• 제목/요약/키워드: Pain self assessment scale

검색결과 47건 처리시간 0.021초

근전도상 불량한 예후를 보였던 Ramsay Hunt Syndrome 환아 1례에 대한 임상적 고찰 (A Case of Ramsay Hunt syndrome with Poor Prognosis on EMG)

  • 고덕재;유한정;조형준;김덕곤;이진용
    • 대한한방소아과학회지
    • /
    • 제18권2호
    • /
    • pp.127-142
    • /
    • 2004
  • Objective : To evaluate the effect of Oriental medical treatment on a patient with Ramsay Hunt syndrome with poor prognosis on EMG. Methods : We applied various methods of Oriental Medical treatment including Acupuncture, Electroacupuncture, Herb medicine, Vesiculation therapy using Mylabris and Crontonis Fructus, Massage, Self-excercise of face muscles. Results : 1. Herb medicine was applied on the basis of Differentiation of Syndromes(辨證): We tried Herb medicine to improve the function of Digestive System. The patient's stool condition, subjective sensation related with abdominal pain and general condition improved. 2. We used the Vesiculation therapy using Mylabris which was used traditionally to treat Facial Palsy. We powdered Mylabris and mixed it with Crontonis Fructus to make a paste. We put it on Ye-poong(?風), Nae-gwan(內關) at left side. It induced vesicles at the applied area, but it disappeared in 48 hours without any scar. 3. We applied acupuncture, electroacupunture, massage and self-excercise of face muscles. On gross scale assessment, there was some improvement. And assessment with regional scale also showed changes. The patient and the guardian were satisfied with the result. Conclusion : We experienced a case of Ramsay Hunt syndrome with poor prognosis on EMG. She also showed poor response to conservative treatment. Through various modalities of Oriental medical treatment, we attained some clinical improvement.

  • PDF

녹화영상 활용 학습법이 학생들의 '환자-의사관계'에서의 자기성찰에 미치는 영향 (The Effect of Recorded Video Monitoring on Students' Self Reflection of Patient-Physician Interaction)

  • 주미선;황지영;김재명;강재구
    • 의학교육논단
    • /
    • 제19권2호
    • /
    • pp.83-89
    • /
    • 2017
  • The aim of this study is to examine the effect of recorded video monitoring on students' self-reflection after completing their clinical performance examination. Taking into account the particular cases involved in the examination, the present study utilized history-taking, physical examination, and patient education as bases for evaluating information-establishment ability, and asking, listening, understanding, explaining, and connectedness as the bases for evaluating patient-physician interaction ability. Student self-monitoring through recorded video feedback was carried out three days after completion of their clinical performance examination. Students self-evaluated their performance with a 10-point scale before and after self-monitoring. The results of this study show that students have a general tendency to lower their own self-evaluation scores after self-monitoring. Although there was not a statistically significant change of interrelationship in the information-establishment ability evaluation, there was a meaningful change of interrelationship in the patient-physician interaction ability evaluation after self-monitoring; specifically, in the case of acute lower abdominal pain, a high correlation was found (r=0.31, p=0.02) between the evaluation scores of standardized patients and students related to patient-physician interaction ability. This implies that self-monitoring enables the students to acquire a reflective viewpoint from which to evaluate their own performance. Therefore, it can be said that self-monitoring through recorded video feedback is a valuable method for students to use in reviewing their performance in patient-physician interactions.

경막외신경차단술로 치료 중인 척추관 협착증 환자에서 거창만령단과 침의 효능 및 안전성 연구(예비임상연구) (Efficacy and Safety of Geochangmanryeung-dan and Acupuncture on Patient with Spinal Stenosis Treated by Epidural Steroid Injection: a Study Protocol for a Randomized Controlled Pilot Trial)

