• Title/Summary/Keyword: Pain Care

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Successful removal of permanent spinal cord stimulators in patients with complex regional pain syndrome after complete relief of pain

  • Lee, Su Jung;Yoo, Yeong Min;You, Jun A;Shin, Sang Wook;Kim, Tae Kyun;Abdi, Salahadin;Kim, Kyung Hoon
    • The Korean Journal of Pain
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    • v.32 no.1
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    • pp.47-50
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    • 2019
  • Background: It is uncommon for patients who have received a permanent implant to remove the spinal cord stimulator (SCS) after discontinuation of medication in complex regional pain syndrome (CRPS) due to their completely painless state. This study evaluated CRPS patients who successfully removed their SCSs. Methods: This 10-year retrospective study was performed on patients who had received the permanent implantation of an SCS and had removed it 6 months after discontinuation of stimulation, while halting all medications for neuropathic pain. Age, sex, duration of implantation, site and type of CRPS, and their return to work were compared between the removal and non-removal groups. Results: Five (12.5%, M/F = 4/1) of 40 patients (M/F = 33/7) successfully removed the permanent implant. The mean age was younger in the removal group ($27.2{\pm}6.4$ vs. $43.5{\pm}10.7$ years, P < 0.01). The mean duration of implantation in the removal group was $34.4{\pm}18.2$ months. Two of 15 patients (13.3%) and 3 of 25 patients (12%) who had upper and lower extremity pain, respectively, had removed the implant. The implants could be removed in 5 of 27 patients (18.5%) with CRPS type 1 (P < 0.01). All 5 patients (100%) who removed their SCS returned to work, while only 5 of 35 (14.3%) in the non-removal group did (P < 0.01). Conclusions: Even though this study had limited data, younger patients with CRPS type 1 could remove their SCSs within a 5-year period and return to work with complete pain relief.

The Comparison of Hospice Care by Nurse, Volunteer and Minister (말기 암환자 호스피스 케어의 사례 - 간호사, 자원봉사자, 목회자의 케어 사례 비교 -)

  • Kim, Boon-Han
    • Journal of Hospice and Palliative Care
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    • v.2 no.1
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    • pp.46-53
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    • 1999
  • The purpose of this case study is to explore the difference of hospice care and the efficiency of hospice education, by comparing the care of the nurse, the volunteer and the minister who have been trained by the Hospice Education Program. The index of common hospice care delivered by cases is that 1) the physical problems (pain, physical discomfort, incontinece, nausea, vomiting etc.) 2) the family problems(family support, change of family function, inefficiency, preparing the death of family) 3) the psychiatric problems(grief and sadness of death, anxiety, fear, helplessness). The case of volunteer and minister is different with the hospice care by nurse, because it is some what related to Christian's base. The index of care by the volunteer and minister is pertaining to social support and spiritual support for family and dying patient. In conclusion, for the wholistic hospice care, we need the hospice caregiver who have diverse background and expert in knowledge of various dimension. For that, it is necessary to build and develop hospice education program as a team apprach, which indudes a systematic expertizing items for care in consideration of caregiver's background.

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Analysis of Symptom and Care Needs of Home-Based Hospice Palliative Patients - Home-Based Hospice Business Centered on Community Health Centers in Busan- (재가 호스피스완화 대상자의 증상 및 돌봄 요구도 분석 -부산광역시 보건소 중심 재가 호스피스사업을 중심으로-)

  • Kim, Jung-Rim;Choi, Soon-Ock;Kim, Sook-Nam
    • The Korean Journal of Health Service Management
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    • v.12 no.4
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    • pp.173-190
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    • 2018
  • Objectives: This study was conducted to analyze the symptoms and care needs of home-based hospice palliative patients in Busan and to provide a basic reference for developing practical guidelines for their care. Methods: By examining the registration cards of 409 hospice palliative patients, who were registered in community health centers in Busan as of 2016, this study retrospectively analyzed their characteristics, symptoms and care needs. Results: The average age was 70.6 years, 59.4% were receiving medical benefits, and 48.4% lived alone. As per the data obtained from the Palliative Performance Scale, many were able to mobile. Fatigue was the most severe and depression and anxiety were reported together, and their care needs were also high. Most subjects reported mild or low pain, but care needs were high. Furthermore, the medical benefits group showed a high level of symptoms and care needs across areas. Conclusions: To help subjects to live in their homes for as long as possible, it is necessary to identify symptoms and care needs and provide services in accordance with their severity and situation. Thus, it is necessary to develop practical guidelines for standardized community hospice palliative care services.

