• Title/Summary/Keyword: Pain perception

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A Case Study Evaluating the Effectiveness of an Interdisciplinary Team-Based Integrated Medical Service Model in Improving the Quality of Life of a Fibromyalgia Patient and Caregiver through Psychological and Various Counseling Interventions (섬유근통 환자와 보호자의 삶의 질 증진을 위한 의·한 협진 기반의 통합의료서비스모델 적용평가 사례 연구: 심리 및 매체 상담개입을 중심으로)

  • Moon Joo Cheong;Do-Eun Lee;Myeung Su Lee;Chang Hoon Lee;Jung Han Lee;Won Bae Ha;Hyung Won Kang;Chong Hyuk Chung
    • Journal of Oriental Neuropsychiatry
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    • v.35 no.2
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    • pp.191-203
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    • 2024
  • Objectives: To evaluate the effectiveness of an integrated medical service model for a fibromyalgia patient and their caregiver, focusing on reducing pain and improving quality of life. Methods: A single-case study design was employed, involving a fibromyalgia patient and their primary caregiver treated at W University Hospital. The integrated medical service program, based on the Ministry of Health and Welfare's model, included medical consultations and complementary therapies such as psychological counseling, art therapy, music therapy, horticultural therapy, yoga, and meditation. The program was conducted weekly for 8 weeks, with each session lasting up to 100 minutes. Data collection involved both quantitative and qualitative assessments. Quantitative data included demographic surveys, psychological tests, health-related quality of life measures, pain indices, and sleep quality indices. Qualitative data were gathered through feedback evaluations and emotional assessments. Results: The patient showed improvements in mobility, self-care, daily activities, and anxiety/depression, with EQ-VAS scores increasing from 20 to 40 and pain perception decreasing from 67.41 to 42.58. The caregiver reported reduced anxiety/depression and an increase in EQ-VAS scores from 95 to 98. Both patient and caregiver exhibited emotional changes, with decreased depression and increased happiness. However, the patient showed an increase in fear and anger. Conclusions: The integrated medical service model positively impacted the emotional and psychological well-being of the fibromyalgia patient and their caregiver. Despite the limitations of a small sample size and a single-case study design, the findings suggest that an integrated approach can be beneficial. Larger-scale studies are needed to confirm and generalize these results.

A Study on the Disturbing Factors which Work against Therapeutic Atmosphere & Environment on Hospital Wards as Perceived by Patients and Nurses (환자 및 간호사가 지각하는 치료적인 병실분위기 조성의 저해요인에 대한 조사 연구)

  • 김영혜;한명은
    • Journal of Korean Academy of Nursing
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    • v.27 no.1
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    • pp.178-188
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    • 1997
  • As a descriptive survey, this study was attempted to get basic data necessary to recognize the factors that disturb the therapeutic atmosphere of hospital wards as perceived by nurses and hospitalized patients, to identify differences between the perceptions of the nurses and of patients. The subjects, 159 patients in Pusan National Hospital and 68 nurses working there were sampled between March 18 and April 13, 1996. The tool used to measure the disturbing factors was an amended form of the one developed by Kim, Mae Ja(1983). The differences between each subject's score for each factor were analyzed using means & SD. and the highest 3 items above the mean score for each factor were collected and compared. The results are described below : 1. Subject's perception of main disturbing factors : patients reported that the main factors were 'loss of role & economic trouble', 'the prognosis of disease', 'the change of daily life' but nurses replied that the main factors were' the prognosis of disease', 'the communication trouble with the medical team & interpersonal relationships'. 'The change of daily life' was not a perceved factor by nurses, but ranked third by the patients. 2. Subject's perception degree of each disturbing factor : (1) among the items related to interpersonal relationship. the patient group reported that the worst disturbance was dur to severely ill patients in the same room' but the nurse group regarded 'greed to monopolize wheelchairs or other supplies' as the worst disturbance. (2) among the items related to physical factors. the patient group regarded 'limitations to wash their body, physical pain and limitations in physical activity' as the worst disturbance, but the nurse group regarded' physical pain', and 'limitations to activity or change of appearance' as the worst disturbance. (3) among the items related to the change of daily activity, the patient group regarded 'the boredom of hospitalization or infavorable diet' as the worst disturbance, but the nurse group regarded 'too much noise or unclean room' as the worst disturbance. (4) among the items related to the communication trouble with medical team, the patient group regarded 'the ignorance of their disease due to poor information. the inability to understand the language of the medical team or the difficulty in seeing physician in time' as the worst disturbance, but the nurse group regarded 'the inability to trust physicians and physician's poor attention to patients' as the worst disturbance.

