• Journal of Korean Clinical Nursing Research
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• v.18 no.1
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• pp.136-148
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• 2012

Purpose: The purpose of this study was to develop a reliable and valid pain assessment tool suitable for critically ill patients with communication problem in Korean intensive care unit. Methods: This pain assessment tool, Critical Care Non-verbal Pain Scale (CNPS), was developed based on review of national and international researches. Data were collected from ten intensive care units at five major general hospitals in Seoul. Reliability and validity were tested during performance of position change and endotracheal suctioning. Pain was measured before, during, and 20 minutes after the two procedures. Results: Interrater reliability of the CNPS was analyzed by ICC (Intraclass correlation coefficients). ICC values were significant from .833 to .883. Significant correlation between the FPS (Face Pain Scale) scores and the CNPS scores verified concurrent validity of the CNPS. For position change, CNPS scores increased significantly between before and during (t=-23.399, p<.001) and decreased significantly between during and 20 minutes after (t=22.760, p<.001). For endotracheal suctioning, CNPS scores increased significantly between before and during (t=-29.064, p<.001) and significantly decreased between during and 20 minutes after (t=28.194, p<.001), verifying construct validity of the CNPS. Conclusion: Results indicate that the CNPS can be used to assess pain of critically ill patients who have communication problem.

• The Korean Journal of Pain
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• v.35 no.2
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• pp.183-190
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• 2022

Background: To compare ultrasound-guided pulsed radiofrequency (PRF) of the genicular nerve with the genicular nerve block using local anesthetic and steroid for management of osteoarthritis (OA) knee pain. Methods: Thirty patients with OA knee were randomly allocated to receive either ultrasound-guided PRF of the genicular nerve (PRF group) or nerve block with bupivacaine and methylprednisolone acetate (local anesthetic steroid [LAS] group). Verbal numeric rating scale (VNRS) and Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) scores were measured at pre-procedure and 1-, 4-, and 12-weeks post-procedure. Results: VNRS scores decreased significantly (P < 0.001) in both the groups at 12 weeks and other follow up times compared to baseline. Seventy-three percent of patients in the PRF group and 66% in the LAS group achieved effective pain relief (≥ 50% pain reduction) at 12 weeks (P > 0.999). There was also a statistically significant (P < 0.001) improvement in WOMAC scores in both groups at all follow up times. However, there was no intergroup difference in VNRS (P = 0.893) and WOMAC scores (P = 0.983). No complications were reported. Conclusions: Both ultrasound-guided PRF of the genicular nerve and blocks of genicular nerve with local anesthetic and a steroid provided comparable pain relief without any complications. However, PRF of the genicular nerve is a procedure that takes much more time and equipment than the genicular nerve block.

• Journal of Korean Clinical Nursing Research
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• v.14 no.2
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• pp.103-114
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• 2008

Purpose: The purpose of this study was to investigate the level of QoL of the terminal cancer patients at home and to identify any influencing factors on QoL. Method: Subjects of this study consisted of 72 terminal cancer patients who were receiving home care nursing for more than 2 weeks in 6 general hospitals. Data were collected by a self-reporting questionnaire on QoL, pain, physical functioning, and symptom experience from Feb, 2006 to Dec, 2006. Data were analyzed by t-test, one way ANOVA, Pearson correlation coefficients, and multiple regression using SPSS Win 14.0. Results: Mean score of QoL was 98.6(230 in total). Except the level of family coping, general characteristics and disease related variables did not show significant difference in QoL. QoL was higher in the family with better coping, and QoL showed negative correlation with three types of pain, physical functioning, and symptom experiences. Least pain, physical functioning, and level of family coping explained QoL up to 26.7%. Conclusion: The QoL was closely related with pain, physical functioning, symptom experience, and family coping. And the least pain, physical functioning and level of family coping were important factors influencing on QoL of terminal cancer patients. However, some other variables influencing the QoL need to be investigated in the future.

• Journal of muscle and joint health
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• v.18 no.1
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• pp.28-38
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• 2011

Purpose: This paper was aimed to investigate the effect of laugher therapy on the pain, depression and sleep disturbance in elderly patients who admitted in long term care facility. Method: This study used a nonequivalent control group pretest-posttest design. A sample of 40 elderly patients (20: experimental group, 20: control group, 65 or older) were recruited. Visual analogue scale was used to measure level of pain level, Geriatric Depression Scale Short Form Korea Version (GDSSF-K) for depression. Sleep Scale for sleep. The laugher therapy was given twice a week for four weeks (8 times). Each therapy consists of preparatory, action and finishing stage. Data were analyzed by PASW 18.0. Results: The pain score in experimental group was significantly different from that in control group (t=4.17, p<.001). The level of depression in experimental group was significantly different from that in control group (Z=4.12, p<.000). The level of sleep in experimental group was not significantly different from that in control group (Z=-1.43, p<.152). Conclusion: A laugher therapy is expected to be practical used an efficient method of a nursing intervention to elderly patients in long term care facility.

• Journal of Hospice and Palliative Care
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• v.22 no.2
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• pp.100-104
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• 2019

Opioids are important drugs for the management of severe cancer pain without a ceiling effect. However, opioid administration leads to dose-limiting complications including drowsiness, hallucinations, delirium, respiratory depression, cognitive impairment, seizure, myoclonus, and hyperalgesia. Opioid-induced hyperalgesia (OIH) is a paradoxical phenomenon as opioid exposure increases pain sensitivity. Reducing or stopping opioids, opioid rotation, or co-administration of N-methyl-D-aspartate (NMDA) antagonists have been suggested for the management of OIH. In this study, we report two clinical cases of successful management of OIH in cancer pain patients that were treated with opioids.

