Pain can be evaluated by experimental methods and clinical methods, but due to subjective characteristics of pain, clinical methods are generally used. The clinical pain measurement tools are divided into unidimensional and multidimensional assessment tools. The former include Visual Analogue Scale, Verbal Rating Scale, Numerical Rating Scale, Pain Faces Scale, and Poker Chip Tool and the latter include McGill Pain Questionnaire, MMPI, Pain Behavior Scale, Pain disability index, and Pain Rating Scale. Unidimensional pain scales mainly measure the intensity of pain on the basis of the patient's self report and their simple construction and ease of use enable the invesgator to assess acute pain. Multidimensional pain scales are used to evaluate subjective, psychological and behavioral aspects of pain and because of its comprehensive and confidential properties they are applied to chronic pain. Patient's linguistic and cognitive abilities are major factors to restrain accurate assessment of pain. Although behavioral patterns and vital sign are inferior to self-report in the measurement of pain, they can be useful indexes in those situations. When deciding on a pain-assessment tool, the investigator must determine which aspect of pain he or she wishes to evaluate on the characteristics of the group of patients, their backgrounds, and their communication skills. Making the proper choice will facilitate the acquisition of meaningful data and the formulation of valid conclusions.
A Study was conducted to examine the nature and extent of psychological differences among diagnostic subgroups of temporomandibular disorders(TMD) patients and to whether psychological distress acts as a precipitator for TMD or is only an incidental consequence of the discomfort and frustrations presented by the disorder. Ninty six TMD patients and ninty seven non-TMD dental patients were included for the study as an experimental group and control group. TMD patients were classified into subgroups according to their primary pain sites and labeled as: 1) Myogenous TMD group; 2) Arthrogenous TMD group; 3) Mixed TMD group. After Hilkimo indices were rated from patient history and clinical examination, levels of psychological distress were measured using SRRS (Social Readjustment Rating Scale) and MMPI (Minnesota Multiphasic Personality Inventory). Outcomes from Helkimo indices, SRRS, and MMPI were assessed in terms of diagnostic subgroups and pain chronicity. The relationship between SRRS and MMPI scores were also assessed. The results were as follows : 1. The TMD patients showed higher frequencies of AiII, DiII, and DiIII of Helkimo indices than those in the control subjects. 2. The chronic TMD patients showed lower frequencies of DiII and DiIII of Helkimo indices than those in the acute group. 3. The arthrogenous TMD group showed higher frequencies of DiII and DiIII of Helkimo indices than those in the myogenous TMD group. 4. The TMD patients showed higher SRRS mean score than that in the non-TMD patients. 5. The SRRS mean score was highest in the myogenous TMD group and lowest in the arthrogenous TMD group. 6. The chronic TMD patients showed higher SRRS mean score than the acute TMD group. 7. The TMD patients showed higher MMPI mean scores on the Hs, D, Hy, and Pt scales than those in the non-TMD patients. 8. The MMPI mean scores on th Hs, D, and Hy scales were higher than of other MMPI scales in the TMD patients as well as in the myogenous and the mixed TMD group and they showed 1-3-2(Hs, -Hy, -D.) profile pattern, conversion "V". 9. The MMPI mean scores on the Hs and Hy scales were higher in all subgroups of TMD patients than non-TMD patients. 10. Although there were no significant differences in the MMPI mean scores on all the scales between the acute and the chronic groups of all TMD patients, the chronic myogenous TMD group showed higher MMPI mean scores on the Hs, Hy, Pa, and Pt scales than the acute myogenous TMD group. 11. There were positive correlationships between SRRS score and each MMPI scores on the Hs and Hy scales.Hy scales.
Purpose : his study was to analyze the reliability and validity on Oswestry Low Back Pain Disability Index (OLBPDI) in patients with low back pain. Methods : The sample consisted of 211 patients who had received treatments at the physical therapy units of 3 medical institutions from February to December 2008 in Andong city. Questionnaires on the OLBPDI were recruited by 6 physical therapists. The internal structure and reliability of the scales were evaluated by means of item-internal consistency(Cronbach's alpha coefficient:${\alpha}$), item-discriminant validity, Pearson's relation coefficient. Results : An average of patients's age was 41.1 years. The range of OLBPDI subscales were .93~.94 in Cronbach's ${\alpha}$. The internal consistency reliability of total item-each item were also internally consistent with Cronbach's ${\alpha}$ range of .94~.95(Pearson's correlation coefficient range: .62~.89). However, high correlation were obtained among 10 items(.67~.83), therefore the item-discriminant validity was a little low. Conclusion: In conclusion, the results reported here confirm the reliability of the OLBPDI scales in patients with low back pain. The collection of information on the level of disability due to low back pain using this instrument was acceptable to patients. A further prospective multi-center study will be necessary to prove the reliability and validity.
