• The Korean Journal of Rehabilitation Nursing
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• v.3 no.1
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• pp.43-58
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• 2000

Pain management is a major issue in caring of cancer patients. Patients' concerns for reporting pain and taking analgesics are patient-related barriers to the management of cancer pain. Since such study has not been done at all in Korea, it is clearly needed to study on these problems. The purpose of this study is to attain basic data in order to improve cancer pain management in Korea. This is done by: 1) examining the extent of patients' concerns that might be barriers to the optimal pain management, and the extent of related factors (pain management hesitancy, adequacy of using analgesics, pain severity and pain interference); 2) identifying the relationship between patients' concerns and the related factors. The data has been collected from 180 cancer patients who were hospitalized in medical wards of one university hospital in Seoul, Korea during the period from November 1, 1997 to February 28, 1998. The data has been collected through interviews with (1) Barriers Questionnaire - Korean Version (BQ-K); (2) Hesitancy Experience Questionnaires (HQ); (3) Pain Management Index (PMI); (4) Brief Pain Inventory (BPI); and (5) Demographic Data. The data were analyzed by descriptive statistics and by t-test, One-way ANOVA, Pearson correlation using SPSSWIN program. The Results are as following: 1) The mean scores of Pain Management Concerns (PMC) by BQ-K were toward the moderate with a little high points(2.59). Most of the patients (99.4%) had some extent of concerns (over lout of maximum 5 points). Among the eight subscales of BQ-K, the Pain Management Concerns (PMC) about 'Fear of tolerance' was the highest (3.80) and 'Worry about side effects' was the least (1.40). 2) The extent of Pain Management Hesitancy (PMH) by HQ of wnom had pain on the day of the interview was a little higher than moderate score(5.53 out of maximum 10 points). 6.7% of the patients with experiencing pain used less adequate analgesics for the severity of pain than they were expected. 27.8% of them never used any analgesics at all. The mean score of pain severity by BPI was 16.59 (maximum: 40), and that of the interference with daily life by BPI was 32.03 (maximum: 70). 3) The patients who were older, less educated, and in low socio-economic status were likely to have more concerns. Pain Management Concerns (PMC) was positively correlated with Pain Management Hesitancy (PMH) (r=.75), pain severity (r=.44) and pain interference (r=.50). Those who were not using adequate analgesics had higher Pain Management Concerns (PMC) than did those who were using adequate analgesics (t=-5.42). The patients who had more Pain Management Concerns (PMC) tended to hesitate more to report pain and to use analgesics. They used more inadequate analgesics for the severity of pain and also had experienced more pain severity and interference with daily life. In conclusion, the patients' concerns for reporting pain and for using analgesics are major patient-related barriers to cancer pain management in Korea. The patients' concerns were correlated significantly with the level of the hesitancy experience, inadequate use of analgesics, the pain severity and the interference with daily life. Considering this, an educational program for cancer patients under the treatment with analgesics should be developed in order to solve these problems.

• Journal of Korean society of Dental Hygiene
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• v.14 no.6
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• pp.881-886
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• 2014

Objectives: The purpose of the study was to investigate the related factors to dental fear in some adults. Methods: A self-reported questionnaire was filled out by 320 adults in Seoul and Gyeonggi-do from April to June, 2013. Except 14 incomplete answers, data were analyzed by SPSS 18.0 program. The questionnaire consisted of general characteristics of the subjects(7 questions), dental fear related factor(18 questions), distrust for dentist(15 questions), and distrust for dental hygienist(11 questions). The instrument for dental treatment fear was Dental fear Survey(DFS) adapted from Kleinknecht and partly modified by Choi. Out of 20 questions, 18 questions were reconstructed and score by Likert 5 scale. Higher score means higher dental fear. Cronbach alpha was 0.959 in the study. The distrust for dentist and dental hygienist was adapted from Choi and reconstructed and score by Likert 5 scale. Higher score means higher distrust for dentist and dental hygienist. Cronbach alpha was 0.937 in distrust for dentist and 0.874 in distrust for dental hygienist in the study. Results: Those who experienced dental pain tended to have dental fear. The reasons for dental fear were as follows; bad breath(2.96 out of 5 points, hereafter represented as of 2.96/5), dental caries(2.88/5), missing teeth(2.87/5) and tooth pain(2.77/5). The distrust for the dentist was the main dental fear in the adults. Conclusions: The dental fear was closely related to gender, experience of dental pain, oral symptoms and distrust for the dentist. As the psychological pain in the patients was mainly influenced by the trustful atmosphere, it is necessary to make the patient easy before treatment.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.10 no.2
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• pp.57-72
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• 2004

