• Title/Summary/Keyword: Pain Care

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The Effect of Stellate Ganglion Block on Breast Cancer-Related Infectious Lymphedema (유방암 감염성 림프부종 환자에서 성상신경절 블록이 미치는 영향)

  • Lee, Youn Young;Park, Hahck Soo;Lee, Yeon Sil;Yoo, Seung Hee;Lee, Heeseung;Kim, Won Joong
    • Journal of Hospice and Palliative Care
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    • v.21 no.4
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    • pp.158-162
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    • 2018
  • Breast cancer related lymphedema (BCRL) is one of the most intractable complications after surgery. Patients suffer from physical impairment, as well as psychological depression. Moreover, a recent study revealed that cellulitis significantly increased the risk of BCRL, and cellulitis has been suggested as a risk factor of BCRL development. We describe a patient treated with stellate ganglion blocks (SGBs) without steroid for relief of symptoms and reduction of the arm circumference of breast cancer-related infectious lymphedema in a month. We measured the arm circumference at four locations; 10 cm and 5 cm above and below the elbow crease, numeric rating scale (NRS) score, lymphedema and breast cancer questionnaire (LBCQ) score on every visit to the pain clinic. A serial decrease of the arm circumference and pain score were observed after second injection. In the middle of the process, cellulitis recurred, we performed successive SGBs to treat infectious lymphedema. The patient was satisfied with the relieved pain and swelling, especially with improved shoulder range of motion as it contributes to better quality of life. This case describes the effects of SGB for infectious BCRL patients. SGB could be an alternative or ancillary treatment for infectious BCRL patients.

The effects of music therapy on labor pain, childbirth experience, and self-esteem during epidural labor analgesia in primiparas: a non-randomized experimental study (음악요법이 초산부의 경막하 무통 분만 중 분만통증, 분만경험, 자아존중감에 미치는 효과: 유사실험 연구)

  • Seong Yeon An;Eun Ji Park;Yu Ri Moon;Bo Young Lee;Eunbyul Lee;Dong Yeon Kim;Seong Hee Jeong;Jin Kyung Kim
    • Women's Health Nursing
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    • v.29 no.2
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    • pp.137-145
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    • 2023
  • Purpose: This non-randomized study was performed to evaluate the effects of music therapy on labor pain, the childbirth experience, and self-esteem in women during vaginal delivery. Methods: In total, 136 primiparous women over 37 weeks of gestation receiving epidural analgesia during vaginal delivery were recruited via convenience sampling. To minimize diffusion effects, data from the control group (n=71) were collected first (April 2020 to March 2021), followed by data from the music group (n=65; April 2021 to May 2022). Participants in the music group listened to classical music during labor, while the control group was offered usual care (no music). Labor pain was measured using a numeric rating scale (NRS), and self-esteem and childbirth experience were collected using self-report questionnaires. Data were analyzed using the independent t-test, chi-square test and Cronbach's α coefficients. Results: The overall pain level (NRS) at baseline was 0 in both groups. Mothers in the music therapy group had lower levels of latent pain (t=1.95, p=.005), active pain (t=3.69, p<.001) and transition-phase pain (t=7.07, p<.001) than the control group. A significant difference was observed between the two groups, and the music therapy group expressed more positive perceptions of the childbirth experience (t=-1.36, p=.018). For self-esteem, the experimental group's score was slightly higher, but without a statistically significant difference from the control group. Conclusion: Using music therapy during labor decreased labor pain and improved the childbirth experience. Music therapy can be clinically recommended as a non-pharmacological, safe, and easy method for nursing care in labor.

Effects of Integrated Palliative Care Intervention on Quality of Life in Terminal Cancer Patients: A Meta-analysis (통합적 완화 돌봄 중재가 말기암환자의 삶의 질에 미치는 효과: 메타분석)