The aim of this study was to measure effects of the following items to pain and pain behavior reaction in patients with chronic orofacial pain. Items that contribute to the first factor(Environmental Influences) measure environmental sources of information that may affect illness behavior; Second factro(Loss of Control) measure appraisals and attributions perceived to influence personal views aobut pain; Third factor(Health Care Avoidance) measures a variety of avoidant behaviors; Fouth factor(Past and Current Experiences) measures experiences with treatment); Fifth factor(Physiological Responsivity) measures physiological parameters that are experienced in association with pain; Sixth factor(Thoughts of Disease Progression) measures thoughts regarding the etiology and progression of disease in relation to pain. 150 patients that were consist of 40 male and 110 female were participated in this study. The obtained results of this study were as follows : 1. Environmental influences and loss of control scales were recorded high score in patients with chronic orofacial pain 2. "Physician's descriptions of what your pain will be like" and "Physician's facial expression when they ask about your pain" items from the environmental influences were recorded high score. These results indicated that responsibility of doctro is very important to the pain reaction behavior of patients. Also, items from thoughts regarding the etiology and progression of disease in relation to pain influenced to the pain reaction. 3. There were significant defferences on the "nurses' descriptions of what you pain will be like", "physician's and nurses' facial expression when they ask about your pain", "TV and radio", and "Literature" items from the environmental influences between male and female patients. 4. There were no significant differences on the each scale between arthrogenous and combitnation group and significant correlated with all 6 scales.
Post-tonsillectomy pain in children is a difficult problem to manage. We examined the effect of 10% aerosol lidocaine for the post-tonsillectomy analgesia. ASA physical status I or II, between five and thirteen years of age were assigned, in a randomized fashion, into two groups. The Group I, 30 patients, received a total dose of 4 mg/kg of ten percent aerosol lidocaine on the tonsillar beds. Lidocaine was administered at the end of the surgical procedure. The Group II, 30 patients, were not sprayed with lidocaine aerosol. The postoperative pain scores were assessed by a "red and white" visual analoge pain scales (VAPS). VAPS values were obtained at one and eight hours after the operation. Values of one hour after the operation in the group I and II were $20.83{\pm}10.01$ and $34.50{\pm}10.53$, values of eight hours after the operation were $17.33{\pm}9.07$ and $23.5{\pm}11.08$. The post-tonsilectomy pains were significantly lower in the group I compared with the group II at one and eight hours after the operation. In conclusion, 4 mg/kg of ten percent aerosol lidocaine applied directly on the tonsillar beds was showen a superior, immediate post-tonsillectomy analgesic technique.
Background: Intrathecal opioid administration has been used widely in patients suffering from severe cancer pain that is not managed with conventional modalities. However, the potential serious neurological complications from the procedure and the side effects of intrathecal opioids have made many clinicians reluctant to employ continuous intrathecal analgesia as a first-line therapeutic option despite its dramatic effect on intractable pain. We retrospectively investigated the efficacy, side effects, and complications of intrathecal morphine administration through intrathecal catheters connected to a subcutaneous injection port (ICSP) in 22 Korean terminal cancer patients with successful intrathecal morphine trials. Methods: Patient demographic data, the duration of intrathecal opioid administration, preoperative numerical pain rating scales (NRS) and doses of systemic opioids, side effects and complications related to intrathecal opioids and the procedure, and the numerical pain rating scales and doses of intrathecal and systemic opioids on the $1^{st}$, $3^{rd}$, $7^{th}$ and $30^{th}$ postoperative days were determined from medical records. Results: Intrathecal morphine administration for $46.0{\pm}61.3$ days significantly reduced NRS from baseline on all the postoperative days. A significant increase in intrathecal opioids with a nonsignificant decrease in systemic opioids was observed on the $7^{th}$ and $30^{th}$ postoperative days compared to the $1^{st}$ postoperative day. The most common side effects of intrathecal opioids were nausea/vomiting (31.8%) and urinary retention (38.9%), which were managed with conservative therapies. Conclusions: Intrathecal morphine administration using ICSP provided immediate and beneficial effects on pain scores with tolerable side effects in terminal cancer patients.
Journal of The Korean Society of Integrative Medicine
/
v.2
no.1
/
pp.101-108
/
2014
Purpose : The purpose of this study was to investigate the effect of horse riding exercise for chronic low back pain patients. Method : 30 subjects in H-equestrian and N-equestrian, K & B hospital were randomly divided two group, instability support surface exercise group and horse-riding exercise group. Each group carried out 40 minutes exercise three times a week for 8 weeks. VAS were measured for sway path of COP movement during standing were measured for evaluation of static balance ability in balance performance monitor(BPM). Result : The results were as follows, scales of VAS between instability support surface exercise and horse-riding exercise groups in post-test, were significantly different in measures(p<.05). And there were significant in two group after exercise(p<.05). The static balance scales of sway path between instability support surface exercise and horse-riding exercise groups in post-test, were significantly different in measures(p<.05). And there were significant in two group after exercise(p<.05). Conclusion : These finding revealed that horse-riding exercise was effective on VAS and static balance abiility of chronic low back pain patient so that these exercise can be new altematives for increase of stability ability in chronic low back pain patients.