Background : The part to be very important that we make the physical development rightly at elementary school student days. Objective : This study investigated the relation of a physical health status which itself recognizes and an exercise performance situation out for an elementary school students. Methods : This cross-sectional study examined health and exercise performance status of 1,032 elementary school children. To examine children's a physical injury experience and injury occurrence characteristic and a personal computer utility condition, a body alignment status of the student which parents recognize and the relation of a fatigue and concentration level was an investigation with other factors. Results: An average age of the children was the 10.95 yr and an average weight was the 39.02 kg and an average height was the 145.17cm. The student to be experiencing currently an pain occurrence was 192(19.07%). It was most high to the grade 6(23.33%) compared with different grade(p<.01). Physical pain occurrence rate did not exist by gender(p>.05). There is most an pain occurrence region the ankle(38.0%). They had a 27.19% an physical injury experience of the students. A injury rate was revealed that were high as were the high grade(grade 6, 36.72%)(p<.01). A reason of the injury rate was high in a collision at the body(19.84%), falling down(18.68%) sequence at a traffic accident(22.96%)(p<.05). There were the significant relation to the school year the reason of the injury (p<.05). Currently there was the student to be taking special exercises a 57.97%. This that they have the relation with exercise with physical pain students to recognize 23.8%. The significant relation did not exist in the physical exercise execution and pain occurrence on the body(p>.05).

• Journal of Yeungnam Medical Science
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• v.17 no.1
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• pp.12-20
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• 2000

The memory of pain can be more damaging than its initial experience. Several factors arc related the directions of pain memory: current pain intensity, emotion, expectation of pain, and peak intensity of previous pain. The possible mechanisms behind the memory of pain are neuroplastic changes of nervous system via peripheral and central sensitization. Peripheral sensitization is induced by neurohumoral alterations at the site of injury and nearby. Biochemicals such as K+, prostaglandins, bradykinin, substance P, histamine and serotonin, increase transduction and produce continuous nociceptive input. Central sensitization takes place within the dorsal horn of spinal cord and amplifies the nociceptive input from the periphery. The mechanisms of central sensitization involve a variety of transmitters and postsynaptic mechanisms resulting from the activations of NMDA receptors by glutamate. and activation of NK-1 tachykinnin receptors by substance-P and neurokinnin. The clinical result of peripheral and central sensitization is hyperalgesia, allodynia, spontaneous pain, referred pain, or sympathetically maintained pain. These persistent sensory responses to noxious stimuli arc a form of memory. The hypothesis of preemptive analgesia is that analgesia administered before the painful stimulus will prevent or reduce subsequent pain and analgesic requirements in comparison to the identical analgesic intervention administered after the painful stimulus, by preventing or reducing the memory of pain in the nervous system. Conventionally, pain management was initiated following noxious stimuli such as surgery. More recently, however many have endorsed preemptive analgesia initiated before surgery. Treatments to control postsurgical pain are often best started before injury activates peripheral nociceptors and triggers central sensitization. Such preemption is not achieved solely by regional anesthesia and drug therapy but also requires behavioral interventions to decrease anxiety or stress. Although the benefit of preemptive analgesia may not be obvious in every circumstance, and in many cases may not sufficient to abolish central sensitization, it is an appropriate and human goal of clinical practice.

• The Korean Journal of Pain
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• v.28 no.4
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• pp.280-283
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• 2015

Caudal epidural injection is a common intervention in patients with low back pain and sciatica. Even though the complications of fluoroscopically directed epidural injections are less frequent than in blind epidural injections, complications due to contrast media can occur. We report a case of anaphylactic shock immediately after injection of an intravenous nonionic contrast medium (iohexol) during the caudal epidural injection for low back pain and sciatica in a patient without a previous allergic history to ionic contrast media (ioxitalamate). Five minutes after the dye was injected, the patient began to experience dizziness, and the systolic blood pressure dropped to 60 mmHg. Subsequently, the patient exhibited a mild drowsy mental state. About 30 minutes after the subcutaneous injection of 0.2 mg epinephrine, the systolic blood pressure increased to 90 mmHg. The patient recovered without any sequela. Life-threatening complications after injection of intravenous contrast medium require immediate treatment.

• The Korean Journal of Pain
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• v.23 no.4
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• pp.254-257
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• 2010

Background: Epidural steroid injection is an established treatment modality for intervertebral disc prolapse to radiculopathy. In cases where two levels of radiculopathy are present, two separate injections are warranted. Herein, we present our experience of management of such cases with a single epidural injection of local anaesthetic, tramadol and methylprednisolone, and table tilt for management of both radiculopathies. Methods: 50 patients of either sex aged between 35-65 years presenting with features of cervical and lumbar radiculopathic pain were included and were subjected to single lumbar epidural injection of local anaesthetic, tramadol and methylprednisolone, in the lateral position. The table was then tilted in the trendelberg position with a tilt of 25 degrees, and patients were maintained for 10 minuted before being turned supine. All patients were administered 3 such injections with an interval of 2 weeks between subsequent injections, and pain relief was assessed with a visual analogue scale. Immediate complications after the block were assessed. Results: Immediate and post procedural complications observed were nausea and vomiting (20%), painful injection site (4%), hypotension (10%) and high block (4%). Pain relief was assessed after the three injections by three grades: 37 (74%) had complete resolution of symptoms; 18% had partial relief and 8% did not benefit from the procedure. Conclusions: This technique may be used as an alternative technique for pain relief in patients with unilateral cervical and lumbar radiculopathies.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.29 no.4
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• pp.530-540
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• 2019