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A Comparison of Ipsilateral Upper Limb Sensory Changes after Mastectomy Alone and Mastectomy with Immediate Breast Reconstruction (유방암 환자에서 유방절제술과 절제 후 즉시 재건술에 의한 동측 상지의 피부 감각 변화 비교)

  • Kim, Jeong Min;Yoo, Sung In;Kim, Eui Sik;Hwang, Jae Ha;Kim, Kwang Seog;Lee, Sam Yong
    • Archives of Plastic Surgery
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    • v.35 no.5
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    • pp.533-538
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    • 2008
  • Purpose: Sensory changes in the upper limb are complications of a mastectomy with immediate breast reconstruction with the treatment of breast cancer. The purpose of this study is to clarify whether immediate breast reconstruction worsens the sensory changes. Methods: From March 2004 to December 2005, 20 patients who had a mastectomy with immediate breast reconstruction(reconstruction group) were compared with 23 patients who had a mastectomy alone(control group). All patients had stage I or II breast cancer. The sensory changes were assessed in a blind manner by one examiner that used light touch sensation, static two-point discrimination, pain, vibration, hot and cold temperature perception. The sensory changes were identified along the sensory dermatome for diagnosing the damaged nerves. The following factors and their relationship with the sensory changes were analyzed : age, complications, and the mastectomy method. Results: There was no statistical difference in the static two-point discrimination, pain, vibration, hot and cold temperature perception between the two groups. However, the ability to recognize light touch was significantly better(p=0.045) in the reconstruction group than in the control group. The main site of sensory change was the proximal and medial portion of the upper limb in both groups. At these sites, the mean value of Semmes-Weinstein monofilament was $1.01g/mm^2$(reconstruction group 0.82, control group 1.17) and 2-point discrimination was 51.74(converted to perfect score of 100; reconstruction group 42.50, control group 59.78). The total rate of early complications was found to be significantly lower(p=0.006) in the reconstruction group than in the control group. Conclusion: These findings suggest that an immediate breast reconstructive procedure following a mastectomy is as safe as or safer than a mastectomy alone with respect to postoperative sensory changes of the ipsilateral upper limb.

The Effect of Supportive Nursing Care on Depression, Mood and Satisfaction in Military Patients with Low Back Pain (지지간호가 군 요통환자의 우울ㆍ기분ㆍ만족에 미치는 영향)

