• Title/Summary/Keyword: Pharmacological intervention

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Development of Cancer Patient Guide for Nausea & Vomiting Management in Chemotherapy (항암화학요법을 받는 암 환자의 오심, 구토관리를 위한 환자용 지침 개발)

  • Yi, Ji-Eun;Park, Myong-Hwa
    • Korean Journal of Adult Nursing
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    • v.22 no.6
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    • pp.570-581
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    • 2010
  • Purpose: This study was conducted to develop a Cancer Patient Guide with patients involvement using evidenced based practice research. The purpose of this patient guide was to help patients undergoing chemotherapy to manage their nausea and vomiting based on evidence. Methods: The design of the research was a methodological study. The participants consisted of seven cancer patients who were asked about their ' need for nausea and vomiting management, and secondly, 16 expert & 15 cancer patients to evaluate the Cancer Patient Guide using the DESCERN tool. Results: 1) Sixty-four relevant research evidences based articles were reviewed. 2) Patients were interviewed as to their needs in controlling nausea and vomiting. 3) The preliminary Cancer Patient Guide utilizing the research evidenced and the cancer patients interviews was then evaluated and revised by the experts and cancer patients. Lastly, the Cancer Patient which included an overview of chemotherapy, pathophysiology of nausea & vomiting, pharmacological and non-pharmacological interventions was finalized with each intervention supported by research evidence and patients' narratives of their experience. Conclusion: The Cancer Patient Guide was developed using evidenced based research and cancer patients in-put and be used to improve patients' self-management skill of nausea and vomiting in chemotherapy. The guide t also provides evidence based patient friendly information and contributes as a baseline data for developing and evaluating evidence-based guide for patients.

Performance of Evidence-based Pain Assessment and Management Guidelines among Medical-Surgical Nurses (내·외과 간호사의 근거기반 통증사정 및 관리 가이드라인 수행도)

  • Kim, Heui Lyang;Song, Chi Eun;So, Hyang Sook
    • Korean Journal of Adult Nursing
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    • v.28 no.5
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    • pp.546-558
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    • 2016
  • Purpose: This study aimed at the effectiveness to investigate the performance of evidence-based pain assessment and management guidelines. Methods: Participants were 140 nurses at the med-surgical units. Data were collected in early July, 2014 using Registered Nurses Association of Ontario (RNAO) guideline (2007) revised and validated by Hong and Lee (2012) and analyzed by descriptive statistics, t-test, ANOVA using SPSS/WIN18.0. Results: The score of performance of pain assessment guideline was higher than the score of pain management. Categories with high score were pain screening, parameter of pain assessment, documentation, assessment of opioids side-effects, and record of pain caused intervention. Categories with low score were comprehensive pain assessment, multidisciplinary communication, establishing a plan for pain management, consultation and education for patients and their families, and education for nurse. Non-pharmacological management was the lowest one. Conclusion: Assessing and managing pain is a complex phenomenon. It might be useful if institutions host training programs to ensure that nurse are better able to understand and implement pain assessment and management. Since non-pharmacological management is less likely to be used by nurses it may be helpful to include these methods in a training program.

Recent Advances in Diagnosis and Treatment of Alzheimer's Disease (알츠하이머병의 최신지견)

  • Lee, Jung Jae;Lee, Seok Bum
    • Korean Journal of Biological Psychiatry
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    • v.23 no.2
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    • pp.48-56
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    • 2016
  • Alzheimer's disease (AD) is a neurodegenerative disorder in which neuronal loss causes cognitive decline and other neuropsychiatric problems. It can be diagnosed based on history, examination, and appropriate objective assessments, using standard criteria such as the Diagnostic and Statistical Manual of Mental Disorders or the National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer's Disease and Related Disorders Association (NINCDS-ADRDA). Brain imaging and biomarkers are making progress in the differential diagnoses among the different disorders. The cholinesterase inhibitors, donepezil, rivastigmine and galantamine and N-methyl-D-aspartate receptors antagonist memantine are approved by the US Food and Drug Administration for AD. Recently some acetylcholinesterase inhibitors gained approval for the treatment of severe AD and became available in a higher dose formulation or a patch formulation. Optimal care in AD is multifactorial and it should include early diagnosis and multidisciplinary care with pharmacological and nonpharmacological interventions including exercise interventions, cognitive interventions and maintenance of social networks.

