The purpose of this study was to understand clinical nurses' knowledge and attitudes on pain management. The subject of the study were 254 nurses working at two hospitals affiliated with a university in Seoul. The questionnaires included four areas: general knowledge on pain, knowledge on the use of analgesia, knowledge and implementation on the pain assessment scales and pain interventions and nurses' general characteristics. The data were analyzed with descriptive statistics, analysis of variance, LSD test and t-test using SPSS statistical package. The results were as follows. 1. The mean score of the general pain knowledge was 61.46 and that of knowledge on the use of analgesia was 52.19. 2. Most nurses(74%) answered with hesitation about injecting narcotic analgesia to patients. 3. The pain assessment scale which nurses knew (57.5%) and used(48.0%) extremely was a simple descriptive scale. 4. The pain intervention which nurses knew (94.5%) and implemented(92.1%) extremely was to inject analgesia. 5. The number of nurses who had learned about pain management was 49 of 254(19.3%). 6. Nurses' knowledge on the use of analgesia was of relevance to having learned pain management, but general pain knowledge was not so relevant. According to this research, I suggest the following. 1. It is necessary to develop an education program with actual practice and intervention which nurses can perform for themselves. 2. It is necessary to continuously educate about pain management in clinical wards.
Purpose: A descriptive study was conducted to examine the levels of distress, state anxiety, and physiologic responses in postoperative patients under patient controlled analgesia (PCA), and to determine correlations among the variables. Method: The study sample included women who underwent an elective hysterectomy procedure or other gynecologic surgeries(N=100). Subjective distress was assessed by visual analog scales around 8 hours postoperatively. Trained nurses collected objective distress data through observation of subject's behavior and vital signs. Data were analyzed with frequencies, percentages, means, Pearson correlation coefficients, ANOVA, and the Scheffe post test using SPSS/PC 11.0. Result: Subjective distress, objective distress, and state anxiety scores were relatively low, except pain scores(5.31 out of 10.0) among sub-scales of subjective distress. Women who had a total abdominal hysterectomy showed significantly higher levels of both subjective distress and state anxiety than those after a minor gynecologic surgery. In relationships among variables, subjective distress correlated positively with postoperative state anxiety, but not with the amount of analgesic medication, verified by further analysis on sub-scales of subjective and objective distress. The higher the levels of state anxiety, the higher the levels of tension, dyspnea, facial change, and systolic blood pressure observed. Conclusion: Regardless of effective pain management, most postoperatively experienced distress in gynecological patients was derived from surgery associated anxiety and pain. Specific psychological strategies should be established as well for those with high levels of state anxiety to facilitate prompt recovery.
Background: Pain due to spinal stenosis is one of the major causes of low back pain, and it sometimes does not respond to conservative treatment. We postulated that anterior epidural irrigation could be a good choice for treating lumbar spinal stenosis patients. However, the effects and theoretical basis of anterior epidural irrigation have not been investigated for spinal stenosis. So, this study was designed to identify the clinical efficacy of anterior epidural irrigation for treating lumbar spinal stenosis. Methods: 71 patients with lumbar spinal stenosis underwent anterior epidural irrigation. Anterior epidural irrigation was performed with normal saline and a mixture of local anesthetic with steroid through a catheter under fluoroscopic guidance. The findings were evaluated with using visual analogue scales for low back pain and leg symptoms. Results: Relief from low back pain and leg pain was observed for up to 12 months after anterior epidural irrigation. None of the patients showed any deterioration of their motor or sensory deficits during follow up. Conclusions: Anterior epidural irrigation is effective for the relief of back and leg pain in spinal stenosis patients.