  • 김정아
    • Journal of Korean Academy of Nursing
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    • v.20 no.3
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    • pp.324-340
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    • 1990
  • Support has always been considered an important nursing concept. However, there is no agreement among nurse researchers as to a conceptual definition of supportive nursing or meaningful supportive behaviors. Clarification of the concept, support in nursing, is necessary to promote communication among nurses on nursing behaviors that are effective in providing support and on understanding the relevant properties and charcteristics of the concept, supportive nursing care. The objectives of the study were : 1. to analyse the concept, support in nursing, in order to provide a definition of supportive nursing care, and 2. to operationalize the definition of supportive nursing care and use it as an experimental nursing intervention for patients with low back pain. The first part of the study used the concept analysis approach developed by Walker and Avant(1983) to define the concept of supportive nursing care. The properties of supportive nursing care, defined by this analysis, included perception of supportive need, reciprocal interaction(Transaction), listening, providing empathy and information related to health, and confirmation of the patient's verbal and non - verbal response. The second part, the experimental part of the study, was done using King's(1970) Interpersonal Theory for Nursing. The concept, supportive nursing care, as defined in the concept analysis was operationalized and used as the experimental intervention. The experiment tested the effectiveness of the independent variable, supportive nursing care on the dependent variables, depression, mood and patient satisfaction, in the patients with low back pain in army hospitals. The instruments used to measure the dependent variables were Zung's(1965) Self- Rating Depression Scale, Ryman and Colleagues'(1974) Mood Questionnaire and LaMonica and Colleagues'(1986) Patient Satisfaction Scale. The experimental design used for this study was a Solomon 4 group experimental design. This design has the strength of allowing for observation of the main effects of supportive nursing care and pretesting, and for observation of the interaction effects of pretesting and supportive nursing care. The design includes one experimental group and three control groups. The Subjects of this study were 150 young male patients with low back pain on Neuro - Surgical Wards in three general army hospitals. There were 35 in the experimental group, 39 in the pre - posttest control group, 36 in the treatment - posttest control group and 40 in the posttest only control group. Supportive nursing care, as operationalized by the researcher according to the concept analysis, was given to the patients in the experimental group and the treatment -posttest control group, individually for 30 minute sessions, every other day for 5 days. Data collection was done using a questionnaire. The data were collected in a pretest one week before the supportive nursing care sessions, a posttest immediately after the sessions and follow- up test one week later. Hypotheses testing was done using 2×2 factorial analysis of variance and Meta analysis(Stouffer's Z method). The results of this study are summarized as follows : 1. Hypothesis Ⅰ, “There will be a difference on depression level between the patients with low back pain who receive supportive nursing care and those who do not receive supportive nursing care”, was supported (F=8.49, p<.05). 2. Hypothesis Ⅱ, “There will be a difference on mood level between the patients with low back pain who receive supportive nursing care and those who to not receive supportive nursing care”, was supported (Z meta=2.17, p<.05). 3. Hypothesis Ⅲ, “There will be a difference on satisfaction level between the patients with low back pain who receive supportive nursing care and those who do not receive supportive nursing care”, was supported (F=13.67, p<.05). 4. ANOVA, done to examine the interaction effect of history and maturation, showed no significant difference on the dependent variables between the observations of the pretest scores of the experimental group, the pretest scores of the pre- posttest control group and the posttest score of the posttest only control group. 5. To test for continuing effect of supportive nursing care, paired t-test was done to compare the scores for the dependent variables at the posttest and at the one week later follow-up test. No significant difference on the scores for the dependent variables was found between the posttest scores and the follow-up test scores for the two groups that received supportive nursing care, the experimental group and the treatment-posttest control group. In conclusion, it was found that in the case of young soldiers with low back pain in army hospitals, their depression level was decreased, their mood state was changed positively and their satisfaction level was increased by receiving supportive nursing care. Further, the effectiveness of the supportive nursing care lasted for at least one week in this study. The significance of this study to nursing is in the analysis of the concept of supportive nursing care and the demonstration of the effectiveness of supportive nursing care as an intervention within the limits of the study.

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Consumer perception, expectation and satisfaction levels of wear comfort of hiking gear (등산복의 착용쾌적감에 대한 인식, 기대수준 및 만족도)

  • Yoo, Hwasook
    • Korean Journal of Human Ecology
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    • v.22 no.4
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    • pp.637-650
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    • 2013
  • The purpose of this study was to examine the consumers' image and factors of wear comfort, expectation and satisfaction levels of wear comfort of hiking gear in order to investigate the consumer perception of wear comfort of hiking gear. The questionnaires were distributed to 400 people in their 40s and 50s and, 260 of which were used to data analysis. The questionnaires were comprised of questions about the image, factors, expectation and satisfaction levels of wear comfort of hiking gear, and demographic characteristics. Data were analyzed by frequency analysis, factor analysis, reliability analysis, correlation analysis, ANOVA, Duncan test, T-test with SPSS 19.0 IBM for Windows. In demographic characteristics, 43.5% of respondents were male and people under 45 years of age were at 17.7%, those between 46 and 50 with 46.5%, those between 51 and 55 with 28.9%, those between 56 and 60 with 6.9%. The results of this study are as follows. Responses of male and female consumers to image of wear comfort were similar and ten or more mentioned reponses by men were well-being and freedom from pain, stretchability, light weight, absorption of sweat, softness. Wear comfort of hiking gear was shown to include mobility/pressure factors, moisture factor, psychological factor, tactile/keeping body temperature factors. It was shown that the expectation and satisfaction levels of wear comfort of hiking gear were relatively high and were not influenced by consumer's sex and age, but were affected by the objective of mountaineering.