  • 이현종;이초인;이사람;곽민아;곽상규;노운석;정진용
    • Korean Journal of Acupuncture
    • /
    • 제32권3호
    • /
    • pp.99-107
    • /
    • 2015
  • Objectives : This study was designed to obtain basic data for a further large-scale trial as evaluating the efficacy and safety of Geochangmanryeung-dan(GMD) and acupuncture on patient with spinal stenosis treated by epidural steroid injection. Methods: The study is a randomized controlled pilot clinical trial, conducted over 8 weeks. Twenty participants will be recruited and randomly allocated to 2 groups: an experimental(GMD and acupuncture with epidural steroid injection) group and a control(only epidural steroid injection) group. The epidural steroid injection will be administered once per 2 weeks for 6 weeks(3 times in total). GMD will be administered as a dose of 5 pills, 3 times per day, for 6 weeks. Acupuncture will be performed 2 times per week for 6 weeks(12 times in total). The primary outcome will be measured by visual analogue scale and self-rated walking distance. The secondary outcome will be measured by PainVision, short-form McGill Pain Questionnaire, and Oswestry Disability Index. Both primary and secondary outcomes will be measured at baseline, 2, 4, 6, and 8 weeks. The last assessment(at 8 weeks) will be performed 2 weeks after treatment cessation. Conclusions : This clinical trial, as the pilot study for a future large-scale trial, will provide clinical information for evaluating the efficacy and safety of GMD and acupuncture treatment in combination with epidural steroid injection for the treatment of spinal stenosis.

치주수술후 치주포대의 사용유무에 따른 임상적 효과에 대한 비교논문 (A Comparative Study of Clinical Sffects Following Periodontal Surgery with and without Dressing)

  • 배상범;임성빈;정진형
    • Journal of Periodontal and Implant Science
    • /
    • 제29권3호
    • /
    • pp.693-703
    • /
    • 1999
  • Since they were introduced by Ward in 1923, periodontal dressing have been routinely used following the periodontal surgery to avoid pain, infection, desensitizing teeth, inhibiting food impaction of the surgical areas, and immobilizing injured areas. Recently, however, the value of periodontal dressings and their effects on periodontal wound healing have been questioned, several authors have been reported that the use of dressing has little influence on healing following periodontal surgical procedures. In addition, there is evidence that when good flap adaptation is achieved, the use of a periodontal dressing does not add to patient comfort nor promote healing. The purpose of this study was to evaluate patient postoperative pain experience and discomfort with and without the use of periodontal dressing following periodontal surgery. Twenty-eight patients, 11 male and 17 female. were selected for this study; The age range was 31 to 56, with an average of 40.2years. Patient selection was based on existence of two bilateral sites presenting similar periodontal involvement, as determined by clinical and radiographic assessment, and requiring comparable bilateral surgical procedures. Using a splitmouth dressing. one site received a periodontal dressing while the other site did not. Pain assessment was made according to a horizontal, rating scale(0-10). After at least a two-week period, the second surgical precedure was performed using the alternate postoperative treatment. At the conclusion of the trial, a self-administered questionnaire on postoperative experience was administered, and were asked of their preference of either, dressed or undressed. The results were as follows: 1. A similar trend for mean pain and discomfort scores as assessed by patients both dressed and salinetreated procedures was evident during 7-day postsurgical period. 2. Statistical analysis of differences between the dressed side and salinetreated side with respect to pain, discomfort and patient's experiences revealed that both treatment sides behaved similarly at any postoperative day(P>0.05). 3. Considering the patient's preference, on the basis of pain and discomfort experienced, 43% preferred the saline-mouthwash and 32% preferred the dressing, 25% showing no preference for either the dressing or the saline-mouthwash. There is evidence to support the use of a periodontal dressing in retention of an apically positioned flap by preventing coronal displacement, or its use to provide additional support to stabilize a free gingival graft. However, there will always be a use for periodontal dressing although routine use of dressings may decrease because of better surgical techniques and the use of antibacterial mouth rinses.

