• Title/Summary/Keyword: children's pain

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Chronic pain control in patients with rheumatoid arthritis (만성통증 환자의 통증 조절)

  • Eun, Young
    • Journal of muscle and joint health
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    • v.2 no.1
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    • pp.17-40
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    • 1995
  • Rheumatoid arthritis is the one of the chronic diseases, one of its major symptoms is a chronic pain. Despite developing medical treatment and surgical techniques, it is suggested that to control the pain is the goal of the treatment. But pain is an inner experience and even those closest to the patient cannot truly observe its progress or share in its suffering. The National Academy of Sciences Institute of Medicine's report on Pain and Disability concluded that there is no objective measure of pain-(exactly) no pain thermometer-nor can there ever be one, because the experience of pain is inseparable from personal perception and social influence such as culture. To explore chronic pain experience is to understand the process and property of the patient's perception of pain through the response to pain, the coping with pain, and the adaptation to pain. Therefore a qualitative study was conducted in order to gain an understanding of pain experience of patients with RA in korea. I used naturalistic inquiry as a research methodology, which had 5 axioms, the first is that realities are multiple, constructed, and holistic, the second is that knower and known are interactive, inseparable, the third is only time and context bound working hypotheses(idiographic statements) are possible, the forth is all entities are in a state of mutual simultaneous shaping, so that it is impossible to distinguish causes from effects and the last is that inquiry is value-bound. Purposive sampling was conducted as a sampling. 20 subjects who experienced pain over 10 years, lived in middle-sized city and big city in Korea, and 17 women and 3 men. The subject's age was from 32 to 62 (average 48.8), all were married, living with their spouse and children, except two-one divorced and the other widow before they became ill. I collected data using In depth structured interview. I had interviews two or three times with each subject, and the interviews were conducted at each subject's home. Each interview lasted about two hours an average. A recording was taken with the consent of the subject. I used inductive data analysis-such as unitizing and categorizing. unitizing is a process of coding, whereby raw data are systematically transformed and aggregated into units. Categorizing is a process wherby previously unitized data are organized into categories that provide descriptive or inferential information about the context or setting from which the units were derived. This process is used constant comparative method. The pain controlling process is composed of behavior of pain control. The behaviors of pain control are rearranging of ADL, hiddening role conflict, balancing treatment, and changing social relation. Rearranging of ADL includes diet management, sleep management, and the adjustment of daily life activities. The subjects try to rearrange their daily activities by modified style of motions, rearranging time span & range of activities, using auxillary facilities, and getting help in order to keep on the pace of daily life. Hiddening role conflict means to reduce conflicts between sick role and their role as a family member. In this process, the subjects use two modes, one is to control the pain complaints, and the other is to internalize the value which is to stay home is good for caring her children and being a good mother. To control pain complaints is done by 'enduring', 'understanding' the other family members, or making them undersood in order to reduce pain. Balancing treatment is composed of two aspects. One is to keep the pain within the endurable level, the other is to keep in touch with medical personnel in order to get the information of treatment and emotional support. Changing social relation is made by information seeking and sharing, formation of mutual support relation, and finally simplification of social relationships. The subjects simplify their social relationships by refraining from relations with someone who makes them physically and psychologically strained. In particular the subjects are apt to avoid contact with in-laws, and the change of relation to in-laws results in lessening the family boundary. In the course of this process, they confront the crisis of family confict result in family dissolution. This crisis is related to the threat of self-existence. Findings from this study contribute to understanding the chronic pain experience. To advance this study, we should compare this result with other cases in different cultural contexts. I think to interpret these results, korean cultural background should be considered. Especially the different family concept, more broader family members and kinship network, and the traditional medical knowledge influences patients' behavior.

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Factors affecting the health-related quality of life of children with cerebral palsy in Indonesia: a cross-sectional study

  • Ade Febrina Lestari;Mei Neni Sitaresmi;Retno Sutomo;Firda Ridhayani
    • Child Health Nursing Research
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    • v.30 no.1
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    • pp.7-16
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    • 2024
  • Purpose: Children with cerebral palsy (CP) and their parents experience various problems that can affect their quality of life. This study examined factors affecting the quality of life of children with CP. Methods: A cross-sectional study was conducted in Yogyakarta, Indonesia, from January to August 2019. The participants were consecutively recruited children with CP aged 2 to 18 years and their parents. Ninety-eight children with CP and their parents, specifically their mothers, were recruited. Children's health-related quality of life (HRQoL) was measured using the Pediatrics Quality of Life Cerebral Palsy. Parental HRQoL and stress were measured using the WHOQOL-BREF and Parenting Stress Index (PSI). Results: Functional level V was the most common category for both Gross Motor Function Classification System (GMFCS) and Bimanual Fine Motor Function (BFMF) (35% and 28%, respectively). Children's mean HRQoL was medium (49.81±20.35). The mean total PSI score was high (94.93±17.02), and 64% of parents experienced severe stress. Bivariate analysis showed that GMFCS, BFMF, number of comorbidities, presence of pain, and parental stress were significantly correlated with the total score for children's HRQoL (p<.05). Multiple linear regression analysis (p<.05) demonstrated that more severe GMFCS and parental stress were associated with lower mean HRQoL scores in children. Conclusion: Factors including the level of GMFCS and parental stress affected the HRQoL of children with CP. Parental stress management should be included in the comprehensive management of these children.