A Study on the Menopause Experience : A Q Methodological Approach (폐경기 경험에 관한 연구 : Q 방법론적 접근)

  • 신혜숙
    • Journal of Korean Academy of Nursing
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    • v.25 no.4
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    • pp.807-824
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    • 1995
  • This study was intended to provide women who are experiencing menopause with effective nursing care by exploring the menopause experience. The purpose of the research was to understand the subjective feelings of women about the question of what the menopause experience is. Q-Methodological method was used for that purpose. As the research method, Q-statements were collected preliminary to the study of through in -depth interviews and a literature review. For the study 34 Q-statements were selected. There were 21 women as subjects for the research. The 21 women sorted the 34 statements using the principle of Forced Normal Distribution. The principle of Forced Normal Distribution, which has nine scales to measure the individual opinions, was called Q-Factor Analysis by using PC Quanl Program to supply the material. As a result, there were four categories(self-com-passion type, self-regulation type, self-perception type, self-abandonment type) of special opinion about the menopause experience in these women. The first type was called Self-compassion This type' was associated with varying degrees of emotonal instability(psychological withdrawal). And type in menopause signifies loss of a socially valued status and may result in depressive symptoms. This type expresses the menopause experience as associated with negative reaction. The second type is called Self-regulation. This type overcomes the menopause experience more actively than the other types and do not express the menopause experience as one of suffering. This type make efforts by themselves to regulate the mono-pause experience. The third type is called Self-perception. This type perceives the experience of menopause which as typical menopausal syndrome (hot flashes and decreased vaginal lubrication, decreased estrogen producing atrophic changes of the labia and vaginal mucosa, making intercourse uncomfortable). The fourth type is called Self- abandonment. This type denies the experience of menopause. The meaning of menopausal experience is significantly related with a life accident or life load. Also, This type experiences pain in the musculoskeletal system. As a result, The meaning of the menopausal experience is affected by perceived subjective experience of the nurses, the need to understand each persons meaning of the menopause experience and to develop appropriate nursing interventions based on the typology of menopause experience. Finally. The result of the study will provide basic data for nursing intervention the menopausal women.

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Meta Analysis of the Effects of Massage Intervention for the Laboring Women (산부를 위한 마사지 중재 효과에 대한 메타분석)

  • Yeo, Jung-Hee;Choi, Hwan-Seok
    • Journal of Society of Preventive Korean Medicine
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    • v.13 no.3
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    • pp.87-99
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    • 2009
  • Objectives : The study was to examine the empirical evidence concerning the effects of massage intervention for the laboring women and to investigate the effect sizes related to the characteristics of intervention. Methods : Meta analysis was performed. A total of 11 trials related to massage intervention between 2000 and 2007 were reviewed. Results : Massage intervention showed a beneficial effect on length of labor(1st stage : U=46.75, p=0.00, 2nd stage : U=6.13, p=0.01), perception of childbirth experience(U=12.57, p=0.00), intensity of uterine contraction at the active(U=6.34, p=0.01) and the transition phases(U=24.83, p=0.00), and interval of uterine contraction at the active phase(U=4.83, p=0.03). Massage decreased systolic(U=10.81, p=0.00) and diastolic blood pressure at the transition phase(U=10.60, p=0.00). However, massage had no effect on subjective and objective labor pain and anxiety. No differences were found in effectiveness of massage according to characteristics of intervention(massage material, massager, and massage site) except for anxiety(QB=4.82, p=0.03) and diastolic blood pressure at the active phase by massage site(QB=4.52, p=0.03). Conclusions :We found that massage intervention for the laboring women had an empirical evidence on improving perception of childbirth experience and shortening length of labor. These results should be interpreted with caution due to the lack of studies. More full-scale randomized clinical trials with reliable designs are recommended to further warrant the effectiveness of massage.