  • Jo, Kae Hwa;Park, Ae Ran;Lee, Jin Ju
    • Journal of Hospice and Palliative Care
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    • v.18 no.2
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    • pp.136-147
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    • 2015
  • Purpose: This study was conducted to evaluate the effects of integrated palliative care intervention on quality of life in terminally ill patients. Methods: A comprehensive literature search was performed via PubMed, Cochrane Library CENTRAL, LWW (Ovid), CINAHL and several Korean databases. The main search strategy was to combine terms indicating palliative care intervention, presence of terminal illness and study design. Methodological quality was assessed using Cochrane's Risk of Bias for randomized studies and Risk of Bias Assessment tool for non-randomized studies. Data were analyzed by the Stata 10 program. Results: Eight clinical trials met the inclusion criteria with a total of 356 participants. Integrated palliative care interventions were administered for a mean of 6.5 weeks, 5.6 sessions and an average of 47.8 minutes per session. Effect sizes were heterogeneous, and subgroup analysis was done. Integrated palliative care interventions had a significant effect on quality of life (ES=1.83, P=0.018, $l^2=92%$), spiritual well-being (ES=0.78, P=0.040, $l^2=0$), depression (ES=0.86, P<0.001, $l^2=32$) and anxiety (ES=0.69, P=0.041, $l^2=71.1$). But integrated palliative care interventions had no significant effect on pain (ES=0.365, P=0.230, $l^2=69.8$). Conclusion: Results support findings that integrated palliative care interventions were helpful in lessening depression and anxiety and improving quality of life and spiritual well-being, however, the interventions did not assist pain management in terminal cancer patients. These findings suggest that various integrated palliative care interventions can assist terminal cancer patients with better quality of life in the socio-psycho-spiritual dimension.

Self Management of Pain by Folk Remedies in Patient with Chronic Arthritis (만성 관절염 환자의 민간요법을 이용한 자가통증조절 행태)

  • Kim, Jong-Im;Kang, Hyun-Sook
    • Journal of muscle and joint health
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    • v.6 no.2
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    • pp.242-252
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    • 1999
  • The purpose of this study was to explore self management of pain by folk remedies in patient with chronic arthritis. The participant of this study were 90 volunteers who were visit C hospital and who want to counsel with researcher for their pain control by convenient sampling method. The results of this study were summarized as follows : The subjects were the 90 patients who had been diagnosed rehumatoid arthritis(52.5%)and osteoarthritis(47.8). 93.3% of participants were women. Mean age of participants was 53.7 and duration of arthritis was 7 years. Mean pain score was 5.5cm. Eighty five kinds of folk remedies were used for pain management. The mean cost for folk remedies was 3,723,207 won and the patients with rheumatoid arthritis paid to folk remedies as much as 3 times. The perceived effect score of pain management by folk remedies was 2.932(the range of perceived effect score were 0-10cm). Percentage of discontinue to use folk remedies was 82.8% and the major reason of discontinue to use folk remedies was no effect to pain control(50.4%). Some participants(30.5%) were experienced side effect such as exacerbation of pain(50.5%). In conculusion, chronic arthritis patients have been experienced various kind of folk remedies for the management of their pain. But the effect of pain control was very low. The important weakness of folk remedies were economical waste and loss of opportunity to treatment for arthritis. The nurse who care for arthritis should be teach about weakness of folk remedies for their pain control to the patients with arthritis.

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Proposal of Applying the Exercise Program for the Prevention of Work-related Chronic Low Back Pain

  • Yang, Yeong-Ae;Kim, Seong-Su;Hur, Jin-Gang;An, Sun-Joung;Kim, Hee-Soo;Cha, Su-Min;Heo, Jun;Park, Yun-Hee;Park, Bo-Ra
    • Journal of the Ergonomics Society of Korea
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    • v.30 no.5
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    • pp.571-579
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    • 2011
  • Objective: The purpose of this research is to provide exercise programs for the prevention of work related chronic back pain. Background: In order to prevent musculoskeletal disease, including proper medical care health promotion programs are needed. Method: This is a research of musculoskeletal disease looking at 618 workers working at a car engine manufacturing factory from April to July of 2008. Through questionnaire specific areas of musculoskeletal diseases experienced by the workers were identified and preventative exercise program for chronic low back pain was recommended. Result: Research showed that of the musculoskeletal disease experienced by the workers, 197 presented with low back pain, 171 presented with shoulder pain, 64 presented with neck pain and 44 presented with knee pain. The symptoms of low back pain included stiffness(143), twinge and burning sensation(24) and absence of sensation(19). Using this result 4 types of exercise programs were recommended for prevention of chronic low back pain. Conclusion: Preventative exercise programs recommended for the workers in this research is easily accessible for the workers. Use of the suggested exercise programs will inevitably decrease work related low back pain. Also 2 other recommendations were made: 1) Internal structural change may be necessary using ergonomics. 2) More exercise programs to be used to increase adaptation and tolerance of joints and muscles that are constantly used for repetitive work. Application: This study can be used to provide for the prevention of work-related Chronic Low Back pain.

