• 제목/요약/키워드: Pain, Validation studies

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Adaptation and validation of body maps for musculoskeletal pain location in patients with severe obesity

  • Mendonca, Carolina Rodrigues;Noll, Matias;Silveira, Erika Aparecida
    • The Korean Journal of Pain
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    • 제31권4호
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    • pp.268-276
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    • 2018
  • Background: Although a variety of instruments implement body maps for the precise identification of pain symptoms, no instrument has been validated for use in people with obesity. This study reports the adaptation and validation of body maps for musculoskeletal pain location in people with obesity. Methods: Nine key anatomical regions were highlighted based on the original images of the Nordic Musculoskeletal Questionnaire body maps. Adult silhouettes were generated from photographs of men and women with obesity. The body dimensions were adjusted to take into account the different body fat distribution patterns of people with obesity. The validity of the images was assessed by 12 experts. Subsequently, a data collection stage was performed with 58 patients with severe obesity from both sexes. The reproducibility of the images was tested by comparison with the original images. Results: The results of the validation pilot study indicated that the adapted images facilitated the location of musculoskeletal pain in men and women with obesity. The reproducibility of the original and adapted versions of the body maps indicated good agreement for pain over the last 12 months and 7 days (80% vs. 79.7%). Pain scores in the last 12 months indicated good and high sensitivity and specificity for all body areas (60.9% vs. 89.1%). Considering pain in the last 7 days, high sensitivity and specificity for all areas of the body (85.1% vs. 70.1%). Conclusions: The body maps developed in this study are reliable and valid to identify the location of pain in people with obesity.

Effect of premedication on postoperative pain after root canal therapy in patients with irreversible pulpitis: a systematic review and meta-analysis

  • Kumar, Gaurav;Sangwan, Pankaj;Tewari, Sanjay
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제21권5호
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    • pp.397-411
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    • 2021
  • This systematic review aimed to assess the effect of premedication on postoperative pain after root canal treatment in vital teeth. Five electronic databases were searched for randomized clinical trials, and two independent reviewers selected eligible studies, extracted data, and assessed the quality of studies using the Cochrane Risk of Bias tool. Meta-analysis was conducted using the random-effects model, and the pooled effect estimate of the standardized mean difference (SMD) between premedication and placebo was calculated. Subgroup analysis was conducted based on the class and route of the drug. Studies with a high risk of bias were excluded from the sensitivity analysis. Ten trials satisfied the inclusion criteria, of which eight were included in the meta-analysis. Premedication was more effective in reducing postoperative pain than placebo at 6 hours (SMD = -1.00; 95% confidence interval [CI] = -1.33 to -0.66), 12 hours (SMD = -0.80; 95% CI = -1.05 to -0.56), and 24 hours (SMD = -0.72; 95% CI = -1.02 to -0.43). The results of the sensitivity analysis confirmed the findings of the primary analysis. Based on these results, it can be concluded that premedication is effective in reducing postoperative pain in teeth with irreversible pulpitis. However, additional quality studies are required for further validation.

미숙아 통증지표(Premature Infant Pain Scale) 개발 (Development of a Premature Infant Pain Scale (PIPS))

  • 김미순;김미진;함은하;김경미
    • 기본간호학회지
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    • 제13권3호
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    • pp.510-519
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    • 2006
  • Purpose: To develop and validate a scale suitable and efficient scale for use in clinical practice as to assess pain in premature infants. Method: Pain indicators identified by observation of preform infants. A cohort of preform infants was studied prospectively to determine the construct validity, inter-rater reliability, and internal consistency of the scale. The PIPS uses four indicators of pain: corrected gestational age, heart rate, oxygen saturation, behavioral state. The validation study included 45 premature infants with gestational age of 37 weeks or less. Results: The inter-rater reliability of the PIPS was acceptable, with Pearson correlations ranging from.720 to.970. Internal consistency was high: Cronbach's alpha coefficients ranged from.551 to.653. There was a strong correlation between the PIPS and PIPP scores (each researcher's r=.743, each indicator's r=.914). Although gestational age showed no association between these factors and the sum, the other variables were positively associated with the sum. Time needed to calculate PIPS scores is was less than Premature Infant Pain Profile (PIPP) scores(p<.000). Conclusion: The validation data suggest that the PIPS is appropriate and efficient for assessing pain in premature infants. Further studies are required about to determine appropriate interventions for each pain score on the PIPS.