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A study on the change of the views on nursing profession of the nursing college students (간호전문대학생의 재학중 간호전문직관의 변화에 관한 연구)

  • Kim Young-Ran
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.2 no.2
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    • pp.169-181
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    • 1995
  • The aims of this study are to identify the perceptions and learning needs related to nursing profession of nursing students and to provide the basic data for development of curriculum. The questionnaire used for this study includes 103 items categorized as the fellowing 8 areas : the perception of nursing profession, competency as a nurse, the perception about clients, priorities in nursing activity, the knowledge required for, an ideology about nursing. Data was collected from the same students through their first grade in 1993 to third grade in 1995. The results are as follows : 1) In terms of the views on nursing profession, most of the students responded it as helping treatment of disease. Higher the grade, more significant with regard to health counseling, utilization of nursing and skills, nursing for community people. 2) Asked about competency as a nurse, sufficient professional knowledge on the nursing was responded as the highest. 3) Asked about the clients of nursing, 'patients' was the highest and as the grade was high, the items on 'family', 'community people', 'community' were high. 4) With regard to the points to be considered in the performance of nursing, while 'physical respect', 'psychological respect' were commonly responded, 'spiritual respect' highly responded in the second and third grades. 5) Asked about what nursing activity is, 'to relieve the pain' was high in the first and second grades, 'the promotion of health' was high in the third grade. 6) With regard to the ideology on nursing, the humanity and belief and faith were commonly responded. These results suggest, even though the expanded role of nursing was recognized, there is the tendency of illness oriented, to be need of reinforcement on the curriculum management in nursing education.

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A study on the job description of paramedics (1급 응급구조사의 직무분석에 관한 연구)

  • Son, In-A
    • The Korean Journal of Emergency Medical Services
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    • v.9 no.1
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    • pp.43-53
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    • 2005
  • The purpose of this study was to survey a perception of frequency & importance level of job performance, from 249 paramedics who were working at fire station. The job related activities of 4 duties, 18 tasks and 145 task elements were checked by 4 rating scale. The data were analyzed using a SPSS program for descriptive statistics. The results of the study were as follows ; 1. Some of the most frequent tasks were medical tx, managing people & organization, trauma care, pt assessment, general coping skill 2. Some of the most frequent task elements were preparation of written reports, operation of pt lifting supplies, transportation of patients on stretchers, administration of cervical collar and utilization of scoop stretcher. 3. Some of the highest level of importance in task were resuscitation of circulation, surgical tx, safety & infection control, environmental emergency care, trauma care. 4. Some of the highest level of importance in task elements were administration of cervical collar, adult CPR, infant CPR, child CPR, and AED. 5. The highest level of task elements in perception of frequency & importance were administration of cervical collar, infection control after pt care, utilization of long back board, disinfection of ambulance after ride a long, care of chest pain pt, care of unconscious pt, tx of asthma. 6. A difference between frequent & importance score were due to lack of supplies(41%), structural problems(30%) and medical control system(16%), lack of skills(10%), Suggestion; 1. This paper would be more reliable and confirm through wilder range of survey. 2. It would be necessary of more depth survey through dacom study from paramedic. 3. Development of field oriented protocol & curriculum that based on task elements which have high score of both frequency & importance level is required.

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A Study on the Use of Complementary and Alternative Therapies in Korean Adults (한국 성인의 보완대체요법 이용에 관한 조사)

  • Lee, Keum Jae;Kim, Ok Hyun;Chun, Woo Jung;Roe, Myung Hee;Kang, Moon Jung;Ko, Sung Hee;Lee, Kyeong Suk;Lee, Ko Eun
    • Korean Journal of Adult Nursing
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    • v.19 no.1
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    • pp.144-154
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    • 2007
  • Purpose: This descriptive study was conducted to identify the use of complementary and alternative therapies, and the perception and attitudes toward CAT in Korean adults. Methods: The 1,010 study subjects were recruited from ten regions in South Korea. Data were collected from July to September, 2004. Results: The 43.2% of the sample(n=436) had an experience of using CAT. The subjects using CAT was more likely to have high score in the CAT perception compared to the subjects with no experience of CAT(p=.001). The primary source of information about CAT was mass media(59.7%). The 52.4% of the sample answered that CAT was supplementary and the 27.7% answered CAT was applicable to chronic pain or musculoskeletal disorders. Subjects(34.8%) pointed out that the greatest problem was no scientific informant in the use of CAT. The primary reason of using CAT was to maintain their health or to prevent disease(44.0%), and the 59.0% of the subjects responded that CAT was effective. Majority of subjects were satisfied with CAT(63.3%) and experienced no side effects of CAT(90.6%). Conclusion: This study suggests that professional counseling and education for CAT is needed for Korean public as well as the research approach to test the effects of CAT.

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