A Study on the Relationship Between Level of Pain and Depression in Middle-aged Women with Chronic Low Back Pain (중년여성이 경험하는 만성요통의 통증정도와 우울)

  • Seo, Bok-Nam;Ham, Young-Lim;Ahn, Yang-Heui
    • Journal of muscle and joint health
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    • v.14 no.2
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    • pp.118-126
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    • 2007
  • Purpose: The purpose of the study was to examine the relationship between the level of pain and depression in middle-aged women with chronic low back pain. Method: A descriptive correlational research design was utilized. The participants were middle-aged women who visited two back pain clinics in Wonju from October, 2006 through February, 2007. A total of 195 low back pain patients agreed to participate in this study, and data from 177 were analyzed. Data was collected using a questionnaire which included Visual Analogue Scale (VAS), Center Epidemiology Studies Depression Scale(CES-D), and general characteristics. Descriptive statistics, t-test, ANOVA and Pearson correlation coefficients were utilized in the analysis. Results: The mean score for chronic low back pain as measured by the VAS was 4.99 (SD 2.41). The average score for depression as measured by the CES-D was 22.00 (SD 10.18). There was a significant relationship between the level of pain and depression (r=.372, p<.001). Conclusion: Nurses need to take into consideration depression of middle-age women with chronic low back pain for assessment and intervention. In the future, developing a strategy for integrating intervention of pain-control and depression will be needed in nursing care for middle-aged women with chronic low back pain.

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Factors Associated with Ketamine Use in Pancreatic Cancer Patient in a Single Hospice Center

  • Kwon, Kyung Min;Lee, Yong Joo;Choi, Chang Jin;Kim, Chul Min;Yoon, Jo Hi;Kim, Min Hee
    • Journal of Hospice and Palliative Care
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    • v.19 no.3
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    • pp.249-255
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    • 2016
  • Purpose: Up to 90% of pancreatic cancer patients suffer from neuropathic pain. In a palliative care setting, pain control in pancreatic cancer patient is one of the major goals. Ketamine is a N-methyl-D-aspartate (NMDA) receptor antagonist, effective in neuropathic pain. Additionally, there have been studies about the opioid sparing effect of ketamine. This study was held in the palliative care unit among pancreatic cancer patients to determine the factors related to ketamine use and the opioid sparing effect. Methods: The medical records of pancreatic cancer patients admitted to St. Mary's hospital palliative care unit between January, 2013 and December, 2014 were reviewed. Patients were divided into 2 categories according to ketamine use. Also, opioid use before and after ketamine use was compared in the ketamine group. Results: Compared to the non-ketamine use group, patients in the ketamine group required a higher dose of opioid. The total opioid dose, daily opioid dose, number of daily rescue medications, and daily average rescue dose were statistically significantly higher in the ketamine group. The opioid requirement was increased after ketamine administration. Conclusion: In this retrospective study, ketamine was frequently considered in patients with severe pain, requiring higher amount of opioid. Studies about palliative use of ketamine in a larger number of patients with diverse types of cancer pain are required in the future.

A Descriptive Study on Pain of Elderly (노인의 동통에 관한 조사연구)

  • 김주희;양경희;이현주
    • Journal of Korean Academy of Nursing
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    • v.26 no.4
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    • pp.878-888
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    • 1996
  • The main purpose of this study was getting related to the pain charactristic data of elderly. It contains past and present health status, daily living activity level, pain frequency, causes, pain area, pain intensity, pain worse causes, and pain releave causes, pain management methods. The subject were 79 elderly whose age were over 65 years old. They were lived in their home environment. Half of them were resident of middle range city at province and the others were Seoul city. The data was collected from Dec. 1st. 1995 to Jan. 30th. 1996. Interviews were held with semi-structured questionaire after pilot study by researchers. Pain measurement tool were used graphic rating scale and Abstract of Korean Pain Language Scale. To analize the subject's general characteristics, past and present health status, daily living activity level, characteristics about pain, pain management methods statistical SPSS for win frequency were employed. The findings were as follows ; 1. There were 33(41.8%) male and 46(58.2%) female Below 69 year old were 20(25.3%), 70-79 year old were 42(53.2%), over 80 year old were 17(21.5%), mean age was 74(from 65 to 89). 2. Buddhist were 24(30.4%), Christian were 29(36. 7%), the other religious status or non religians were 26 (32.9%). 3. Past good health status were 63(79.7%), not so good status were 6(7.6%). Present good health status were 19(24.1%), moderated health status were 6(7.6%), not so good status were 14(17.7%). 4. Daily living activity limitation were 39(49.4%), nonlimitation of activity were 5(6.3%). 5. Walking limitation were 3(3.8%), nonlimitation walking were 52(65,8%). 6. Insomnia was 23(29.1%), no difficult were 38(48.1%). 7. Chronic pain complaints were 64(81%), diseases causes of pain were 25(31.6%), bad health behavior causes of pain were 27(34.2%). 8. Most pain area were back 30(29.4%), leg 17(16.7%), knee 16(15.7%), arm 13(12.7%), teeth, chest and head were each 5(4.9%), loin, trunk were each 4(3.9%), the other areas were 3(3%). 9. Pain intensity was 3.49(mean) by Korean Language Scale, 6.59(mean) by graphic rating scale. Sensitive pain was 3.5(47.9%), affective pain was 3(20.8%) It was high pain level and sensitive pain. 10. Most pain worse causes moving was 35(44.3%), pain relieving causes rest was 29(36.7%), 11. Pain management method were medication 40(42.1%), physiotherapy 23(24.2%), hospital 12(12.6%), the others 7(7.4%), none 13(13.7%). The conclusion ; Present health status of eldery was not so good. Almost half of them have some diseases. Most common diseases of eldery were arthristis, respitatory and heart problems. Foully nine percent of elderly had limitation of daily living activities. Eighty one percent of eldely had chronic pain. Most of them was back pain (30%). Pain intensity was high(score over 3.5). The worsening pain causes was moving and releiving causes was rest. Pain management method were pain medication, physiotherapy. Therefore, Nursing care plan for the elderly have to focus on pain because majority of elderly have chronic high level of pain related to the arthritis.