Purpose: This study was intended to measure the knowledge and attitudes of nurses working in a psychiatric ward regarding the subject of pain. Methods: In this descriptive study, data were collected in psychiatric wards(or hospitals) located in the Kyungnam and Kyungpook area from December 2013 to January 2014, using a modified version of the McCaffrey and Pasero Clinical Manual Survey Regarding Pain. The content of the survey follows a logical progression from common pain management problems through mechanisms of pain, assessment and pharmacology. Results: The average score of knowledge regarding pain was roughly $21.59{\pm}2.93$ among the 181 participants. The nurses selected Tylenol as the preferred choice (81.2%). Seventy-one percent of respondents didn't use Pain Intensity Instruments during the pain assessment. The subjects preferred the Numerical Rating Scale rather than Visual Analogue Scales. Pharmacology questions were the least likely to be answered correctly. No specific correlations were found between score and demographic variables of age and experience. No specific correlation between score and educational level was noted. Conclusion: Nurses require ongoing education on pain management, particularly regarding pharmaceutical agents.
Purpose: The purpose of this study was to assess the relationship between psychological factors and symptoms of oral mucosal diseases by means of the revised version of the Minnesota Multiphasic Personality Inventory (MMPI-2). Methods: Three hundred and eighteen college students in Gyeonggi-do completed the MMPI-2 and a questionnaire related to symptoms of oral mucosal diseases and collected data were analyzed by Student's t-test and one way ANOVA. Results: Subjects who have experienced herpetic stomatitis revealed significantly higher mean values of T-scores than subjects who have not on hypochondriasis (Hs) and hysteria (Hy) clinical scales of the MMPI-2 (p<0.05). In comparison with subjects who have had recurrent aphthous ulceration, subjects who have not had it manifested significantly higher elevations on the schizophrenia (Sc) clinical scale (p<0.05). Subjects who have suffered oral lichen planus (OLP) showed significantly higher mean values of T-scores than subjects who have not on paranoia (Pa) (p<0.05) and hypomania (Ma) (p<0.01) clinical scales. Mean values of T-scores on Ma clinical scale were significantly higher in subjects having experienced glossodynia than in subjects having not experienced (p<0.05). Subjects having felt taste disturbance exhibited significantly higher elevations on Hs (p<0.0001) and Hy (p<0.01) clinical scales compared to subjects having not. Conclusions: Symptoms of oral mucosal diseases such as herpetic stomatitis, taste disturbance, OLP, and glossodynia were found to be related to Hs, Hy, Pa, Ma clinical scales of the MMPI-2. Therefore, comprehensive psychological evaluations of those oral mucosal diseases may be beneficial in a therapeutic approach.
Objectives : A number of instruments have been developed to measure the quality of life in patients with various shoulder disorders. Much progress has been made in this area, and currently an appropriate instrument exists for each shoulder state. The purpose of this study is to review the instruments that are currently in use for assessing the shoulder joint. Methods : A literature research was performed to choose appropriate scales for assessment of function and the disability of the shoulder. Theoretically based scales were selected for review. Therefore, 11 scales were reviewed. The status of scales involved in shoulder treatment of acupuncture throughout several countries was evaluated. Results : 11 scales: The American shoulder and elbow surgeons evaluation form(ASES), Constant Shoulder Score, The disabilities of the arm, shoulder and hand(DASH), Shoulder Disability Questionnaire (SDQ), The Shoulder Pain And Disability index(SPADI), The simple shoulder test(SST), Oxford Shoulder Questionnaire(OSQ), The Rotator Cuff quality-of-life Measure(RC-QoL), Western Ontario Shoulder Instability Index(WOSI), Western Ontario Osteoarthritis of the Shoulder Index(WOOS), Western Ontario Rotator Cuff Index(WORC), wereevaluated. Each measurement has its own composition and characteristics. Their validity, reliability, responsiveness and practical characteristics were already evaluated. We found 3 domestic and 10 overseas papers about shoulder treatments using acupuncture assessed with shoulder scales. Conclusions : In clinical research, the selection of the measurement scale should take account of the condition of disease, the patient's traits and the characteristics of the research. Moreover, appropriate scales, which havevalidity, reliability, responsiveness and practical characteristics, are needed to enhance the quality of research.