Effect of Balance Taping Therapy on Neck Pain in High School Students (경부통증을 호소하는 고등학생에게 적용한 밸런스 테이핑 요법의 효과)

  • Ko, Mi-A;Lee, Ji-A
    • Korean Journal of Adult Nursing
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    • v.24 no.4
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    • pp.417-427
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    • 2012
  • Purpose: The purpose of this study was to examine the effect of balance taping therapy on neck pain in high school students. Methods: The study employed a randomized control group pretest-posttest design with four-time repeated measures. Data were collected from 62 high school students with neck pain. The experimental group (n=31) took balance taping therapy for six days with appropriate position and stretching education while the control group (n=31) applied patches including non-steroidal anti-inflammatory drugs (NSAIDS) for six days with appropriate position and stretching education. Neck pain, cervical range of motion (CROM) and neck disability were measured at pretest, day one, day three and day six which was the posttest day. Results: For the experimental group, the neck pain was significantly improved on all three days (F=16.82, p<.001), and extension and right lateral flexion of the CROMs were significantly improved over time compared to the control group (F=3.85, p =.011; F=2.71, p=.047, respectively). Neck disability was also improved in the experimental group compared to the control group (F=8.64, p<.001). Conclusion: The balance taping therapy was an efficient intervention for high school students with neck pain. Nurses could apply non-pharmacological interventions such as balance taping therapy without pharmacological side effects.

Effect of Net-Step Exercise on Gait Ability, Depression, Cognitive Function and Activities of Daily Living in Older Adults (Net-Step Exercise가 노인의 보행기능, 우울, 인지기능 및 일상생활 수행능력에 미치는 영향)

  • Lee, Eun Ja;Yoo, Jae Boone
    • The Korean Journal of Rehabilitation Nursing
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    • v.19 no.2
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    • pp.108-117
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    • 2016
  • Purpose: This study aimed to prove the effects of the net-step exercise (NSE) on gait ability, depression, cognitive function and activities of daily living (ADL) in older adults. Methods: The study employed a non-equivalent control group non-synchronized design. A total of 64 community-dwelling older adults were recruited and divided equally into two groups; 32 subjects for an experimental group and 32 subjects for a control group. In the experimental group, the NSE was applied to an hour, two times per week for 4 weeks. The level of gait ability, depression, cognitive function and ADL were measured before and after NSE. The study conducted from July to August, 2016. Data were analyzed with descriptive statistics, $x^2$ test, Fisher's exact test, t-test, ANCOVA, and Pearson correlation coefficients using SPSS/WIN 22.0 version. Results: Gait ability, depression, cognitive function were significantly better in the experimental group than the control group. However, the difference in ADL was not significant between the two groups. Conclusion: These findings in this study showed that the NSE was an efficient intervention for older adults. Nurses could apply non-pharmacological interventions to avoid pharmacological side-effects.

A review of non-pharmacological intervention efficacy in patients with mild cognitive impairment (경도인지장애의 비약물요법에 대한 고찰)

  • Kim, Wu-Young;Han, Chang-Hyun;Heo, Eun-Jung;Kang, Hyung-Won;Jeon, Won-Kyung
    • Journal of Oriental Neuropsychiatry
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    • v.22 no.3
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    • pp.1-11
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    • 2011
  • Objectives : As the number of patient with dementia increases, interest in mild cognitive impairment (MCI), which is a pre-dementia stage, has been expanding. In this study, we investigated the effects from selected clinical research articles to evaluate the effectiveness of non-pharmacological interventions. Methods : We searched MCI related articles on MEDLINE and the Web of Science using keywords related to MCI. We selected 26 articles, and 13 evaluated efficiency using the Jadad score. Results : Physical exercise and cognitive remediation techniques were effective for improving MCI. Transcutaneous electrical nerve stimulation, taichi, and music belonged to "perhaps" effectiveness group. Many of the 13 articles that evaluated MCI using the Jadad score evaluated them as "good" or "poor", and only three articles evaluated MCI as "excellent". Conclusions : The present evidence suggests that cognitive remediation techniques to improve memory and physical exercise were effective for people with MCI. However, further studies are needed to identify the physical exercise effects.

