• 동국한의학연구소논문집
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• 제8권2호
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• pp.25-46
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• 2000

통증은 환자들로 하여금 내원하게 하는 주된 증상중의 하나로, 치료방법의 선택 및 효과 판정을 위해서는 적절한 평가가 필요하다. 통증은 실험적인 방법과 임상적인 방법에 의해 측정될 수 있는데, 통증의 주관적인 성격상 임상적인 방법이 일반적으로 사용된다. 통증의 임상적측정법은 일차원적측정법과 다차원적측정법으로 대별할 수 있는데, 일차원적 측정법으로는 시각적상사척도(Visual Analogue Scale), 구술적평정척도(Verbal Rating Scale), 수치평정척도(Numerical Rating Scale), 통증표정척도(Pain Faces Scale), 그리고 포커칩 도구(Poker Chip Tool)등이 있고, 다차원적 측정법으로는 McGill 동통질문서(McGill Pain Questionnaire), 다면적인성검사(MMPI), 통증행동척도(Pain Behavior Scale), 통증장애지표(Pain Disability Index), 그리고 통증평정척도(Pain Raing Scale)등이 있다. 일차원적 측정법은 주로 환자의 자가통증평가법에 기초하여 통증의 강도를 측정하는데, 측정방법의 단순함과 신속성으로 인해 급성통증을 평가하는데 주로 사용된다. 다차원적인 측정법은 통증의 주관적, 정신적 그리고 행동적인 면을 측정하는데, 측정방법이 포괄적이고 신뢰성이 있어서 만성통증을 측정하는데 사용된다. 환자의 언어와 인지능력은 정확한 통증을 평가하는데 장애가 되는 주된 요인이다. 통증에 따른 행동반응이나 생체반응은 환자의 통증을 완전히 대변하지 못하지만 이러한 상황에 있어 유용한 통증평가지표가 될 수 있다. 통증평가법을 결정할 때에는 먼저 측정하려고 하는 통증의 성격을 고려하여 어떠한 면을 측정할 것인가를 결정해야하며 아울러 환자의 언어와 인지능력을 고려해야 한다. 적절한 평가법의 선택은 환자의 진단과 치료에 있어 유효한 결론에 이르게 하는 중요한 과정이다.

• 한국콘텐츠학회논문지
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• 제8권2호
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• pp.205-212
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• 2008

소아 환자는 정맥주사의 통증에 대한 심리적인 거부감 및 두려움이 존재하고 있다. 정맥 카데터 주입시의 통증을 평가하기 위해 CT검사를 위해 내원한 소아 130명(나이 $8{\sim}13$)을 대상으로 하였다. 통증 분석은 시각적 상사 척도(visual analog scale, VAS), 수치 통증 강도 척도(numeric pain rating scale, NPRS), Wong-Baker의 안면 통증 단계 척도(Wong-Baker faces pain scale, WBFPS)를 개량한 3종류의 평가 도구를 이용하였다. 시각적 상사 척도, 수치 통증 강도 척도, Wong-Baker의 안면 통증 단계 척도 간의 양의 상관관계($r=0.70{\sim}0.92$)를 보이고 있다. 시각적 상사 척도/수치 통증 강도 척도에서 보다 좋은 일치도를 나타냈다.

• Journal of Acupuncture Research
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• 제26권6호
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• pp.215-224
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• 2009

Objectives : Low back pain is the most prevalent condition for receiving Korean traditional medical treatment. The aim of this review is to provide fundamental data for development of low back pain classification and assessment criteria which can be used in clinical trials and clinical practice. Methods : Domestic and international clinical studies on oriental medicine treatment for low back pain were searched through on-line databases. The searched articles were reviewed and the evaluation tools used in the studies were investigated. Results : A total of 38 possibly relevant articles in Pubmed were identified, of which 34 articles included assessment criteria for low back pain. And 38 articles were reviewed in the Journal of Korean Oriental Medicine and the Journal of Korean Acupuncture & Moxibustion Society. 29 articles used pain scales, 24 used functional scales, and 20 among 34 articles in PubMed used both pain and functional scales. The majority of articles which published in Korea used worthless assessment scales of simple grades. There was no articles which used assessment scales related to the concepts of Korean traditional medicine. Conclusions : Our review of articles suggests that we would use both pain and functional scales. Future assessment scales should include the concepts of Korean traditional medicine.

• 기본간호학회지
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• 제14권1호
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• pp.29-43
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• 2007

Purpose: This study was done to develop a pain management protocol for nursing home patients with dementia and to examine effects of the protocol on pain assessments and interventions by the nurses and on pain relief signs in the patients. Method: The six steps in the protocol development and the examination of effect are outlined. Three rounds using the Delphi technique and one group pretest-posttest design experiment were developed. Design issues, such as sample selection and sample size, are addressed in relation to the study protocol. Results: After implementation of the pain management protocol, there were significant changes nursing actions including frequency of number of physical examinations, utilization of pain assessment tools, and request to doctors for discomfort management and there were significant changes in frequency in the number of verbal and physical expressions of pain, and emotional patterns. Conclusion: This is the first pain management protocol for patients with dementia in Korea. However, more study will be needed to determine the methodological strength and necessary revisions for the protocol.