Curriculum Development for Hospice and Palliative Care Nurses (간호사를 위한 호스피스 완화의료 교육과정 개발)

  • Choi, Eun-Sook;Kim, Hyun-Sook;Lee, So-Woo;Yoo, Yang-Sook
    • Journal of Hospice and Palliative Care
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    • v.9 no.2
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    • pp.77-85
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    • 2006
  • Purpose: The purpose of this study is to develop the basic curriculum for the nurses who work at hospice and palliative care settings. Methods: Seven curricula of hospice and palliative care for the nurses in Korea and other countries were reviewed, and Education Need for hospice and palliative care was surveyed from 162 nurses by mailing the questionnaires to hospice palliative care settings. Results: 1. The curricula of hospice and palliative care for the nurses in Korea and other countries in common include 'understanding of hospice and palliative care', 'understanding of lift and death', 'pain and symptom management for person with terminal disease', 'on-the-spot study and practical training', 'management of hospice and palliative ward', 'hospice and palliative care at home', 'physical assessment', 'therapeutic communication skills', 'children's hospice', 'administration and management of hospice and palliative care', 'interdisciplinary team of hospice and palliative care', 'ethics and laws in hospice and palliative care', 'psychological, social and spiritual care', 'care of the dying', 'bereavement care', etc. 2. The scores above 3.3 were marked for 34 items in education Need Survey. The highest scores were given in the order for the items 'understanding of death and dying', 'attitude and response to death and dying', 'understanding and assessment of pain' etc. respondents marked that they have been trained for 'pain and symptom management', 'ethics and laws in hospice and palliative care', 'building the system for cooperation and publicity activities in hospice' etc. 3. The basic curriculum of hospice and palliative care for the nurses requires 78 studying hours for 17 subjects, comprising 48 hours of theory education and 30 hours of practical training. The education methods are lectures, discussions, and case studies. Conclusion: The efforts of developed basic curriculum should be evaluated after educating nurses. It is necessary to develop the standard curriculum and regularly update it based on the result of education Need Survey for actively working nurses in hospice and palliative care settings.

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Knowledge Discovery in Nursing Minimum Data Set Using Data Mining

  • Park Myong-Hwa;Park Jeong-Sook;Kim Chong-Nam;Park Kyung-Min;Kwon Young-Sook
    • Journal of Korean Academy of Nursing
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    • v.36 no.4
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    • pp.652-661
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    • 2006
  • Purpose. The purposes of this study were to apply data mining tool to nursing specific knowledge discovery process and to identify the utilization of data mining skill for clinical decision making. Methods. Data mining based on rough set model was conducted on a large clinical data set containing NMDS elements. Randomized 1000 patient data were selected from year 1998 database which had at least one of the five most frequently used nursing diagnoses. Patient characteristics and care service characteristics including nursing diagnoses, interventions and outcomes were analyzed to derive the meaningful decision rules. Results. Number of comorbidity, marital status, nursing diagnosis related to risk for infection and nursing intervention related to infection protection, and discharge status were the predictors that could determine the length of stay. Four variables (age, impaired skin integrity, pain, and discharge status) were identified as valuable predictors for nursing outcome, relived pain. Five variables (age, pain, potential for infection, marital status, and primary disease) were identified as important predictors for mortality. Conclusions. This study demonstrated the utilization of data mining method through a large data set with stan dardized language format to identify the contribution of nursing care to patient's health.

Development and Application of an Early Exercise Program for Open Heart Surgery Patients (개심술 환자를 위한 조기 운동프로그램의 개발 및 적용에 관한 연구)

  • Ha, Yi-Kyung;Jung, Yoen-Yi
    • Journal of Korean Critical Care Nursing
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    • v.4 no.1
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    • pp.65-73
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    • 2011
  • Purpose: This study was to develop and evaluate stability and effects of an early exercise program for patients with open heart surgery. Methods: The subjects of this study were 30 patients who had either a coronary bypass surgery or a valvular heart surgery at a tertiary hospital in Seoul. The data was collected by observation and measurement from October 1, 2004 to November 15, 2004. Results: The early exercise program developed for this study consisted of range of motion exercise and walking. Intensity of walking was 1~3 METs and increased progressively to daily target distance. During exercise, the subjects were monitored heart rate, blood pressure and RPE (Rating of Perceived Exertion). The mean FIM (Functional Independent Measurements) score of subjects was significantly improved after the early exercise program. However, several complaints such as dizziness or pain were also reported. Most complaints were associated with chest tube and RPE. Conclusion: The early exercise program can help to recover patients' physical activities after surgery, and can be applied to most patients. Patients' RPE, dizziness and pain was possible limitations, therefore, active pain control and prevention of accidents for patients would be needed.

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The Effect of Early Ambulation after 4 Hours of Bed Rest in Patients with Transarterial Chemoembolization (간동맥 화학색전술을 시행 받은 환자에게서 4시간 절대침상안정 후 조기 이상의 효과)

  • Nam, Sun Hee;Kim, Young-Ju
    • Korean Journal of Adult Nursing
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    • v.28 no.1
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    • pp.53-60
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    • 2016
  • Purpose: This study was to compare the effects of early ambulation to usual care of late ambulation in patients with transarterial chemoembolization on back pain, discomfort, and puncture site complications. Methods: A nonequivalent control pretest-posttest design was used. Total 40 patients were recruited from a gastrointestinal unit of an urban general hospital in Seoul, South Korea. The experimental group began to ambulate after 4 hours of bed rest with a compression bandage after receiving transarterial chemoembolization. The control group stayed in bed with a compression bandage overnight. Results: Back pain was not significantly different between the two group. The experimental group reported significantly lower discomfort than the control group. There was no incidence of bleeding complications on puncture site between two groups. Conclusion: The results of this study showed that early ambulation with four hours of bed rest after femoral sheet removal did not cause bleeding complications compared to the usual care and even decreased patients' level of discomfort due to bed rest. Repetitive research on the effect of short bed rest is warranted for its clinical utilization.