• Tuberculosis and Respiratory Diseases
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• v.77 no.1
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• pp.6-12
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• 2014

Severe sepsis is the most common cause of death among critically ill patients in non-coronary intensive care units. In 2002, the guideline titled "Surviving Sepsis Campaign" was published by American and European Critical Care Medicine to decrease the mortality of severe sepsis and septic shock patients, which has been the basis of the treatment for those patients. After the first revised guidelines were published on 2008, the most current version was published in 2013 based on the updated literature of until fall 2012. Other important revised guidelines in critical care field such as 'Clinical Practice Guidelines for the Management of Pain, Agitation, and Delirium in Adult Patients in the Intensive Care Unit' were revised in 2013. This article will review the revised guidelines and several additional interesting published papers of until March 2014, including the part of ventilator-induced lung injury and the preventive strategies.

• Journal of Hospice and Palliative Care
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• v.20 no.1
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• pp.18-25
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• 2017

Purpose: Adequate control of breakthrough pain is essential for patients with cancer. Managing breakthrough pain mainly depends on understanding the concept of breakthrough pain and the proper usage of rescue medication by physicians. This study aims to assess the attitudes and practice patterns of palliative physicians in managing breakthrough pain for patients in Korea. Methods: This study was based on data from the 2014 breakthrough cancer pain survey conducted by the Korean Society for Hospice and Palliative Care. One hundred physicians participated in the online survey. Among total 33 self-reported questionnaires, twelve items were selected in this analysis. Results: Rapid onset of action is the main influencing factor in selecting rescue opioids. Oral oxycodone (65%) and parenteral morphine (27%) are commonly used. A few physicians (3%) prefer to use transmucosal fentanyl. The percentage of physicians prescribing oral oxycodone due to its rapid onset of action is just 21.5%, whereas the percentage of physicians using parenteral morphine is 81.5%. Two thirds of respondents (66%) answered that breakthrough pain is not well controlled with rescue medications. Conclusion: There is a gap between the needs of physicians in terms of the perceived difficulties of managing breakthrough cancer pain and their practice patterns selecting rescue medications.

• Journal of Korean Academy of Nursing Administration
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• v.10 no.4
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• pp.449-457
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• 2004

Purpose: This study seeks to identify situations where nurses are required to consider alternatives, for the delivery of nursing care, appropriate to the needs of a medical care unit, surgical care unit, and intensive care unit in a university hospital. Method: Data was collected from 100 nurses using an open questionnaire, during a one week period in May, 2003. These nurses all had at least two years of experience within a medical care unit, surgical care unit, or intensive care unit at a university hospital. Results: The situations that nurses typically faced were categorized into 21 problems for nurses including : respiratory problems(26.8%), pain(23.6%), problems in relation to bowel habit(23.2%). In cases where nurses were faced with making decisions in relation to solving respiratory problems, the alternatives included ; applying oxygen(29.3%), physical assessment and monitoring(14.7%), refining and modifying order and suggestion order(9.3%). Ventilator care(9.3%), was chosen to solve pain problems ; doing pm orders(30.3%), placebo medication(27.3%), and to refine and modify orders and suggestions(18.2%). To solve problems in relation to bowel habits ; enemas accounted for 32.3%, and laxative medication 30.8%. Conclusion: To improve the quality of nursing, the outcome of nursing care associated with 21 problems for nurses including : respiratory problems, pain, and problems in relation to bowel habit, should be identified and the best alternative nursing care should be developed.

• Journal of Korean Clinical Nursing Research
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• v.14 no.3
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• pp.141-151
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• 2008

Purpose: This study aimed at applying a standardized nursing process to adult surgery patients of post anesthetic care unit, and examining the validity of linkages in the measuring index of nursing outcome by which nursing outcome was applied. Method: The subjects were 184 surgery adult patients admitted at the post anesthetic care unit of Y university hospital. This study was used the measured tool developed by Choi et al.(2004) and by Lee (2004) who had already verified a validity based on Johnson and Bulechek's study(2001). Results: The nursing diagnosis of an acute pain, an urinary retention, a nausea, a decreased cardiac output, an ineffective airway clearance and an ineffective airway clearance were used in taking care for patients. The related factors according to the main nursing diagnosis were as the following: an injurious physical factor in an acute pain, reflex are inhibition in an urinary retention, post surgical anesthesia in a nausea, stroke volume change in a decreased cardiac output, secretory stasis in an ineffective airway clearance, pain in an ineffective breathing pattern. Conclusion: The study results could be facilitated in nursing process application for nurses at post anesthetic care unit. Also this study would provide basic data to develop a computerized program for the improvement of nursing process application.

• Clinical Pain
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• v.20 no.2
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• pp.59-69
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• 2021

Patients with pain, numbness, and weakness in their elbows, wrists, and hands often need proper rehabilitation treatments. Among them, musculoskeletal injection therapy should be performed after a full evaluation of the patient, taking into account history and physical examination leading to clinical diagnosis. General rules such as accurate diagnosis and injection materials selection are used to achieve maximum benefit with minimal side effects. During injection, patient location, aseptic care, penetration techniques, follow-up and follow-up care must be maintained. Specific techniques may vary depending on the type, lesion, and location of the injection therapy. For optimal effectiveness, physician should inject directly into the lesion and avoid the injection of surroundings as much as possible. Therefore, ultrasound-guided injections are needed to accurately inject. These conditions and other conditions of the hands, wrists, and elbows can be effectively diagnosed and treated with diagnostic ultrasound and ultrasound-guided injections.