pain. Methods: We assessed the pain as a $5^{th}$ vital sign after using TTS-fentanyl in 471 hospitalized cancer patients during 4 days. The data were collected from September, 2003 to December, 2003. Pain severity was assessed by using a numeric pain intensity scale($0{\sim}10$) by ongoing pain assessment. Results: Pain assessment as a $5^{th}$ vital sign had led to reduce patient's pain scores. High degrees of satisfaction scores in both patients and doctors with TTS-fentanyl were observed. They were also negatively correlated with the pain severity. Conclusion: Regular pain assessment was effective in the management of cancer pain.
Purpose: This study was conducted to provide basic data for developing an effective strategy for cancer pain management by comparing the levels of barriers to pain management of metastatic or advanced cancer patient and their nurses. Methods: The subject of this study were 155 patients who were treated for metastatic or advanced cancer at one of three hospitals in Seoul from January 2004 to January 2005, and 153 nurses who take care of those patients. The levels of barriers to pain management were measured using a tool developed by Gunnarsdottir et al. (2002), 27 questions on a six point scale. The levels of stresses were measured using a tool modified from a stress response measurement reported by Goh Gyung-bong et al. (2000), 27 questions on a five point scale. The levels of barriers in cancer patients were analyzed using t-test and ANOVA, while the data obtained from patients and nurses were compared by t-test. Results: Higher levels of barriers to pain management were found in three groups: 'less than middle school,' 'not treated with anti-cancer chemotherapy,' and 'ECOG of 2.' The level (2.55) of barriers to pain management in the patient group was higher than that (1.76) of the nurse group. Both of the two groups had high levels of barriers in two variables: 'There is a danger of becoming addicted to pain medicine.' and 'Using pain medicine blocks your ability to know if you have any new pain.' There was not a significant difference in the levels of stresses between the two groups. Conclusion: It was found that, for effective cancer pain management practices, it would be necessary to provide cancer patients and their nurses with education and training about pain management and related barriers.
Purpose: Studies focus on cancer control, prevention, or assessment of psychosocial problems and intervention methods. However, few studies exist concerning psychosocial problems, measuring tools for those problems, and interventions for cancer patients in Korea. One of the purposes of this study was to review studies in this area, to examine various psychosocial problems experienced by cancer patients. This is a crucial area to investigate, since psychosocial problems in turn negatively influence the patients' immune function, which speeds the progress of the disease. Another goal was to identify instruments used to measure psychosocial functioning and problems in cancer patients, to analyze their validity and reliability, with the aim to discover the best instruments. A final goal was to explore and compare the effects of psychosocial interventions, to determine the most effective practices. Method: Journal articles published since 1995 were searched from PubMed Data base, Google search engine, and published cancer-related studies, using search keywords "psychosocial function and intervention for the cancer patients"; whole articles of selected references were reviewed and analyzed. Result: Most common psychosocial problems were depression, fatigue, nausea, pain, distress, resulting in a low quality of life. The seven scales found in the literature to assess the psychosocial functioning were Center for Epidemiological Studies-Depression, State-Trait Anxiety Inventory, Symptom Checklist 90-R, Profile of Mood States, Psychosocial Adjustment to Illness Scale, Brief Symptom Inventory, and SF-36 HRQOL(Health Related Quality of Life). Social support interventions for cancer patients were effective in improving quality of life scores. Conclusion: It is necessary to apply support intervention strategies to help cancer patients in Korea. These strategies can help to reduce the effects of psychosocial symptoms, which in turn affect the development and control of cancer. Strategies developed in Western countries may need to be modified for use within Korea. Further studies are warranted to review the support intervention strategies that were being used to for cancer patients
Background: Successful implementation of pain management procedures and guidelines in an institution depends very much on the acceptance of many levels of healthcare providers. Aim: The main purpose of this study was to determine the level of knowledge and attitudes regarding pain among nurses working in tertiary care in a local setting and the factors that may be associated with this. Materials and Methods: This cross-sectional research study used a modified version of the Nurses' Knowledge and Attitudes Survey (NKAS) regarding pain. Basic demographic data were obtained for further correlation with the level of pain knowledge. Results: A total of 566 nurses, 34 male and 532 female, volunteered to participate in this study. The response rate (RR) was 76%, with an overall mean percentage score of $42.7{\pm}10.9$ (range: 5-92.5). The majority of participants were younger nurses below 40 years of age and more than 70% had worked for less than 10 years ($6.6{\pm}4.45$). Up to 92% had never had any formal education in pain management in general. The total mean score of correct answers was $58.6{\pm}9.58$, with oncology nursing staff scoring a higher percentage when compared with nurses from other general and critical care wards ($63.52{\pm}9.27$, p<0.045). Only 2.5% out of all participants obtained a score of 80% or greater. The majority of the oncology nurses achieved the expected competency level (p<0.03). Conclusions: The present findings give further support for the universal concern about poor knowledge and attitudes among nurses' related to the optimal management of pain. The results reflected that neither number of years working nor age influenced the level of knowledge or attitudes of the practising nurses. Oncology nursing staff consistently scored better than the rest of the cohort. This reflects that clinical experience helped to improve attitudes and knowledge concerning better pain management.
