• 제목/요약/키워드: Pain Care

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호스피스간호가 말기암환자의 통증에 미치는 효과에 관한 연구 (The Study on the Effects of Hospice Care on the Pain Management of the Terminal Cancer Patients)

  • 윤매옥
    • Journal of Hospice and Palliative Care
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    • 제6권1호
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    • pp.34-44
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    • 2003
  • 목적 : 본 연구는 호스피스 간호가 말기암환자의 통증정도에 미치는 효과를 파악하고 분석함으로써, 말기암환자의 안위를 도모하여 전인적이고 개별화된 간호를 제공하는데 도움을 주기 위하여 시도된 단일군 전후설계(one group pre-post test)이다. 방법 : 2000년 7월부터 11월까지 전주시에 소재하는 1개 종합병원의 호스피스에 의뢰되어 연구참여에 동의한 말기암환자 37명을 대상으로 하였다. 호스피스 간호는 1주일에 $5{\sim}6$회를 조주 동안 제공하였으며, 자료분석은 실수, 백분율, 평균, 표준편차 등의 서술통계와 paired t-test로 분석하였다. 결과 : 1) 통증정도의 중증도는 통증정도가 24시간 동안 가장 심했을 때 통증점수는 중재전이 6.35점, 중재후가 4.76점이었다. 통증으로 인한 지장정도는 중재전에는 인생을 즐김(8.22점), 통상적인 일(7.46점), 보행(7.08점), 일반적인 활동(7.08점)순이었으며, 중재후에는 인생을 즐김(6.62점), 통상적인 일(6.43점), 보행(6.11점), 일반적인 활동(5.78점)순으로 중재전과 후가 동일한 순위를 보였다. 2) 통증의 중증도는 중재전보다 중재후에서 각각 유의하게 감소하였다. 영역별로 분석하였을 때 24시간 동안 가장 심했을 때 통증(t=4.085, P=0.000), 24시간 동안 가장 약했을 때 통증(t=4.020, P=0.000), 평균통증(t=4.254, P=0.000), 조사당시 바로 지금 느끼는 통증(t=5.017, P=0.000)영역에서 중재후 통증이 중재전보다 유의하게 감소하였다. 3) 통증으로 인한 지장정도는 중재전보다 중재후에서 각각 유의하게 감소하였다. 영역별로 분석하였을 때 일반적인 활동(t=3.137, P=0.003), 기분(t=6.713, P=0.000), 보행능력(t=2.027, P=0.050), 통상적인 일(t=20.132, P=0.040), 대인관계(t=4.143, P=0.000), 수면(t=4.071, P=0.000), 인생을 즐김(t=3.881, P=0.000)에서 통계적으로 유의한 차이가 나타났다. 결론 : 호스피스 간호를 제공받은 말기암환자는 제공받지 않은 말기암환자에 비해 통증정도와 삶의 치장 정도에서 모두 낮아짐이 확인되었으며, 유의한 차이를 보였다. 이상과 같이 말기암환자에 대한 호스피스 간호는 통증감소와 통증이 생활에 지장을 주는 정도를 감소하는데 효과적인 것으로 확인되었으므로 앞으로 말기암환자를 위해 적극적인 활용을 권장한다.

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Role of Catheter's Position for Final Results in Intrathecal Drug Delivery. Analysis Based on CSF Dynamics and Specific Drugs Profiles

  • De Andres, Jose;Perotti, Luciano;Villanueva, Vicente;Asensio Samper, Juan Marcos;Fabregat-Cid, Gustavo
    • The Korean Journal of Pain
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    • 제26권4호
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    • pp.336-346
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    • 2013
  • Intrathecal drug delivery is an effective and safe option for the treatment of chronic pathology refractory to conventional pain therapies. Typical intrathecal administered drugs are opioids, baclofen, local anesthetics and adjuvant medications. Although knowledge about mechanisms of action of intrathecal drugs are every day more clear many doubt remain respect the correct location of intrathecal catheter in order to achieve the best therapeutic result. We analyze the factors that can affect drug distribution within the cerebrospinal fluid. Three categories of variables were identified: drug features, cerebrospinal fluid (CSF) dynamics and patients features. First category includes physicochemical properties and pharmacological features of intrathecal administered drugs with special attention to drug lipophilicity. In the second category, the variables in CSF flow, are considered that can modify the drug distribution within the CSF with special attention to the new theories of liquoral circulation. Last category try to explain inter-individual difference in baclofen response with difference that are specific for each patients such as the anatomical area to treat, patient posture or reaction to inflammatory stimulus. We conclude that a comprehensive evaluation of the patients, including imaging techniques to study the anatomy and physiology of intrathecal environment and CSF dynamics, could become essential in the future to the purpose of optimize the clinical outcome of intrathecal therapy.

