• 종양간호연구
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• 제11권1호
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• pp.83-92
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• 2011

Purpose: This study was to analyze the characteristics and effect size of intervention studies in reference to cancer pain. Methods: In order to conduct a meta-analysis, a total of 208 studies were retrieved from search engine. And 29 studies published from 2000 to 2010 were selected upon their satisfaction with the inclusion criteria. The data was analyzed by the RevMan 5.0 program of Cochrane library. Results: 1) Intervention studies included 7 studies on reflexology (24.1%), 5 for pain management education (17.2%), 3 studies for each music therapy, spiritual care and hand massage (10.3%, respectively), and 2 studies for each hospice and horticultural therapy (6.7%, respectively). 2) The effect size of the intervention studies were high in hand massage (d=-0.98), reflexology (d=-0.74), spiritual care (d=-0.72), pain management education (d=-0.66), music therapy (d=-0.41), and horticultural therapy (d=-0.32). Conclusion: This study suggest that non-drug therapy can reduce the levels of cancer pain intensity, even though the numbers of intervention studies and randomized controlled trials are very rare.

• The Korean Journal of Pain
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• 제33권1호
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• pp.40-47
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• 2020

Background: Duloxetine is an antidepressant that is also useful in chronic neuropathic and central origin pain. In this study, the role of duloxetine in decreasing acute postoperative pain after lumbar canal stenosis surgery is explored. Methods: In this single center, triple blinded, and placebo-controlled trial, 96 patients were randomized for statistical analysis. The intervention group received oral duloxetine 30 mg once a day (OD) for 2 days before surgery, 60 mg OD from the day of surgery to the postoperative second day and 30 mg OD for the next 2 days (a total duration of 7 days). A placebo capsule was given in the other group for a similar time and schedule. The same standard perioperative analgesia protocols were followed in both groups. Results: Total morphine consumption up to 24 hours was significantly decreased in the duloxetine group (P < 0.01). The time to the first analgesia requirement was similar in both groups but the time to the second and third dose of rescue analgesia increased significantly in the duloxetine group. The time to ambulation was decreased significantly (P < 0.01) in the duloxetine group as compared to the placebo group. Pain scores remained similar during most of the time interval. No significant difference was observed in the complication rate and patient satisfaction score recorded. Conclusions: Duloxetine reduces postoperative pain after lumbar canal stenosis surgery with no increase in adverse effects.

• 기본간호학회지
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• 제10권2호
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• pp.206-213
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• 2003

Purpose: This study was designed to explore pain and self-care behaviors and identify related variables in patients with chronic arthritis. Method: One hundred fifty patients with arthritis were recruited from two university based arthritis centers according to selection criteria. Collected data were analyzed using the SAS program to analyze the responses to the structured questionnaires of the study. Result: Most of the participants expressed pain and the intensity of the pain was moderate. There were significant differences according to age, educational level, diagnosis, duration of illness, number of affected joint, and use of complementary therapy. Self-care behavior scores were moderately high. The highest practice was for 'regular visits to the hospital', and the lowest for 'applying physical therapy at home'. The mean self-care behavior scores showed significant differences according to economic status and educational level. Pain scores showed no correlation with self-care behavior. Conclusion: Developing self-management programs for patients with chronic arthritis should focus on self-care skills which are applicable in the relief of pain and enhancement of knowledge. The skills are recommended not only for better health practices but also for enhancing the level of well-being and life satisfaction.

• The Korean Journal of Pain
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• 제34권2호
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• pp.193-200
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• 2021

Background: Local anesthetic infiltration at the site of a surgical wound is commonly used to control postoperative pain. In this study, we examined the effectiveness of continuous local infiltration at an abdominal surgical site in patients undergoing anterior lumbar interbody fusion (ALIF) surgery. Methods: Sixty-one patients who underwent ALIF surgery were enrolled. For thirtyone of them, a continuous local anesthetics infiltration system was used at the abdominal site. We collected data regarding the patients' sleep quality; satisfaction with pain control after surgery; abilities to perform physical tasks and the additional application of opioids in the postoperative 48 hours. Results: The On-Q system group showed reduced visual analogue scale scores for pain at the surgical site during rest and movement at 0, 12, 24, and 48 hours; and more was satisfied with pain control management at the first postoperative day (7.0 ± 1.2 vs. 6.0 ± 1.4; P = 0.003) and week (8.1 ± 1.6 vs. 7.0 ± 1.8; P = 0.010) than the control group. The number of additional patient-controlled analgesia (PCA) bolus and pethidine injections was lower in the On-Q group (PCA: 3.67 ± 1.35 vs. 4.60 ± 1.88; P = 0.049 and pethidine: 2.09 ± 1.07 vs. 2.73 ± 1.38; P = 0.032). Patients who used the On-Q system performed more diverse activity and achieved earlier ambulation than those in the control group. Conclusions: Continuous wound infiltration with ropivacaine using an On-Q system may be effective for controlling postoperative pain after ALIF surgery.