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산욕기 산모의 유방간호에 대한 체계적 문헌고찰 (A Systematic Review of Breast Care for Postpartum Mothers)

  • 송지아;허명행
    • 여성건강간호학회지
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    • 제25권3호
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    • pp.258-272
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    • 2019
  • Purpose: The purpose of this study was to identify nursing interventions for the postpartum breast care of mothers and determine the effectiveness of interventions for breast pain and engorgement by systematic review. Methods: Eight national and international databases were reviewed to retrieve and collect randomized controlled trial and controlled clinical trial literature published up to March 2015. Two reviewers independently selected the studies and performed data abstraction and validation. The risk of bias was assessed using Cochrane criteria. A meta-analysis of the studies was performed to analyze the data. Results: The meta-analysis showed that breast massage, along with routine breast care, resulted in a 3.52-point reduction in pain on a 10-point visual analogue scale. Meta-analysis of therapy with cold cabbage leaves and routine breast care showed a pain reduction of 0.54 points. Meta-analysis of cold cabbage leaf application in the experimental group versus cold compress therapy in the comparison group showed a pain reduction of 0.44 points. Meta-analysis of cold cabbage leaf application and routine breast care showed an engorgement reduction of 0.67 points. Conclusion: The results of the analysis of 12 articles showed that hot and cold compresses, breast massage, and cabbage application were effective for postpartum breast pain and engorgement.

Usefulness of four commonly used neuropathic pain screening questionnaires in patients with chronic low back pain: a cross-sectional study

  • Gudala, Kapil;Ghai, Babita;Bansal, Dipika
    • The Korean Journal of Pain
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    • 제30권1호
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    • pp.51-58
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    • 2017
  • Background: Recently symptoms-based screening questionnaires have gained attention for screening for a neuropathic pain component (NePC) in various chronic pain conditions. The present study assessed the usefulness of four commonly used NePC screening questionnaires including the Self-completed douleur neuropathique 4 (S-DN4), the ID Pain, the painDETECT questionnaire (PDQ), and the Self-completed Leeds Assessment of neuropathic Symptoms and Signs (S-LANSS) questionnaire in patients with chronic low back pain (CLBP) to assess the presence of NePC. Methods: This is a single-center cross-sectional study where patients with CLBP, with or without leg pain, were included. Participants were initially screened for NePC presence by a physician according to the regular practice, and later assessed using screening questionnaires. The diagnostic accuracy of these questionnaires was compared assuming the physician-made diagnosis as the gold standard. Results: A total of 215 patients with CLBP of which 164 (76.3%, 95% CI, 70.2-81.5) had a NePC were included. S-DN4, ID Pain, and PDQ have an area under the curve (AUC) > 0.8 indicating excellent discrimination. However, S-LANSS has an AUC of 0.69 (0.62-0.75), indicating low discrimination. S-DN4 has a significantly higher AUC as compared to ID Pain (d(AUC) = 0.063, P < 0.01) and S-LANSS (d(AUC) = 0.197, P < 0.01). But the AUC of S-DN4 does not significantly differ from that of PDQ (d(AUC) = 0.013, P = 0.62). Conclusions: S-DN4, ID Pain, and PDQ, but not S-LANSS, have good discriminant validity to screen for NePCs in patients with CLBP. Despite using all the tests, 20-30% of patients with an NePC were missed. Thus, these questionnaires can only be used as an initial clue in screening for NePCs, but do not replace clinical judgment.