Analysis of Nursing Records for Elderly Patients with Abdominal Pain in the Emergency Medical Center (응급의료센터에 내원한 복부통증 노인 환자에 대한 간호기록 분석)

  • Lee, Hyeo Ki;Kim, Jong Im
    • Journal of muscle and joint health
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    • v.26 no.1
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    • pp.27-34
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    • 2019
  • Purpose: This study was done to analyze nursing assessment and nursing care for pain in the electronic nursing records for the elderly patients with abdominal pain visiting the Emergency Medical Center. Methods: This study is a descriptive study based on nursing records from January to December 2015. A total of 1155 records for elderly patients with abdominal pain were gathered. Results: The mean age of elderly patients whose records were analyzed was 75.2 years. Analysis of nursing records regarding pain management showed that semi-urgent severity (93.7%), direct emergency room visits (58%), and 6.01 hours of emergency room stay (6.01 hours)were the most frequently documented characteristics of the elderly patients with pain complaints. Recording time of nursing assessment for abdominal patients was 1.01 hour; the average pain intensity was 3.97. The mostly used nursing intervention for abdominal pain was medication (65.1%). There was no record of non-pharmacological pain nursing interventions. Conclusion: The results of this study showed that improving knowledge and nursing practice for pain management is much of necessity. In particular, development of the non-pharmacological nursing interventions for pain is needed. Further research is also imperative to develop and evaluate record systems for pain management that can be used in the emergency room.

Pharmacological Therapies of Obesity: A Review of Current Treatment Options

  • Bacher, H.Peter;Shepherd, Gillian M.;Legler, Udo F.
    • Biomolecules & Therapeutics
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    • v.17 no.4
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    • pp.348-352
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    • 2009
  • Over the last decade, the incidence of overweight and obesity has nearly doubled in many countries and is considered a pandemic. Obesity was identified as a major risk factor for cardiovascular disease as the same level as smoking and diabetes. Visceral fat is considered one of the key contributors to outcome and certain ethnic groups such as Asians seem to be more affected than others. Weight reduction through lifestyle changes was found to be impactful to improve overall health, but weight loss and maintenance thereof is limited and difficult to sustain. Surgical intervention demonstrated a greater weight loss in the severely obese and was associated with improved all-cause mortality. Despite numerous pharmacological targets and a high medical need, only few drugs have been successfully developed. Earlier studies with amphetamine-derived compounds showed significant weight loss but their critical safety profiles led to market withdrawals and disappointment. More recent compounds; orlistat - a lipase inhibitor, rimonabant - a cannaboid-1-receptor antagonist, and sibutramine - a combined serotonin/norepinephrine re-uptake inhibitor, all demonstrated similar significant efficacy; however, they carry specific safety profiles making them unsuitable for every patient. The main limitation of pharmacotherapy is the absence of clear benefit-risk assessments through outcome studies. Such a study - the SCOUT trial - was designed to compare sibutramine versus placebo and the effect on morbidity and mortality in nearly 10,000 obese patients with additional risk factors. Such studies could provide new scientific evidence for obesity treatment and may support future pharmacological approaches.

Chewing gum as a non-pharmacological alternative for orthodontic pain relief: A randomized clinical trial using an intention-to-treat analysis