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The Analysis of Prescription Used for Low Back Pain in the Yomun(腰門) Chapter of 《Donguibogam(東醫寶鑑)》 (동의보감(東醫寶鑑) 요문(腰門)의 요통처방(腰痛處方)에 대(對)한 분석(分析))

  • An, Jung-Hyeok;Lee, Myung-Jong
    • Journal of Korean Medicine Rehabilitation
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    • v.15 no.1
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    • pp.77-87
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    • 2005
  • Objectives: This analysis of prescription used for low back pain in the Yomun(腰門) chapter of ${\ll}$Donguibogam(東醫寶鑑); The Precious Mirror of Oriental Medicine${\gg}$ is designed to be helpful to practical use of clinics. Methods : Proscriptions used for low back pain in the Yomun(腰門) chapter of ${\ll}$Donguibogam(東醫寶鑑)${\gg}$ were classified and analyzed according to the frequency of proscriptions and the characteristics of each herbs in proscriptions(efficacy, used frequency, related organs etc.) Results and conclusions : After analysis, we obtained the following results : 1. The causes of low back pain are mainly eohyeol(瘀血), yangheo(陽虛), punghanseub(風寒濕). In care of low back pain, I suppose more efficiency that if Angelica gigas NAKAI(當歸) Cnidium officinale MAKINO(三芎) Prunus persica BATSCH(桃仁) is added when the cause is eohyeol(瘀血), or if Psoralea corylifolia L.(破古紙), Cinnamomum cassia PRESL(肉桂), Foeniculum vulare MILL(茴香), Eucommia ulmoides OLIV.(杜冲), Citrus unshiu MARKOVICH(陳皮) are added when the cause is yangheo(陽虛), or if Phellodendron amurense RUPR.(黃柏), Notopterygium incisum TING(羌活), Atractylodes Japonica KOIDZ.(蒼朮) are added when the cause is punghanseub(風寒濕).

Effect of Stretching Exercise on Depression, Pain, and Fatigue in Patients with Systemic Lupus Erythematosus (신전운동이 루푸스 환자의 우울, 통증 및 피로에 미치는 영향)

  • An, Min-Jeong;Park, In-Hyae
    • Journal of muscle and joint health
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    • v.13 no.1
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    • pp.43-52
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    • 2006
  • Objective: The purpose of this study was to determine the effect of stretching exercise on depression, pain, and fatigue in patients with systemic lupus erythematosus(SLE). Methods: The study was designed as a non-equivalent control group pre-posttest quasi-experimental design. The patients with SLE who signed the consent form were conveniently assigned into two groups(11 experimental subjects and 10 control subjects). The subjects in the experimental group were participated in 6 weeks stretching exercise program for one and a half hours per session twice a week. The data were analyzed by using a SAS-pc+ 8.01 program. Results: 'The experimental group would have less depression scores than the control group' was supported (Z=2.2, p=.025). 'The experimental group would have less pain scores than the control group' was supported (Z=3.4, p=.001). 'The experimental group would have less fatigue scores than the control group' was supported (Z=-2.0, p=.041). With this study, we identified the stretching exercise program was effective on depression, pain, and fatigue of SLE patients. Conclusions: From above results, 6 weeks stretching exercise program could be an effective nursing intervention to reduce depression, pain, and fatigue in patients with SLE.

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