• Asian Pacific Journal of Cancer Prevention
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• 제17권8호
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• pp.3997-4001
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• 2016

Background: Cancer is a worldwide health problem and pain is among the most common and unpleasant effects affecting well-being of cancer patients. Accurate description of pain can help physicians to improve its management. Many English tools have been developed to assess pain. Onkly a limited number of these are applied in Arab countries. Our aim was to assess the quality, the nature and the severity of pain using the short McGill Pain Questionnaire (SF-MPQ) on cancer patients in the National Institute of Oncology (NIO) in Rabat, Morocco. Materials and Methods: The tool used is the SF-MPQ inspired from the Arabic version of the MPQ. The subjects were cancer patients (N=182) attending the NIO, from 24th October 2015 to 8th January 2016, aging ${\geq}18$ years old, experiencing pain and coming to have or to update their pain medication. Results: The rate of participation was 96.3%. Eight patients had difficulties to express their pain using descriptors, but could use the Visual Analogue Scale (VAS) and the body diagram. The most frequent sensory descriptors were 'Throbbing', 'Shooting', 'Hot-Burning'. The most used affective descriptor was 'Tiring-Exhausting'. The mean VAS was 6.6 (2.4). The mean score of all items was 11.9 (7.8). The patients were suffering from severe pain. The internal consistency of the form was s acceptable. Conclusions: The findings indicate that most of the patients attending the pain center of the NIO could use the descriptors of the SF-MPQ to describe their pain. They indicate the usefulness of the SF-MPQ to assess the nature and the severity of pain in cancer patients. This tool should be tested in other Moroccan and Arabic contexts associated with other tools in clinical trials.

• 대한물리의학회지
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• 제9권4호
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• pp.415-424
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• 2014

PURPOSE: This study examined the effect of high-frequency transcutaneous electrical nerve stimulation (TENS) and San-Yin-Jiao (SP6) acupressure on primary dysmenorrhea. Furthermore, the difference in effectiveness between the two methods were compared. METHODS: Twenty-six students participated in this study, and were randomly assigned to a high-frequency TENS group(experimental 1, n=9), a San-Yin-Jiao (SP6) acupressure group(experimental 2, n=9), and no treatment group(control, n=8). They were assessed and treated on the first day of their menstruation. The TENS protocol included applying 20 minutes of stimulation with a frequency of 100Hz, $100{\mu}sec$ pulse width. Four electrodes were placed on the skin 3 cm from midline at T12-L1 and S2-3 paravertebral muscles. San-Yin-Jiao (SP6) acupressure should be applied with the thumb for 10 minutes(8 seconds pressure and 2 seconds rest) on the SP6 acupoint. This procedure should be repeated for the other foot. Dysmenorrheal pain measured two pain assessment tools (VAS, DPT) pre-treatment; immediate post-treatment; 30minutes, 1, 2hours; and 3, 4, 5, 6, 24 hours after the VAS test were added. RESULTS: The results showed significant differences in pain assessments (VAS, DPT) after treatment for subjects of experimental group1 (p<.05) and experimental group2 (p<.05), whereas the between-group comparison found no statistically significant differences. CONCLUSION: This result supports the idea that using two methods could be effective in pain reduction among students who suffered from primary dysmenorrhea.

• 한국전문물리치료학회지
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• 제17권2호
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• pp.25-32
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• 2010

The purpose of this study was to investigate the most effective and comprehensible method for the assessment of resting scapular position (RSP) and pain level (PL) in unilateral shoulder pain (USP). Fifty volunteers with USP were involved in the study. Resting scapular assessments of the patients' pain sides (PS) and non-pain sides (NPS) were evaluated. The assessment tools for RSP are: 1) sternal notch (SN) to coracoid process (CP) distance 2) 3rd thoracic spinous process (T3S) to posterolateral angle of acromion (PLA) distance 3) scapular index 4) 8th thoracic spinous process (T8S) to inferior angle of scapular (IAS) distance 5) supine measurement of pectoralis minor (PM) distance 6) standing PM distance 7) PM index (PMI) and 8) PM pain. The paired t-test was used to compare PS and NPS in RSP. Pearson correlation analysis was used to confer a relationship between the PL and RSP. The results of this study indicated that: 1) all the variables between the PS and NPS for RSP were statistically significant(p<.05) and 2) the PMI showed the strongest relationship in the correlation analysis between RSP and PL(p<.05, r=.37). Therefore, it can be concluded that there is a relationship between PMI and PL and it is suggested that an assessment tool using PMI to diagnose shoulder pain would be clinically effective.