요추 수술 후 급성기 통증 환자에 대한 통합의학 표준임상경로 임상시험 프로토콜 (An Integrative Care Model of Clinical Pathway Approach for Acute Pain after Back Surgery: A Protocol for Clinical Trial)

  • 김병준;신병철;황만석;신경민;허인;임경태;박인화;손동욱;황의형
    • 한방재활의학과학회지
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    • 제27권4호
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    • pp.111-119
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    • 2017
  • Objectives Clinical pathway (CP), is management plans that display goals for patients and have led to improve outcomes for many diseases. In Korea, Interest in Korean medicine's stabilization (Clinical pathway, Clinical Practice Guideline) is increasing, But the number of studies is scare. Method and Analysis This trials composes nonequivalent control group pretest-posttest design to conduct clincal pathway trial for the acute pain after back surgery. The subjects were 10 control patients with back surgery, and 10 experimental patients with application of integrative CP. Each group patient will observed 6 weeks. We check validation of CP. Also we compared the patient's status using the pain, function, Quality of life index between the two groups. Discussion This trial is the first CP for the acute pain after back surgery using integrative medicine concepts. Aim of this trial is to find the effectiveness and validity of clincal pathway for acute pain after back surgery.

언어적 의사소통이 어려운 치매환자에서의 통증 사정 (Pain Assessment in Nonverbal Older Adults with Dementia)

  • 김현숙;유수정
    • Journal of Hospice and Palliative Care
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    • 제16권3호
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    • pp.145-154
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    • 2013
  • 목적: 본고는 완화의료에서 언어적 의사소통이 제한되어있어 통증의 자가보고가 어려운 대상자들 중 치매환자를 대상으로 한 통증 사정 방법을 고찰하여 임상실천에서의 지식을 증가하는데 그 목적이 있다. 방법: 본 연구는 문헌고찰연구로, '통증(pain)', '통증 사정/평가(pain assessment)', '인지기능장애/치매(cognitive impairment/dementia)'를 주제어로 Google scholar, 한국교육학술정보원(www.riss4u.net), KoreaMed, Medline, Science-Direct, CINAHL 등의 database에서 2000년 이후에 발간된 국내외 문헌을 검색하였다. 또한 필요시 언어적 의사소통이 어려운 치매환자에서 통증 사정과 관련된 국내외 전문서적을 참고하였다. 결과: 언어적 의사소통이 어려운 치매 환자의 통증 사정 방법에는 자가보고 외에 행동관찰 통증 사정 도구를 활용하여 환자의 행동을 관찰하는 방법과 대리인의 관찰에 의한 측정방법 등이 사용되고 있었다. 이중 행동 관찰 통증 사정에는 여러 가지 표준화된 도구들이 제시되었으나, 표준화되어 일반적으로 흔히 사용되는 도구는 없었다. 이에 통증 행동관찰 사정 도구 중 비교적 타당도 및 신뢰도가 높게 나타난 도구인 CNPI, DOLOPLUS 2, PACSLAC, PAINAD와 국내에서 유일하게 사용된 도구인 DS-DAT를 선택하여 고찰 후 비교분석 하였다. 결론: 완화의료에서 언어적 의사소통이 어려운 치매환자의 통증을 정확하게 사정하는 것은 어려운 일이지만 적절한 통증관리를 위해 매우 중요하다. 본고에서 제시한 치매환자 통증 사정의 일반적 지침들은 임상에서 활용하기에 유용할 것으로 기대된다. 추후 국내에서 언어적 의사소통이 어려운 치매환자들의 통증 사정 시 행동관찰 통증 사정 도구들을 사용하기 위해서 한글판 타당도 및 신뢰도 검증 연구가 선행되어야 할 것이다.