가정간호기반 완화케어프로그램의 효과 (Effects of a Palliative Care Program based on Home Care Nursing)

  • 황문숙;유호신
    • 대한간호학회지
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    • 제39권4호
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    • pp.528-538
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    • 2009
  • Purpose: This study was done to develop and test a palliative care program based on home care nursing. Methods: A quasi-experimental design was employed. Changes in the variables were evaluated to test effects of the developed program. Participants were patients with terminal cancer and their families receiving home care nursing from six hospitals (experimental group: 24 and control group: 22). Data collection was conducted from February to October, 2006. Chi-square test, Fisher's exact test, t-test, Mann-Whitney U test and repeated measures ANOVA were used to analyse the data. Results: Hypothesis 1, the experimental group receiving this program will experience less pain (severe, average, weak pain) than the control group, was supported. Hypothesis 2, the experimental group will have less symptom experience than the control group, was supported. Hypothesis 3, the experimental group will have higher QOL than the control group, was supported and the last hypothesis 4, family burden in the experimental group will be less than the control group, was supported. Conclusion: The home care nursing based palliative program developed in this study was found to be an effective program to reduce patient pain and symptom experience, to improve patient QOL and to decrease family burden.

Impact of Socioeconomic Status on 30-Day and 1-Year Mortalities after Intensive Care Unit Admission in South Korea: A Retrospective Cohort Study

  • Oh, Tak Kyu;Jo, Jihoon;Jeon, Young-Tae;Song, In-Ae
    • Acute and Critical Care
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    • 제33권4호
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    • pp.230-237
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    • 2018
  • Background: Socioeconomic status (SES) is closely associated with health outcomes, including mortality in critically ill patients admitted to intensive care unit (ICU). However, research regarding this issue is lacking, especially in countries where the National Health Insurance System is mainly responsible for health care. This study aimed to investigate how the SES of ICU patients in South Korea is associated with mortality. Methods: This was a retrospective observational study of adult patients aged ${\geq}20$ years admitted to ICU. Associations between SES-related factors recorded at the time of ICU admission and 30-day and 1-year mortalities were analyzed using univariable and multivariable Cox regression analyses. Results: A total of 6,008 patients were included. Of these, 394 (6.6%) died within 30 days of ICU admission, and 1,125 (18.7%) died within 1 year. Multivariable Cox regression analysis found no significant associations between 30-day mortality after ICU admission and SES factors (P>0.05). However, occupation was significantly associated with 1-year mortality after ICU admission. Conclusions: Our study shows that 30-day mortality after ICU admission is not associated with SES in the National Health Insurance coverage setting. However, occupation was associated with 1-year mortality after ICU admission.

Attitudes toward Social Issues Related to Opioid Use among Palliative Care Physicians

  • In Cheol Hwang;Seong Hoon Shin;Youn Seon Choi;Myung Ah Lee;DaeKyun Kim;Kyung Hee Lee
    • Journal of Hospice and Palliative Care
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    • 제27권1호
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    • pp.45-49
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    • 2024
  • Purpose: This study investigated palliative care physicians' attitudes regarding social issues related to opioid use. Methods: An email survey was sent to 674 physicians who were members of the Korean Society for Hospice and Palliative Care (KSHPC). Results: Data from 66 physicians were analyzed (response rate, 9.8%). About 70% of participants stated that their prescribing patterns were not influenced by social issues related to opioid use, and 90% of participants thought that additional regulations should be limited to non-cancer pain. Under the current circumstances, pain education for physicians is urgently needed, as well as increased awareness among the public. Half of the respondents identified the KSHPC as the primary organization responsible for providing pain education. Conclusion: Palliative care physicians' prescribing patterns were not influenced by social issues related to opioid use, and these issues also should not affect cancer pain control.

산후병 및 산후관리에 대한 국내 한의학 임상 연구 동향 분석 (An Analysis of Clinical Research Trends on Interventions of Oriental Medicine for Postpartum Disease and Postpartum Care)