Objectives: The purpose of this study was to identify factors related with demographic and work characteristics that affect musculoskeletal pain and quality of life among personal assistants for people with severe disabilities. Methods: The subjects were recruited among personal assistant for people with severe disabilities who participated in refresher training held in K-si, Gyeonggi-do Province through convenience sampling. Using a survey instrument developed by the authors, subjects responded to questionnaires concerning muscluloskeletal pain and quality of life. The collected data was analyzed using SPSS 21.0. Basically, collected data was analyzed in terms of frequency, t-test or ANOVA and multiple regression analysis. Results: Total years of work experience and subjective physical workload were associated with the number of pain sites and intensity. Additionally, for quality of life, subjective physical workload was related in the regression model. Conclusions: Based on this study, we identified that characteristics of work affected the musculoskeletal pain and quality of life of personal assistants for the severely disabled, and suggested improvement of the working environment, including musculoskeletal pain prevention education programs during the refresher education for assistants to the severely disabled.

• The Korean Journal of Pain
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• v.6 no.2
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• pp.280-283
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• 1993

Idiopathic hyperhidrosis is a physically and emotionally distressing symptom, which lacks a precise definition. Although operative and nonoperative methods have been shown to be effective in the treatment of idiopathic hyperhidrosis, limitations, cautions and complications are inherent in their extended use. The purpose of this report is to describe the theraputetic effects of magnetic resonance for managing idiopathic hyperhidrosis. A 28 years old woman had been suffering from profuse sweating on both planter and palmar sides for 15 years. We successfully treated this symptom with the 6 magnetic resonance treatments without any complications. Now she lives well in a condition of normal sweating after the applications. It suggest that short daily periods of exposure to appropriate magnetic resonance can beneficially modulate the balance of autonomic nervous system that are responsible for sympathetic overflow, and that there is an effective window of induced electrical magnetism in which sympathetic function can be controlled in the absence of side effects.

• Journal of International Academy of Physical Therapy Research
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• v.7 no.2
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• pp.1066-1070
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• 2016

The purpose of this article was to investigate the effects of Maitland's transverse movement on change of pain, trunk flexion movement and Cobb's angle in patient with upper thoracic scoliosis. The subject are 37 years old with chronic low back pain participated in this study and has no experience surgery within the last six months due to back pain. 10 set was applied 10 times on the T3-T5 applied the transverse movement with grade IV to each segment by skilled physical therapist. Transverse movement was applied convex toward the concave side. Pressure pain threshold was reduced from 4/10 to 2/10. Trunk flexion range that is the distance between the middle finger and floor was increase from 7.3cm to 2cm. Cobb's angle was decreased from degree 18 to 16. This result demonstrated that the Maitland's transverse movement was benefit to reduce the pain and Cobb's angle, and to increase the trunk flexion movement.

• Journal of Korean society of Dental Hygiene
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• v.15 no.4
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• pp.649-659
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• 2015

Objectives: The purpose of the study is to investigate the musculo-skeletal pain prevalence and severity in the dental hygienists based on PRECEDE model. Methods: A self-reported questionnaire was completed by 483 dental hygienists in Gwangju from September 13 to October 12, 2013. Data were analyzed by frequency analysis, chi-square test, t-test, and multiple logistic regression analysis using SPSS 18.0 program. Musculo-skeletal pain severity was classified from 1 to 5 by PRECEDE model. The questionnaire consisted of six questions of the general characteristics of the subjects, one question of musculo-skeletal pain prevalence, one question of body part musculo-skeletal pain prevalence, one question of subjective health status, three questions of activities of daily living, six questions of working environment, one question of musculoskeletal system diseases knowledge, two questions of social support, two questions of education experience and data use method, and five questions of necessity of health education. Results: The prevalence rate of musculo-skeletal pain within a year was 83.9% and 22.8% of the dental hygienists complained of severe pain. The odds ratio of moderate pain severity was 1.99(95% CI, 1.10-3.60) and the odds ratio of unhealthiness was 3.27 (95% CI, 1.35-7.94). The odds ratio of pain severity in those working for 4-6 years was 0.21(95% CI, 0.08-0.57). The odds ratio of pain severity in those practicing 6-10 scaling cases per day was 0.33(95% CI, 0.17-0.65). The odds ratio of pain severity in wrist turning and bending was 3.56(95% CI, 1.19-10.62). Conclusions: The muscolu-skeletal pain severity in the dental hygienists was closely associated with subjective health condition, work duration, the number of scaling practice activity, and a treatment posture. Regular physical checkup for the dental hygienists will improve the musculo-skeletal pain due to scaling practice.