  • PDF

Factors Related to Substantial Pain in Terminally Ill Cancer Patients

  • Suh, Sang-Yeon;Song, Kyung-Po;Choi, Sung-Eun;Ahn, Hong-Yup;Choi, Youn-Seon;Shim, Jae-Yong
    • Journal of Hospice and Palliative Care
    • /
    • 제14권4호
    • /
    • pp.197-203
    • /
    • 2011
  • 목적: 암환자에게 통증은 가장 흔하고 영향이 큰 증상이다. 그러나 말기암환자에서 통증 강도에 대한 연구는 부족하였다. 본 연구는 중등도 이상의 통증과 연관된 요인을 밝히고자 한다. 방법: 우리나라 완화의료 기관 6곳의 입원 병동을 대상으로 말기 암 환자 162명 자료를 사용하였다. 통증은 담당의가 10점 만점 숫자통증등급으로 측정하였다. 중등도 이상의 통증은 보건복지부 지침의 정의에 따랐다. 증상 평가에는 MD Anderson 증상 평가조사지 한국어본을 활용하였다. 생존기간 예측은 입원 당시 담당 전문의가 하였다. 결과: 예측 생존 기간이 6주 미만인 경우와 지난 24시간 졸린 정도가 6점 이상인 경우가 중등도 이상의 통증과 유의하게 연관되었다(각각 P=0.012, P=0.046). 마약성 진통제 투여량도 중등도 이상의 통증에 비례하였다(P=0.004). 결론: 중등도 이상의 통증과 유의하게 연관된 요인은 예측 생존 기간이 6주 미만인 것과 상당한 졸림이었다. 이러한 요인을 나타내는 말기 암 환자에서 주의 깊은 통증의 감시와 적극적인 대비가 필요하다.

방사선 치료 중인 암환자의 정신병리, 자아존중감 및 삶의 질 (Psychopathology, Self Esteem and Quality of Life in Cancer Patients with Radiotherapy)

  • 정찬영;양종철;신일선;최영;윤진상;이무석;이형영;나병식
    • 정신신체의학
    • /
    • 제10권2호
    • /
    • pp.92-100
    • /
    • 2002
  • 목적: 의학의 발달에 따라 암환자의 생존율이 높아졌으며, 이에 따라 암환자의 심리적 이해와 삶의 질의 향상이 중요시되고 있다. 본 연구의 목적은 암환자의 사회인구학적 변인과 임상적 특성에 따라 정신병리, 자아존중감 및 삶의 질 등이 어떤 양상을 보이는 지 조사하고 동시에 이틀 간의 상호 연관성에 대해 알아보고자 함에 있다. 방법: 전남대학교병원 치료방사선과에 정규적으로 방사선치료를 받고있는 암환자 41 명과 정상 대조 군 20명을 대상으로 하였다. 환자들의 사회인구학적 자료 및 임상적 특성을 평가하였고, 정신병리는 symptom checklist-90-revised, 자아존중감은 Rosenberg의 self-esteem scale, 삶의 질은 World Health Organization Quality of Life Assessment Instrument를 통해 두 군을 비교 분석한 후, 변인들간의 상관을 조사하였다. 결과: 1) 암환자 군은 정상대조 군에 비해 신체화, 강박, 우울, 불안, 적대감, 공포, 정신중적 경향 등이 더 높았는데, 특히 신체화와 불안, 정신중이 유의하게 높았다. 2) 자아 존중감과 삶의 질은 암환자 군이 정상대조 군보다 유의하게 낮았다. 3) 사회인구학적 변인에 따른 정신병리, 자아존중감, 삶의 질의 비교에서는 유의한 차이가 없었다. 임상적 특정 중에서는 체중감량이 심할수록 신체화가 높았으며, 통증이 있는 경우에 신체화가 높고 삶의 질이 낮게 나타났다. 4) 불안이 높을수록 자아존중감이 낮았고, 신체화와 불안이 높고 자아존중감이 낮을수록 삶의 질이 낮게 나타났다. 결론: 암환자는 여러 정신증상이 있었고, 자아존중감과 삶의 질이 낮았다. 특히 암환자의 삶의 질에는 신체화 및 불안 등의 정신중상, 자아존중감, 통증 등이 중요한 것으로 드러났다. 따라서 암환자의 치료와 삶의 질의 개선을 위해서는 정신증상의 치료와 자아존중감의 증진, 통증 관리 등이 필요할 것으로 생각된다.