Chae, Young Hee;Lee, Won Hee;Min, Young Mi;Shin, A Mi;Kim, Hyang Mi
Journal of Korean Clinical Nursing Research
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v.19
no.3
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pp.407-418
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2013
Purpose: The purpose of this study is to examine the nurse's role performance and the perception of the importance of role among nurses practicing in a cancer care facility. Methods: A descriptive study design was applied with convenient sampling of 175 nurses working at a cancer care facility in Daegu, Korea. Data was collected using a structured questionnaire from July 1, 2013 to July 5, 2013. Results: Cancer care facility nurse's role performance score was measured on average $3.23{\pm}0.64.$ Oral medication was the most frequently performed role, followed by encouragement, care related to medication, and pain management. The perception of the importance of nurse's role was measured on average $3.31{\pm}0.35$. Care related to medication was regarded as the most important, followed by transfusion, oral medication, and intravenous & intramuscular medication. Nurse's role performance was different according to nurse's age (F=3.21, p=.024) and current practice area (F=3.73, p=.012). The perception of the importance of nurse's role was different only in relation to current practice area (F=6.82, p<.001). Conclusion: Nurses practicing in oncology setting frequently involve encouraging patients and pain management. Training programs designed to facilitate frequently performed and highly regarded nurse's roles are required for nurses practicing in oncology setting.
Journal of Korean Academy of Fundamentals of Nursing
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v.24
no.2
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pp.95-105
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2017
Purpose: A systematic literature review and meta-analysis were conducted to synthesis research findings on relationships of quality of life with multi-dimensional correlates in Korean breast cancer patients. Methods: For the study purpose, 18 studies were selected through a systematic process of searching the literature. Results: Among the general characteristics, variables having a significant relationship with quality of life were age (ES=.19), marital status (ES=.15), education (ES=.19), economic status (ES=.16), job status (ES=.10), and religion (ES=.13). Among the disease characteristics, type of treatment (ES=.12), length of time since diagnosis (ES=.13), stage of disease (ES=.14), length of time since operation (ES=.10), frequency of treatment (ES=.19), wound site and pain (ES=.16) were shown to have a significant relationship with quality of life. Depression (ES=-.60), one of the psychological factor, was the variable most significantly related to quality of life. Conclusion: The findings indicate that the variables which strongly impact quality of life in breast cancer patients are depression and pain.
Background: The study evaluated the patient, lifestyle and tumor profile in patients undergoing upfront surgery for sporadic colorectal cancer (CRC) in Indian population. Materials and Methods: One hundred consecutive patients were included. Details related to their demographic profile, habits, signs and symptoms, tumor profile, further treatment and follow up were recorded. Results: The majority of the patients had colonic cancer (68%), advanced tumor stage 3 & 4 (46%), moderately differentiated tumors (70%) with absence of lymphatic invasion (60%) and metastasis (90%). Correlations between tumor location and abdominal pain (p-value 0.002), bleeding per rectum (p-value <0.001), difficulty in micturition (p-value 0.012) and constipation (p-value 0.007) were found to be statistically significant. Abdominal pain was more frequently reported in patients with metastasis (p-value 0.031). Loss of weight statistically correlated with absence of lymphatic invasion (p-value 0.047). Associations between tumor stage and alcohol intake (p-value 0.050) and non vegetarian diet (p-value 0.006); lymphatic invasion and intake of spicy food (p-value 0.040) and non vegetarian diet (p-value 0.001) and metastasis and alcohol intake (p-value 0.041) were also observed. Age and tumor grade were also correlated (p-value 0.020). Conclusions: Minimizing the adverse lifestyle factors can help in reducing the overall incidence of CRC in the Indian population.
Spinal nerve injury causes mechanical allodynia and structural imbalance of neurotransmission, which were typically associated with calcium overload. Storeoperated calcium entry (SOCE) is considered crucial elements-mediating intracellular calcium homeostasis, ion channel activity, and synaptic plasticity. However, the underlying mechanism of SOCE in mediating neuronal transmitter release and synaptic transmission remains ambiguous in neuropathic pain. Neuropathic rats were operated by spinal nerve ligations. Neurotransmissions were assessed by whole-cell recording in substantia gelatinosa. Immunofluorescence staining of STIM1 with neuronal and glial biomarkers in the spinal dorsal horn. The endoplasmic reticulum stress level was estimated from qRT-PCR. Intrathecal injection of SOCE antagonist SKF96365 dose-dependently alleviated mechanical allodynia in ipsilateral hind paws of neuropathic rats with ED50 of 18 ㎍. Immunofluorescence staining demonstrated that STIM1 was specifically and significantly expressed in neurons but not astrocytes and microglia in the spinal dorsal horn. Bath application of SKF96365 inhibited enhanced miniature excitatory postsynaptic currents in a dosage-dependent manner without affecting miniature inhibitory postsynaptic currents. Mal-adaption of SOCE was commonly related to endoplasmic reticulum (ER) stress in the central nervous system. SKF96365 markedly suppressed ER stress levels by alleviating mRNA expression of C/ EBP homologous protein and heat shock protein 70 in neuropathic rats. Our findings suggested that nerve injury might promote SOCE-mediated calcium levels, resulting in long-term imbalance of spinal synaptic transmission and behavioral sensitization, SKF96365 produces antinociception by alleviating glutamatergic transmission and ER stress. This work demonstrated the involvement of SOCE in neuropathic pain, implying that SOCE might be a potential target for pain management.
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