Objectives : The object is to the difference among the funtional disability scale for low back pain and to use Methods : I researched the contents of funtional disability scale for low back pain Results & Conclusions : 1. The funtional disability scale for low back pain is specific-condition and general-health 2. A proposal of set core of funtional disability scale for low back pain is back specific function, generic health state, pain, work disability, satisfaction 3. Oswestry disability index or Rolland disability questionnaire. wase used for standard specific-condition scale and SF-36 was used for standard general-health scale 4. SF-36 is able to use the funtional disability scale for low back pain independence 5. In the future, scale for low back pain shulod be standardized in multiple dimension by computer
The purpose of this study was to assess the pain-relieving effect of iontophoretically applied prednisolone on the patients with temporomandibular joint (TMJ) pain. 30 TMJ pain patients participated in this study. Inclusion criteria for subject selection were 1) tenderness of TMJ on palpation and 2) visual analog scales (VAS) of above 20 mm. The patients with polyarthralgia, rheumatic arthralgia, and systemic diseases were excluded for this experiment. The patients were randomly assigned to one of three groups; (1) Group 1 for administration of 2% prednisolone, (2) Group 2 for administration of 1% prednisolone, and (3) Group 3 for administration of saline. Phoresor PM600(Motion Control Utah, U.S.A) was used for administration of drugs by iontophoresis. Baseline and post-medication pain levels were recorded by VAS, pressure pain threshold (PPT), and palpation index (PI). Post-medication data were compared with baseline data for each group. The results were as follows : 1. All the groups showed significant decrease of VAS scores after treatment. 2. PPT was significantly increase only in Group 1 and 2 not in Group 3. 3. PI was significantly decreased only in Group 1 and 2 not in group 3.
Purpose: This study was conducted to identify the impact of fatigue, pain, anxiety and depression on the quality of life (QOL) among breast cancer patients. Methods: This study was conducted from July 12th to July 20th, 2010. One hundred and fifty breast cancer patients were recruited from D city in Korea. The instruments used in this study were the fatigue, pain, anxiety, depression and the quality of life scales for patients with breast cancer. Data were analyzed using descriptive statistics, t-test, ANOVA, Pearson correlation coefficients and multiple regression with the SPSS/WIN 12.0 program. Results: The quality of life for cancer patients showed a significant relationship with fatigue, pain, anxiety and depression. The significant factors influencing quality of life were fatigue, pain, anxiety and depression that explained 65.6% of the variance. Conclusion: Patients with breast cancer experienced fatigue, pain, anxiety and depression which led to a negative effect on quality of life. The results suggest that intervention programs to reduce fatigue, pain, anxiety and depression could improve the quality of life for breast cancer patients.
Background: Studies on the pain have been dealing with many different ways for last several centuries. Especially, preemptive analgesia is being used as a method to control the postoperative pain. Many studies on its efficacy have been processed in different ways about various drugs, administration methods and times for various operations. And the value of preemptive analgesia are still controversial regarding the results of other clinical studies. The authors performed a clinical study on efficacy of preemptive analgesia using an non-steroidal anti-inflammatory drug (NSAID) for the surgical extraction of impacted third molar teeth and present the more effective pain treatment after oral surgery with literature review. Methods: Using a randomized double blind test design, this study compared the analgesic efficacies of an NSAID, Talniflumate 370 mg. This drug administrated first either 1 hour preoperatively (experimental group) or when the pain developed moderately to severely over 5 scale of verbal rating scales (0-10) to respective 30 patients undergoing the removal of impacted third molars. Pain intensity and the time from the end of surgery were assessed postoperatively whenever the patients demanded additional drug over 5 scale for forty eight hours using same verbal rating scales. Results: The sex distribution, the age of the patients. and the time required for surgery in two groups were similar. The average first time for demanding additional drug after surgery was 163.9 minutes in experimental group and 191.5 minutes in control group. At this time, the average pain intensity was 5.8 in experimental group and 6.1 in control group. And the average second time for demanding additional drug was 365.5 minutes in experimental group and 351.8 minutes in control group. At this time. the average pain intensities were 6.6 in experimental group and 6.2 in control group. No statistically significant difference was found between the average first times and second times, and the average pain intensities at first and second times in two groups. Conclusions: From these results the efficacy of preemptive analgesia used in this study was not appeared. This clinical study indicates that many NSAIDs administrated preoperatively in present practices have weak efficacy of preemptive analgesia for postoperative pain, thus the authors recommend that only postoperative analgesics are adequate without preoperative use of analgesics.
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