  • da Silva Santos, Diego Junior;Capelli, Jonas Jr.
    • The korean journal of orthodontics
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    • v.51 no.5
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    • pp.346-354
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    • 2021
  • Objective: To compare the effectiveness of ibuprofen, acetaminophen, and chewing gum for orthodontic pain relief and to assess if chewing gum can be a non-pharmacological alternative for orthodontic pain relief. Methods: The study enrolled 106 patients of both sexes, aged ≥ 12 years, with body weight > 50 kg, and mild-to-moderate dental crowding in the upper arch. After randomization and allocation concealment, the intervention groups were either administered with ibuprofen (400 mg) or acetaminophen (500 mg) or chewed sugar-free chewing gum immediately after initial archwire placement and every 6 hours for 1 week if the pain persisted. The control group did not receive any pain relief. The pain was assessed on a 100-mm visual analog scale at rest and while biting down at T1 (2 hours), T2 (24 hours), T3 (2 days), T4 (3 days), T5 (7 days), and T6 (21 days). Statistical analyses were performed using the Kruskal-Wallis and post-hoc Mann-Whitney U tests (α = 0.05). Results: The chewing gum group experienced more pain relief than the ibuprofen group at while biting down at T3 (p = 0.04) and at rest at T4 (p < 0.001). The chewing gum group reported more pain relief than the acetaminophen and control groups while biting down at T3 (p = 0.03 and p = 0.0006, respectively) and T4 (both p < 0.001). Conclusions: Chewing gum can be a non-pharmacological alternative for orthodontic pain relief at 2 and 3 days after initial archwire placement.

A Study on the Knowledge Related to Children's Pain of pediatric Nurses According to their Career (아동병동 간호사의 경력에 따른 아동 통증지식에 대한 연구)

  • Choi, Seon-Il;Choe, Myoung-Ae
    • Journal of Korean Biological Nursing Science
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    • v.7 no.1
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    • pp.69-87
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    • 2005
  • Purpose : The purpose of this study was to identify pediatric nurses's knowledge related to children's pain and pediatric nurses' career including educational experience and to examine whether there is a difference of their knowledge according to their career. Method : Subjects of this study was 115 pediatric nurses of one university hospital who understood purpose of this study and accepted to participate in this study. Subjects responded questionnaire by self report. The data were gathered for 7 days during the period from October 20 to October '2:7, 2003. The pediatric nurses' knowledge and attitude survey regarding pain developed by Manworren(2001) was used to identify the knowledge related to children's pain of pediatric nurses. Nurses' career consisted of level of education, presently working ward, duration of experience at clinic, pediatric clinic and presently working ward and educational experience related to children's pain during undergraduate courses, ward orientation and continuing education. Educational experience regarding children's pain was measured by whether they had education related to children's pain during undergraduate courses, ward orientation and continuing education or not and their perception on the contents of education was measured by 5 point Likert type scale. SPSS Windows was used to analyze the data. Scores of the knowledge regarding children's pain and career including educational experience of pediatric nurses were presented as mean and standard deviation. Mean percentage of correct answers responded by the subjects was presented under the category of introduction, assessment, pharmacological and nonpharmacological intervention for children's pain. The difference of scores of the knowledge regarding children's pain according to nurses' career was analyzed using t-test, ANOVA and Tukey as a post hoc. Statistical significance was accepted at the level of p<.05. Result : Pediatric nurses had deficient knowledge related to children's pain on the whole and did not trust pain complaint and underestimated the pain. They were short of concrete practical knowledge about pain assessment and pharmacological and nonpharmacological intervention for children's pain. They were excessively concerned with side effect and addiction of analgesic drugs and had a negative view point on nonpharmacological pain intervention. About 50% of the subjects received education regarding children's pain while their undergraduate courses. The number of nurses who received education regarding children's pain while their undergraduate courses was found to be greater among the recently graduated nurses. In ward orientation and continuing education, only less than 10% of the nurses received education regarding children's pain. Nurses perceived their experienced educational content deficient; experienced educational content consisted of pain introduction, assessment and pharmacological and nonpharmacological intervention for children's pain while their undergraduate course, ward orientation and continuing education. There were no significant differences of the knowledge regarding children's pain of pediatric nurses according to level of education, duration of experience at clinic, pediatric clinic and presently working ward. Scores of the knowledge regarding children's pain of nurses at neonatal ward were significantly greater than those of nurses at pediatric intensive care unit. Scores of the knowledge regarding children's pain of pediatric nurses who received education during their undergraduate course were significantly greater than those who did not receive it during their undergraduate courses. Also scores of the knowledge regarding children's pain of pediatric nurses who received one kind of educational experience were significantly greater than those who had no educational experience. Conclusion : Pediatric nurses had deficient knowledge of children's pain and underestimated the pain of children. Also they were short of concrete practical knowledge on pain assessment and intervention for children's pain.

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