  • PDF

견관절의 임상적 평가도구에 관한 고찰 (A Review of Clinical Shoulder Assessment Scales)

  • 양동훈;김건형;김행범;최양식;박영배
    • Journal of Acupuncture Research
    • /
    • 제24권6호
    • /
    • pp.123-135
    • /
    • 2007
  • 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.

  • PDF

만성 견비통에 대한 동씨침 치료의 무작위 대조군의 임상 연구 (Randomized Controlled Trial : Effect of Master Dong's Acupuncture in Chronic Shoulder Pain Patients)

  • 김찬영;권나현;신예지;남동우;김건형;김종인;최도영;이윤호;이재동
    • Journal of Acupuncture Research
    • /
    • 제24권6호
    • /
    • pp.89-96
    • /
    • 2007
  • Objectives : To observe the effect of acupuncture treatment in chronic shoulder pain patients. Methods : 36 voluntary patients were randomly assigned to an acupuncture treatment group(E Group, n=18) and a control group(C Group, n=18). The E Group patients received acupuncture treatment on $LI_{15}$, $TE_{14}$, $GB_{21}$ and Master Dong's acupuncture points, Shin-gwan and Gyun-joong, twice a week for four weeks. The C Group patients received no treatment. All patients in both groups were instructed to practise self exercise in their daily lives. Evaluations were made at baseline and after four weeks of study. The Constant Shoulder Assessment(CSA), Shoulder Pain and Disability Index(SPADI) and the patient's subjective pain was measured by Visual Analogue Scale(VAS). The obtained data was analyzed. Results : The E Group showed significant(p<0.05) improvement in CSA, SPADI and VAS after four weeks of treatment. The C Group showed significant(p<0.05) improvement in CSA, but the change of SPADI and VAS was insignificant(p>0.05). CSA and SPADI of E Group significantly(p<0.05) improved compared to the C Group, but the difference of VAS change in the two groups was insignificant(p>0.05). Conclusions : Four weeks of acupuncture treatment significantly improved CSA, SPADI and VAS. The improvement of CSA and SPADI was significant(p<0.05) compared to untreated patients.

  • PDF

Efficacy of alpha-lipoic acid in patients with burning mouth syndrome compared to that of placebo or other interventions: a systematic review with meta-analyses

  • Christy, Jessica;Noorani, Salman;Sy, Frank;Al-Eryani, Kamal;Enciso, Reyes
    • Journal of Dental Anesthesia and Pain Medicine
    • /
    • 제22권5호
    • /
    • pp.323-338
    • /
    • 2022
  • Burning mouth syndrome (BMS) is a chronic oral disorder of unknown etiology which presents therapeutic challenges. Alpha-lipoic acid (ALA) has been studied as a potential treatment for BMS. The objective of this systematic review and meta-analysis was to evaluate the effectiveness of ALA compared to that of placebo or other interventions in individuals with BMS. Randomized controlled trials (RCT) using ALA to treat BMS were identified from MEDLINE, Cochrane Library, EMBASE, and Web of Science up to February 3, 2021. The assessment of the risk of bias in the included studies was based on the Cochrane guidelines. The primary outcome evaluated was the visual analog scale (VAS) pain intensity. ALA was compared with placebo, clonazepam, gabapentin, pregabalin, ALA plus gabapentin, capsaicin, Biotène®, and laser therapy. Altogether, 137 records were scanned for inclusion/exclusion, and nine RCTs (two unclear and seven at high risk of bias) were included in the qualitative and quantitative analyses, with a total of 594 patients with BMS included in this review. All studies reported an improvement in VAS pain scores ranging from -0.72 to -2.77. Meta-analysis results showed a non-significant reduction in pain intensity for ALA (P = 0.616) compared to that of placebo on a VAS of 0-10. Patients taking ALA were 1.923 times more likely to show an improvement in self-reported BMS symptoms (P = 0.031) than those in the placebo group. Clonazepam and pregabalin showed a significant VAS pain reduction of 4.08 and 4.68 (P < 0.001), respectively, compared to that with ALA. Although ALA intervention provided a non-significant improvement in the pain score and was more likely to produce a reduction in BMS symptoms, the evidence was of low quality. Further research is needed to establish clear guidelines for the use of ALA for BMS treatment.