Objectives : The objective of this study was to observe the relationships between neck pain and psychological factors such as stress, anger, anxiety and depression. Methods: Under mental stress. the 31 patients with neck stiffness and 32 control subjects with no neck stiffness were measured by using NDI, BEPSI, GARS, STAXI, STAI, and BDI scales. The psychological scales between the patients and the controls were taken to observe the average results by comparing between the two groups. Also NDI and psychological scales of correlation analysis was performed. Results: 1. The mean scores of NDI, BEPSI, GARS, State-Anger, Trait-Anger, Anger-out, Anger-In, Sate-Anxiety, TraitAnxiety, and BDI under patients group were significantly higher than those in control group. 2. The value of NDI comparing to the values of BEPSI, GARS, State-Anger, Trait-Anger, Anger-out, Anger-In, Sate-Anxiety, Trait-Anxiety, and BDI in this study resulted in high correlation among each others which showed statistically significant. Conclusions : It has the possibility that the neck pain with stress. anxiety. anger and depression might be related highly in correlation. especially in stress and anxiety which showed the most high correlation.
Purpose: This study examine the functioning level and quality of life (QoL) of people with non-specific neck pain and neck pain with radiculopathy using the neck disability index (NDI), functional rating index (FRI), and short form of health survey 36 (SF-36) and each of linked lCF code lists of those scales. Methods: Each item of the NDI, FRI, and SF-36 were linked conceptually to the ICF code, and the lCF code lists of those scales were produced as iNDI, iFRI, and iSF-36, respectively. Seventy-nine patients with neck pain filled the instruments and its linked ICF code lists. The subjects were divided into two groups based on the diagnosis, non-specific neck pain (Group1), and neck pain with radiculopathy (Group2). A group comparison was performed using an independent t-test. The Pearson correlation coefficient was also used to analyze the relationships between each scale and the linked ICF code list. Results: The participants in Group 2 experienced more difficulties in their daily activities than those in Group 2 when examined in NDI and FRI (p<0.05). This result was also found consistently in the ICF code lists, iNDI and iFRI (p=0.05). On the other hand, the QoL did not show a difference between groups (p=0.06). A strong correlation was observed between the instruments and linked ICF code lists: NDI and iNDI (r=0.90), FRI and iFRI (r=0.91), and SF-36 and iSF-36 (r=-0.61). Conclusion: These findings suggest that the concept of each item in NDI and FRI could be linked to the ICF codes when examining patients with neck pain, but the items of SF-36 were found to be linked and expressed in ICF.
This study aimed at analyzing the trend of re-search on pain in Korea, suggesting direction future pain research, and contributing to the use of pain interventions in nursing practice. Research studies on pain were selected from journals of medical and nursing schools, the Korean Nurse, the Korean Nurses' Academic Society Journal, the Central Journal of Medicine, the New Medical Journal, and from theses and dissertations, which were conducted between 1970 and 1994. The total number of the studies was 93. These studies were analyzed for 1) time of publication or presentation, 2) thesis for a degree or nondegree, 3) research design, 4) characteristics of subjects used in each study, 5) measurement tool, 6) types of correlated variables, 7) Korean terms for pain 8) types of nursing interventions, and 9) results of studies. The findings of the analysis can be summerized as follows : 1) The number of studies related to pain has increased rapidly since the early 1980's. The number of experimental research studies related to pain has increased chronologically, but the number of survey research studies related to pain was highest from 1981 to 1985, after that it decreased slowly. 2) The subjects in 19 studies were healthy people and, in 73 studies, patients with various illnesses. Thirty two studies were conducted with surgical patients. 3) Sixty one pain research studies were done for a thesis for a degree and 32 were nondegree research studies. 4) As measurement tools for pain, self- report pain scales were used in 54 studies and more than two tools were used in 28 studies. In the experimental studies, the trend was to use more than two tools. And in the nonexperirnental studies, the trend was to use self-report pain scales only. 5) There were 11 correlational studies. In these studies, the trend was to study anxiety, depression and variables such as intravenous infusion as related to pain.6) In the thirty six experimental studies, the effects of 16 types of nursing interventions weretested. Teaching and information, and relaxation technique were the most popular interventions for pain. 7) In eighteen methodological studies, the majority were studies testing the validity and re-liability of Dr. Lee's Korean Pain Rating Questionnaire. The following suggestions are made based on the above findings : 1) The patterns of these studies related to pain in Korea need to be compared with trends in other countries. 2) Meta - analysis should be done to analyze and integrate the results of various studies. 3) This analysis of pain research is needed to identify the present trend of pain research and to suggest the direction of future pain research, so these patterns of studies should be done in 5 to 10 year intervals. 4) More replicated pain research is needed to prove the effect of nursing interventions and more qualitative research on pain is needed to identify indepth the meaning of pain. 5) Pain researchers should make an effort to apply research result in various clinical settings and try to carry out team research with clinical nurses or with other multidiscipinary researchers.
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