• 한국전문물리치료학회지
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• 제18권3호
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• pp.94-102
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• 2011

The purpose of this study was to review existing assessment tools for patients with low back pain and improve them through combination. A total of 314 patients with low back pain participated. Their condition was assessed using the Oswestry Disability Questionnaire (ODQ), the Quebec Back Pain Disability Scale (QBPD), and the Back Pain Functional Scale (BPFS). Rasch analysis was applied to identify inappropriate items, item difficulties, and the separation index. In this study, the 'sex life' item of the ODQ (10 items) and the 'sleeping' item of the BPFS (12 items) showed misfit statistics, whereas all items of the QBPD (20 items) were appropriate. After combining the ODQ, QBPD and BPFS, Rasch analysis was applied. The 'pain intensity', and the 'sex life' item of the ODQ and the 'throw a ball' item of QBPD showed misfit statistics. These 3 items were retained for further analysis. The remaining 42 combined ODQ-QBPD-BPFS items were arranged according to difficulty. For all subjects, the most difficult item was 'pain intensity', whereas the easiest was 'take food out of the refrigerator'. As the separation index of 42 combined ODQ-QBPD-BPFS was higher than that of the three questionnaires separately, difficulty of items varied with some need for rearrangement. The results of this study confirmed the possibility and need for a new back pain disability assessment tool, and produced one. Further study is needed to refine the questionnaire in consideration of psychosocial and occupational factors.

• 보건의료산업학회지
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• 제9권2호
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• pp.89-102
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• 2015

Patients unable to speak are at higher risk for untreated pain. Use of valid behavioral and physiologic measures for pain is highly recommended for uncommunicative patients. This study was performed to compare the reliability and validity of NVPS-K and CPOT-K for pain assessment of nonverbal patients. This study was conducted from July to November 2011. A total of 29 nonverbal adult patients admitted to a university hospital intensive care unit participated in this study. Interrater reliability of the NVPS-K and CPOT-K had intermediate to high intraclass correlation coefficients (NVPS-K 0.680 ~ 0.921, CPOT-K 0.710 ~ 0.896). Discriminant validity was supported with higher instrument scores during turning and endotracheal suctioning than that of NIBP. For criterion validity, the NVPS-K scores were correlated to the self-reported pain of the patients but not the CPOT-K scores. The areas under the ROC curve for the NVPS-K and CPOT-K were 0.748 and 0.696 with cutoff points of 1 and 2, respectively. Thus, the NVPS-K and CPOT-K had a sensitivity and specificity of 94.7% and 45.0%, and 60.5% and 75.0%, respectively. The NVPS-K and CPOT-K are reliable and valid tools to assess pain in nonverbal patient and thus, are recommended for the assessment of the pain in nonverbal patients.

• Journal of Hospice and Palliative Care
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• 제22권2호
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• pp.67-76
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• 2019

포괄적이고 총체적 돌봄을 제공하는 호스피스 완화의료의 경우 평가도구를 사용하여 문제목록의 객관화하고 돌봄 계획의 구체화하는 것이 필요하다. 초기평가는 입원 당일 혹은 1일 이내에 환자의 증상과 사회적, 영적 문제, 완화의료에 대한 요구가 무엇인지 파악하며 개괄적인 돌봄의 방향을 설정하는 과정이다. 현재 병에 대한 인식과 예후를 파악하는 것부터 연명의료계획서 작성까지 함께 검토한다. 초기평가도구로는 간단하지만 포괄적으로 신체적, 정신적, 사회적, 영적 영역을 아우르는 13개의 간단한 질문으로 구성된 NEST를 추천한다. 초기평가에서 파악된 문제에 대하여 구체적인 평가도구들을 활용하여 돌봄 계획을 수립하며 입원 후 3일이내 시행하는 것이 좋다. 신체적 영역의 경우 기능상태를 포함하여 통증과 비 통증 증상, 삶의 질을 함께 파악할 수 있는 다증상 평가도구가 도움이 될 수 있다. 환자의 증상은 단독으로 의미를 가지는 것이 아니라 복합적인 상호작용으로 발생하며, 그에 따라 포괄적으로 접근해야 하기 때문이다. 정신심리적 영역은 심리적 고통과 불안, 우울을 평가한다. 사회적 영역의 평가는 의사결정, 사회경제적 환경 파악, 가족 평가 및 임종 준비의 단계로 이루어진다. 영적 평가 역시 중요한데 FACIT-Sp나 SHI를 사용할 수 있다. 평가도구를 활용하는 것은 환자의 고통을 경감시키고 삶의 질을 향상시킬 뿐 아니라 의료진이 체계적으로 훈련되는 방안이 될 수 있으며 그 과정 자체가 더 나은 돌봄 제공을 위한 발판이 될 수 있다.