방사선치료 중인 암 환자의 심리와 삶의 질 (Psychology and Quality of Life in Cancer Patients on Radiation Therapy)

  • 양종철;정웅기
    • Radiation Oncology Journal
    • /
    • 제22권4호
    • /
    • pp.271-279
    • /
    • 2004
  • 목적: 본 연구의 목적은 방사선치료 중인 암 환자의 심리적 특징과 삶의 질을 조사하고, 삶의 질에 영향을 미치는 변인들을 파악함으로써 암 환자의 심리에 대한 이해와 치료적 접근 및 삶의 질 향상을 위한 기초 자료를 제공함에 있다. 대상 및 방법: 전남대학교병원 방사선종양학과에서 방사선치료를 받고 있는 암 환자 36명과 정상대조군 20명을 대상으로 하였다. 환자들의 사회 인구학적 자료 및 임상적 특성을 조사하였고, 심리적 특징은 symptom checklist-90-revised, Rosenberg의 self-esteem scale을 통해 평가하였으며, 삶의 질은 World Health Organization Quality of Life Assessment Instrument를 통해 비교 분석한 후, 이들 간의 상관관계를 조사하였다. 결과: 암 환자는 정상대조군에 비해 신체화 경향, 우울, 불안, 적대감 등이 유의하게 높았고, 자아존중감과 삶의 질은 유의하게 낮았다. 사회 인구학적 변인에 따른 심리, 자아존중감, 삶의 질의 비교에서는 유의한 차이가 없었다. 임상적 특성과 연관성 조사에서는 전이가 있는 군에서는 불안, 공포, 경계심이 높고, 통증이 있는 경우에 신체화가 높게 나타났으며, 체중감량이 심할수록 신체화가 높았다. 우울, 불안, 적대감이 높을수록 자아존중감이 낮았으며, 신체화, 우울, 불안, 적대감이 높을수록 삶의 질이 낮은 것으로 나타났다. 결론: 방사선치료를 받고 있는 암 환자의 치료에 있어서는 신체화 경향, 우울, 불안, 적대감 등의 심리적 문제에 대한 이해와 치료적 접근이 병행되어야 하고, 특히 삶의 질을 개선하기 위해서 이러한 심리적인 문제의 해결과 통증 관리가 중요한 것으로 나타났다.{\%}$(1명)에서 관찰되었다.선기능저하증이 각각 7예($9\%$)씩 그리고 성선기능저하증 2예 ($3\%$) 등이 관찰되었다. 전예 중 15예 ($20\%$)에서는 정기적인 호르몬 추적검사를 실시하지 못하였다.이었다.인가는 단정할 수 없다. 이는 앞으로 관찰기간이 더 경과한 이후에 판단할 수 있겠고 또한 방사선치료전에 전지주막하의 종양범위를 명확히 확인할 것이 요구된다.고 (p < 0.05). LP1 군을 제외한 다른 모든 군 사이에는 유의한 차이가 없었다 (p > 0.05). 2. 파절양상을 관찰한 결과, LP1 군에서는 접착성 파절이 우세하게 나타났고, LP1 군을 제외한 다른 모든 군에서는 혼합형 파절이 주로 일어났다.64.96\%$, 5:5 첨가구가 $25.6{\times}10^3$cps와 $60.90\%$, 3:7 첨가구가 각각 $21.9{\times}10^3$cps와 $55.19\%$로 첨가량이 증가하면서 두 항목 모두 크게 감소하는 결과를 보였다. 색도를 분석한 결과 L값, a값, b값 모두 표고버섯 분말 함량이 증가하면서 감소하였고, 모든 처리구에서 기존 무첨가구와 극히 현저한 차이를 보이는 것으로 나타났다. 시료별 관능검사 결과에서 색 (color), 먹을때의 느낌 (chewiness)과 단맛(sweetness)의 경우 무첨가구와 모든 처리구가 유의적인 차이를 보였으며, 향미 (flavor)와 전반적인 기호도(overall acceptability)에서 당화액과 추출액의 혼합비가 7:3인 시료구만이 무첨가구와 유의적인 차이를 보이지 않았다