Report of 5 Clinical Cases of Visiting Korean Medicine Care for Community in 2020 (2020년 지역사회 한의학 방문돌봄사업 5례 임상증례 보고)

  • Dae Sung Jung;Jae Ryong Bae;Jae Heung Lee
    • Journal of Korean Medical Ki-Gong Academy
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    • v.21 no.1
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    • pp.22-42
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    • 2022
  • Objective : The researcher participated in the visiting treatment project organized by OO City in 2020 and showed the advantages of visiting Korean Medicine, so I would like to report it. Methods : A comprehensive Korean Medicine intervention method was performed for each symptom, and changes in basic physical strength were observed through vital signs, NRS, Single Leg Stance (SLS), and Chair Stand Test (CST) tests. Results : It can be seen that the NRS level, a pain scale for chronic pain, generally decreased at the last treatment compared to the beginning of treatment. Satisfaction with Project Information (PI) was relatively low at 3.20±1.30, but Ease of Participation (EoP), Intention to Participate Again (IPA), Expansion of Project (ExP), and Overall Satisfaction (OS) were high at 5.00±0.00. Conclusions : Summarizing the advantages of visiting Korean Medicine is that the treatment satisfaction for chronic pain is high, the patient's satisfaction is high, the treatment tool is easy to carry, and various visiting treatment services can be implemented.

Comparison of the Effect of Music and Noise Blocking on Postoperative Pain, Length of Stay at Post Anesthetic Care Unit and Satisfaction after a Laparoscopic Colectomy (음악요법과 소음차단요법이 수술 후 통증, 진통제 투여량, 회복실 체류시간 및 만족도에 미치는 효과 비교)

  • Seo, Eunju;Yoon, Haesang
    • Journal of Korean Biological Nursing Science
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    • v.17 no.4
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    • pp.315-323
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    • 2015
  • Purpose: This study compared the effect of music and noise blocking on the vital signs, postoperative pain, analgesic use, length of stay in the Post Anesthesia Care Unit (PACU) and satisfaction after a laparoscopic colectomy. Methods: This randomized controlled trial was performed in a 555-bed National Cancer Center, from February 13 through May 31, 2012. Subjects consisted of 69 patients who underwent a laparoscopic colectomy under general anesthesia, and were recruited by informed notices. The inclusion criteria were patients between the ages of 35-75, with an American Society Anesthesiologist physical classification I or II. The subjects were randomly allocated to three groups; music therapy group (MTG), noise blocking group (NBG) and control group (CG). Collected data were analyzed using Repeated measures ANOVA, one-way ANOVA and Kruskal-Wallis test through IBM SPSS (Version 19.0). Results: There were no significant differences in vital signs among the three groups. Postoperative pain in MTG (p<.05) and NBG (p<.05) was significantly decreased compared to CG. The amount of analgesics (p=.030) and length of stay at PACU (p=.021) in MTG was significantly decreased compared to NBG or CG; satisfaction in MTG and NBG was significantly higher compared to CG. Conclusion: Music seems to reduce postoperative pain, the amount of analgesics, and the length of stay at PACU. Therefore, music therapy is considered to be included in nursing intervention for postoperative patients at PACU.

The Effect of the Weight of a Sandbag on the Sheath Region after a Transcatheter Arterial Chemoembolization (간동맥 화학색전술 후 시술부위의 모래주머니 적용무게에 따른 효과)

  • Cha, Kyeong-Sook;Ko, Ji Woon;Lee, Kee-Lyong
    • Journal of Korean Critical Care Nursing
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    • v.10 no.2
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    • pp.24-33
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    • 2017
  • Purpose: This study aimed to investigate the differences in exudate and bleeding incidence and the changes in back pain and discomfort based on the weight of a sand bag applied to the femoral puncture site after hepatic transcatheter arterial chemoembolization. Methods: This quasi-experimental study comprised 82 patients randomly divided into three different groups. Experimental group 1 patients had a 600g sandbag, experimental group 2 patients an 800g sandbag, and control group patients a 1900g sandbag, on femoral access sites post procedure. The three groups of patients were assessed on level of exudate and bleeding and asked about back pain and discomfort at 30, 60, 120, 180 and 240 minutes after the procedure. Results: There were no significant differences in exudate and bleeding between the three groups before and after application of the sandbag post procedure. Both back pain and discomfort were significantly lower in the experimental groups than in the control group. Conclusion: There was no significant effect on bleeding and exudation due to the weight of the sandbag. The lowest level of back pain and discomfort was found in the group with the lightest weight (600 g). Therefore, the use of lighter-weight sandbags to prevent post procedure vascular complications is proposed.

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