• The Korean Journal of Pain
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• 제33권4호
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• pp.378-385
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• 2020

Background: The thoracic paravertebral block is an effective analgesic technique for postoperative pain management after breast surgery. The ultrasound-guided retrolaminar block (RLB) is a safer alternative to conventional paravertebral block. Thus, we assessed the analgesic efficacy of ultrasound-guided RLB for postoperative pain management after breast surgery. Methods: Patients requiring breast surgery were randomly allocated to group C (retrolaminar injection with saline) and group R (RLB with local anesthetic mixture). The RLB was performed at the level of T3 with local anesthetic mixture (0.75% ropivacaine 20 mL + 2% lidocaine 10 mL) under general anesthesia before the skin incision. The primary outcome was cumulative morphine consumption using intravenous patient-controlled analgesia (IV-PCA) at 24 hour postoperatively. The secondary outcomes were the visual analogue scale (VAS) scores at 1, 6, 24, and 48 hour postoperatively and the occurrence of adverse events and patient satisfaction after the surgery. Results: Forty-six patients were included, 24 in group C and 22 in group R. The cumulative morphine consumption using IV-PCA did not differ between the two groups (P = 0.631). The intraoperative use of remifentanil was higher in group C than in group R (P = 0.025). The resting and coughing VAS scores at 1 hour postoperatively were higher in group R than in group C (P = 0.011, P = 0.004). The incidence of adverse events and patient satisfaction was not significantly different between the two groups. Conclusions: A single injection of ultrasound-guided RLB did not reduce postoperative analgesic requirements following breast surgery.

• 대한간호학회지
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• 제32권5호
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• pp.735-742
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• 2002

This study was conducted to identify the pain characteristics, family support and physical functioning and to determine predictors of the quality of life in aged women with chronic pain. Method: The questionnaires were collected through direct interview by a trained research assistant from July 2 to August 24, 2001. Subjects were 108 women clients with chronic pain over 65 years of age. Data analyzed frequency, percentage, mean, Pearson's correlation, ANOVA and stepwise multiple regression by SAS. Result: Care providers were mostly spouses and daughters in law. Care providers who took care of elderly for a few hours a day had the highest percentile. Aged women had persistently had chronic pain of moderate intensity and was moderately satisfied with pain management. The mean score of disability due to pain was 3 on a 10 point scale. The mean scores of physical function and quality of life were moderate and there were negative correlations between pain characteristics, physical functioning, and quality of life at the range from r=-.46 to r=-.83. Satisfaction with care, duration of pain, disability due to pain, and physical functioning accounted for 56% of the variance in perceived quality of life for aged women with chronic pain. Disability due to pain was the most predictable variable of quality of life and physical function was the second .Conclusion: The results suggest that care by family, education in pain control, prevention of disability, and maintenance of physical function are important to improve and maintain quality of life in aged women with chronic pain. Therefore, there is a need for program development that enhance family support and nursing intervention that focuses on active pain control.

• Journal of Hospice and Palliative Care
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• 제7권2호
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• pp.238-247
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• 2004

목적: 통증조절 실패의 주요 원인 중 하나는 부적절한 통증 평가이다. 규칙적이고 지속적인 암성통증의 평가가 효과적인 통증조절에 도움이 되는지를 검증하고자 하였다. 방법: 2003년 9월에서 12월 사이 전국 25개 병원에 입원하여 듀로제식$^{(R)}$을 처음 사용한 암환자를 대상으로4일간 통증을 제5의 활력징후로 평가하였다. 평가기간 동안의 일 평균 통증 강도 및 진통제 사용량, 돌발성 통증에 사용한 구제 진통제의 용량 및 투여 횟수를 분석하였다. 결과: 최종 분석대상자는 471명이었으며 평균연령은 57.2세, 남자가 59.1%이었다. 연구시작 전 대상자의 평균 통증강도는 6.0점이었고 78.6%가 진통제를 사용하고있었다. 듀로제식$^{(R)}$을 붙인 후 통증을 활력징후로 측정하였는데, 4일째 일 평균 통증강도는 2.9점으로 감소하였다(P<0001). 활력징후 측정 횟수가 많을 수록 4일간의 일 평균 통증강도가 감소하였다(r=-0.143, P=0.0018). 일 평균 듀로제식$^{(R)}$의 사용량은 통계적으로 유의한 차이를 보이지 않았다(P=0.14). 구제 진통제의 사용량과 횟수는 시간에 따라 감소하였다. 의사65.7%, 환자 58.1%가 듀로제식$^{(R)}$ 사용 후 만족한다고 답하였다. 결론: 암성 통증을 제5의 활력징후로 측정하였을 때 보다 효과적으로 통증조절이 이루어졌다. 듀로제식$^{(R)}$ 또한 암성 통증의 조절에 효과적이며, 안전한 약제이나 처음 사용 시에는 신중한 용량적정이 필요하다.