  • 김누리;이은희
    • 대한한방부인과학회지
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    • 제35권1호
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    • pp.34-58
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    • 2022
  • Objectives: This study was performed to analyze the interventions of Oriental Medicine which had been commonly used for postpartum disease and postpartum care. Methods: We searched research on the interventions for postpartum disease and postpartum care in 4 domestic search engines. After that, we conducted eligibility screening based on inclusion and exclusion criteria. Results: 1. We selected total 50 studies. There were 2 randomized controlled trial (RCT), 5 non-RCT, 35 case reports, 8 case series within the 6~8 weeks after childbirth. 2. Of the 35 case reports, several interventions were used : acupuncture (22), moxibustion (11), cupping therapy (7), pharmacopuncture (5), chuna manipulation (4), herbal medicine (34). The most common symptoms were musculoskeletal symptoms (8), followed by postpartum depression (7). Various prescriptions and acupoints of oriental medicine were used depending on the diseases or symptoms. 3. Of the 8 case series, 382 subjects in 5 case series had taken Saenghwa-tang-gagam. And Acupuncture, moxibustion, cupping therapy (5), pharmacopuncture (1) were used as an intervention. 4. The most commonly used acupoint is 腎兪 (BL23) in the pain including postpartum back pain and 三陰交 (SP6), 關元 (CV4) in the postpartum care. 關元 (CV4) is the most commomly used moxibustion point not only the postpartum disease but also the postpartum care. Conclusions: In clinical studies of oriental medicine related to postpartum disease and postpartum care, pain-related clinical studies that belong to or progress to Sanhupung were the most common (30%), and among them, postpartum low back pain studies were the most common (20%). Based on this, we believe that large-scale clinical studies with high quality using oriental interventions including chuna and pharmacopuncture are needed to establish guidelines for the management of pain treatment including postpartum back pain.

중환자실 요통관련 간호업무특성 (Nursing Work Related to Low Back Pain in Intensive Care Unit)

  • 이재희;송영신
    • 산업융합연구
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    • 제21권10호
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    • pp.103-110
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    • 2023
  • 본 연구는 종합병원 중환자실 간호사의 요통 유무에 따른 개인적 특성과 간호업무 특성을 파악하고 요통 유발에 영향을 미치는 주요 요인을 탐색하기 위한 서술적 비교 조사 연구이다. D시에 소재한 종합병원 중환자실 간호사를 대상으로 설문조사를 실시하였고, 총 100부를 분석에 이용하였다. 자료 분석은 IBM SPSS 24.0을 이용하여 기술통계, 카이제곱 검정, Fisher 정확 검정, 로지스틱 회귀분석을 하였다. 연구 결과 중환자실 간호사의 69%가 요통이 있었고 이 중 65.2%가 최근 1년 동안 3개월 이상의 요통을 경험하였으며 중환자실 업무 후 요통이 발생한 경우가 84.1%로 나타났다. NRS로 측정한 요통 강도 점수는 49%가 4점 이상을 경험하는 것으로 응답 하였다. 요통 관련 요인으로 개인적 특성에서 성별(p=.03)과 간호업무 특성에서 환자 부축 횟수(p=.03), 환의 교환 횟수(p=.01), 무거운 물건 들기(p=.04), 신발 상태 만족도(p=<.001)가 요통 유발에 영향을 미치는 유의한 변수로 확인되었다. 중환자실 간호사의 요통 예방 및 관리를 위해서 병원 조직 및 국가 정책이 필요할 것으로 사료된다.

수중운동 프로그램 참여 후 골관절염 환자의 통증과 자기간호활동, 유연성, 악력 및 무력감의 변화 (Effects of Aquatic Exercise Program on Pain, Flexibility, Grip Strength, Self-Care Activities and Helplessness in Patients having Osteoarthritis)

  • 김영재;김창숙;박인혜
    • 근관절건강학회지
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    • 제11권2호
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    • pp.127-135
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    • 2004
  • Purpose: The purpose of this study was to explore the effects of aquatic exercise program on pain, flexibility, grip strength, self-care activities, helplessness in osteoarthritis patients. Methods: This program was carried out three times a week for 6 weeks by 3 groups of patients among 42 patients in regular swimming pool. Data were analysed by paired t-test for pre and post comparison. Results: There were significantly improved in pain flexibility, grip strength, self-care activities and helplessness after the program. However no significant differences were found in fatigue, difficulty of daily living activities and depression. Conclusion: Aquatic program was proved to be an effective nursing intervention to increase the self-care activities flexibility and grip strength, and to decrease pain and helplessness in osteoarthritis patients.

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광센서를 이용한 실시간 중환자 요량감시 장치 (Real-time urine monitoring system for intensive care patient using optical sensor)

  • 김종명;이진영;홍주현;임승운;차은종;이태수
    • 센서학회지
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    • 제17권1호
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    • pp.81-85
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    • 2008
  • This paper addressed real-time urine monitoring device for intensive care patients. The device was developed to detect and count each urine drop using optical sensor and calculate the current urine output volume and its hourly rate. In experiment, the water volume scale of drainage bottle was observed and compared with the count of the device so that the volume of each drop was found to vary with the dropping rate per minute. From this measurement, the relationship equation was derived to estimate the total water volume from the drop rate (correlation coefficient : r= 0.99). The developed device could be applied to count patient's urine drop successfully. Therefore, this device can be used to monitor intensive care patient's urine status in real-time.