Endoscopic slide-in orbital wall reconstruction for isolated medial blowout fractures

  • Kim, Taewoon;Kim, Baek-Kyu
    • 대한두개안면성형외과학회지
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    • 제21권6호
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    • pp.345-350
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    • 2020
  • Background: This study evaluated the efficacy of the endoscopic medial orbital wall repair by comparing it with the conventional transcaruncular method. This surgical approach differs from the established endoscopic technique in that we push the mesh inside the orbit rather than placing it over the defect. Methods: We retrospectively reviewed 40 patients with isolated medial orbital blowout fractures who underwent medial orbital wall reconstruction. Twenty-six patients underwent endoscopic repair, and 14 patients underwent external repair. All patients had preoperative computed tomography scans taken to determine the defect size. Pre- and postoperative exophthalmometry, operation time, the existence of diplopia, and pain were evaluated and compared between the two methods. We present a case showing our procedure. Results: The operation time was significantly shorter in the endoscopic group (44.7 minutes vs. 73.9 minutes, p= 0.035). The preoperative defect size, enophthalmos correction rate, and pain did not significantly differ between the two groups. All patients with preoperative diplopia, eyeball movement limitation, or enophthalmos had their symptoms resolved, except for one patient who had preexisting strabismus. Conclusion: This study demonstrates that endoscopic medial orbital wall repair is not inferior to the transcaruncular method. The endoscopic approach seems to reduce the operation time, probably because the dissection process is shorter, and no wound repair is needed. Compared to the previous endoscopic method, our method is not complicated, and is more physiological. Larger scale studies should be performed for validation.

'표준치료를 받은 폐암 환자의 한방병원 입원 임상경로' 개발 및 적용 (Developed and Implemented a Clinical Pathway for Lung Cancer Patients Admitted to Korean Medicine Hospital after Standard Treatment)

  • 고금영;박소정;김동현;하기태;유화승;윤성훈;최준용
    • 동의생리병리학회지
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    • 제37권6호
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    • pp.178-184
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    • 2023
  • The objective of this study was to develop a critical pathway of integrative medicine to improve the quality of life of lung cancer patients who received standard western medicine treatments. A total of 10 medical professionals, including western and Korean medicine doctors, and nurses participated in a validation survey and revised clinical pathway. Then we applied the critical pathway to 11 lung cancer patients who admitted at Korean medicine hospital and evaluated quality of life at the beginning and discharge of admission using European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire(EORTC QLQ). More than 80% of the respondents gave a score of 3 (appropriate) or more for all items in the validation survey and we modified the clinical pathway by adding 'bed rest'to the activity item. When applying the revised critical pathway to 11 lung cancer patients, the score of 'Nausea and vomiting', 'Insomnia' in EORTC QLQ-30 and 'chest pain'in EORTC LC-13 showed statistically significant improvements in the before-and-after admission comparision. The application of revised inpatient critical pathway of integrative medicine for lung cancer showed improvement in some symptoms. Development of more critical pathway in various clinical setting and larger scaled application studies of critical pathway are needed.

Identification of a Copy Number Variation on Chromosome 20q13.12 Associated with Osteoporotic Fractures in the Korean Population

  • Park, Tae-Joon;Hwang, Mi Yeong;Moon, Sanghoon;Hwang, Joo-Yeon;Go, Min Jin;Kim, Bong-Jo
    • Genomics & Informatics
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    • 제14권4호
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    • pp.216-221
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    • 2016
  • Osteoporotic fractures (OFs) are critical hard outcomes of osteoporosis and are characterized by decreased bone strength induced by low bone density and microarchitectural deterioration in bone tissue. Most OFs cause acute pain, hospitalization, immobilization, and slow recovery in patients and are associated with increased mortality. A variety of genetic studies have suggested associations of genetic variants with the risk of OF. Genome-wide association studies have reported various single-nucleotide polymorphisms and copy number variations (CNVs) in European and Asian populations. To identify CNV regions associated with OF risk, we conducted a genome-wide CNV study in a Korean population. We performed logistic regression analyses in 1,537 Korean subjects (299 OF cases and 1,238 healthy controls) and identified a total of 8 CNV regions significantly associated with OF (p < 0.05). Then, one CNV region located on chromosome 20q13.12 was selected for experimental validation. The selected CNV region was experimentally validated by quantitative polymerase chain reaction. The CNV region of chromosome 20q13.12 is positioned upstream of a family of long non-coding RNAs, LINC01260. Our findings could provide new information on the genetic factors associated with the risk of OF.