• 대한인간공학회지
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• 제34권6호
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• pp.609-622
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• 2015

Objective: This study aims to investigate the correlation between office and work environment satisfaction levels and workers' musculoskeletal symptoms by conducting surveys asking office workers to state their musculoskeletal symptoms and office and work environment satisfaction levels. Background: The increased number of office workers and their indoor work hours using computers have led to new understandings of the importance of office environment including its temperature, humidity, noise levels, lighting and quality of air, and work environment including monitor arrangement, space arrangement and the functions of desks and chairs. Method: Specific details on office work, office environment satisfaction levels, work environment satisfaction levels, musculoskeletal symptoms, absence from work and treatment due to musculoskeletal related symptoms were analyzed based on the survey answers given by 397 office workers who were the subjects of this research. Results: Office workers showed different characteristics of musculoskeletal symptoms depending on their gender, age, work experience, office hours, break time and time spent on computers. Also, differences in symptoms were found for workers'with different satisfaction levels for office environment (temperature, humidity, noise levels, quality of air, lighting) and work environment (location of monitors, area and display of office space, chairs and desks). ANOVA shows the differences between groups of subjects classified by the experience of work-absences and treatments or pain complaints. Conclusion and Application: Relationship between workers' satisfaction levels with the office and work environment and their musculoskeletal symptoms is expected to be served as essential data for systematic management of the workplace.

• The Korean Journal of Pain
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• 제10권1호
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• pp.34-41
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• 1997

Background : Patient-controlled analgesia(PCA) is a safe and effective technique for providing postoperative pain relief. Studies that compare epidural vs intravenous routes of opiate administration show conflicting results. We designed a prospective, randomized, controlled study to evaluate the safety and efficacy of epidural(EPI-PCA) morphine-bupivacaine versus intravenous (IV-PCA) nalbuphine when administered with a PCA system. Methods : Forty healthy women were randomly assigned to receive an epidural bolus of morphine 3 mg and 0.5% bupivacaine 10 ml, followed by a EPI-PCA with 0.01% morphine and 0.143% bupivacane (basal infusion 1 ml/hr, bolus 1 ml, lock-out interval 30 min) or intravenous bolus of nalbuphine 0.1 mg/kg followed by a IV-PCA with nalbuphine(basal infusion 1 mg/hr, bolus 1 ml, lock-out interval 20 min) for pain relief after cesarean delivery. This study was conducted for 2 days after cesarean section to compare the analgesic efficacy, side effects, patient satisfaction either as EPI-PCA or as IV-PCA. Results : EPI-PCA group had significant lower visual analog pain scale(VAS) at immediate postoperative period, whereas no significant difference was observed when pain was assessed at other time sequence. Urinary retention and pruritus were more frequent with EPI-PCA group, although the incidence of other side effects were the same. Conclusions : Although EPI-PCA with morphine-bupivacaine was of significantly lower VAS at immediate postoperative period, IV-PCA with nalbuphine is a safe and effective alternative to EPI-PCA with morphine-bupivacaine for providing pain relief after cesarean delivery. Further studies about IV-PCA with nalbuphine are needed to control the immediate postoperative pain and to further improve effective pain management.

• 보건행정학회지
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• 제18권3호
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• pp.1-17
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• 2008

The measurement and management of patient satisfaction has become one of the key issues in the last two decades. Hospitals must thoroughly understand the needs of their customers and design products and health services that meet and exceed their expectations. The importance-performance analysis(IPA) is a widely used analytical technique that yields strategies for managing customer satisfaction in a variety of applications. IP A is a two-dimensional grid based on customer-perceived importance of quality attributes and attribute performance. Depending on the interplay of these two dimensions, four strategies can be derived. The aim of this study is to develop the management strategies for improving patient satisfaction in university hospitals using the I-P analysis. The attributes on inpatient service quality in 4 university hospitals was investigated using the Martilla and James(l977)' s a mean adjusted I-P grid where the axes of the grid cross at the average rating point of all items. The patient satisfaction questionnaires were completed by 600 hospital inpatients. The main statistical methods are path analysis and IPA with SPSS 12.0 and AMOS 4.0 statistical softwares. The two attributes, physician and medical service, administrative staff kindness attributes position in first quadrant(Keep Up the Good domain). The nurse and nursing service attributes position in second quadrant(Possible Overkill domain). The two attributes, convenience of check-in service, facilities and physical environment position in third quadrant(Low Priority domain). Finally the quality of inpatient service(food etc.) attributes position in fourth quadrant(Concentrate Here domain). These findings show various implications on the development of strategies in university hospitals in the future. It was determined that quality of inpatient service(food etc.) need to concentrate more on investments. These investments include a taste, price, proper provision of food service and quick response of pain management. A low priority was given to investment in streamlining the check-in process of inpatient and hospital facilities and physical environment in the long run.