Pain measurement in oral and maxillofacial surgery

  • Sirintawat, Nattapong;Sawang, Kamonpun;Chaiyasamut, Teeranut;Wongsirichat, Natthamet
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.17 no.4
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    • pp.253-263
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    • 2017
  • Regardless of whether it is acute or chronic, the assessment of pain should be simple and practical. Since the intensity of pain is thought to be one of the primary factors that determine its effect on a human's overall function and sense, there are many scales to assess pain. The aim of the current article was to review pain intensity scales that are commonly used in dental and oral and maxillofacial surgery (OMFS). Previous studies demonstrated that multidimensional scales, such as the McGill Pain Questionnaire, Short form of the McGill Pain Questionnaire, and Wisconsin Brief Pain Questionnaire were suitable for assessing chronic pain, while unidimensional scales, like the Visual Analogue Scales (VAS), Verbal descriptor scale, Verbal rating scale, Numerical rating Scale, Faces Pain Scale, Wong-Baker Faces Pain Rating Scale (WBS), and Full Cup Test, were used to evaluate acute pain. The WBS is widely used to assess pain in children and elderly because other scales are often difficult to understand, which could consequently lead to an overestimation of the pain intensity. In dental or OMFS research, the use of the VAS is more common because it is more reliable, valid, sensitive, and appropriate. However, some researchers use NRS to evaluate OMFS pain in adults because this scale is easier to use than VAS and yields relatively similar pain scores. This review only assessed pain scales used for post-operative OMFS or dental pain.

A Case of Acute Poststreptococcal Glomerulonephritis Accompanied with Acute Pyelonephritis (급성 신우신염이 병발한 급성 연쇄상구균 감염후 사구체신염 1례)

  • Cho Chang-Yee;Cho Seung-Hee;Choi Young-Kwon;Kim Byung-Hee;Yoo Yong-Sang;Yoo Yong-Sang;Kim Joon-Sung
    • Childhood Kidney Diseases
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    • v.8 no.2
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    • pp.239-243
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    • 2004
  • Acute poststreptococcal glomerulonephritis(APSGN) is the most common form of postinfectious glomerulonephritis, and acute pyelonephritis(APN) is the most severe form of urinary tract infection in childhood. However, the concurrence of two diseases is uncommon in the literature. We describe a case of APSGN accompanied with APN in a 5-year-old female who presented with fever, left flank pain, headache and facial edema. Urinalysis showed pyuria, microscopic hematuria, and mild proteinulra. Serial urine cultures grew Escherichia coli. ${^99m}$Tc-DMSA renal scan revealed a cortical defect in the upper pole of left kidney. She had a history of preceding pharyngitis, in addition, showed high blood pressure, high anti-streptolysin 0 titer, and low serum complement levels. The patient improved completely with supportive treatment, Including antibiotic and antihypertensive therapy. These findings suggested that APSGN and APN could be manifested simultaneously or be .superimposed on each other.

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A Clinical Study on the Effects of Extravascular Laser System on Osgood-Schlatter Disease (비침습 레이저 조사기를 이용한 Osgood-Schlatter's disease의 치료 증례보고)

  • Suk, Yun Hee;Min, Sang Yeon;Kim, Jang Hyun
    • The Journal of Pediatrics of Korean Medicine
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    • v.26 no.4
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    • pp.77-83
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    • 2012
  • Objectives: The purpose of this study was to assess the effect of Extravascular Laser System on Osgood-Schlatter Disease Methods: In this study, we treated the 6 cases of children who were diagnosed with Osgood-Schlatter disease with Extravascular Laser System. 4 of them were treated with acupuncture as well, the other 2 were given with combined acupuncture and Blood-pricking Treatment. For evaluation, 6 children explained the degree of pain relief by comparing with degree of pain before treatment. Results: Extravascular Laser System for Osgood-Schlatter Disease resulted in a significant decline in the subjective pain degree. All of them were almost cured. The average treatment times was 6.7 times, and the average treatment period was 26.7days. Conclusions We report the good result of the efficacy of extravascular laser system on Osgood-Schlatter Desease. Cases in this study, however, were small in number. Therefore more study is required.

Postinfectious Glomerulonephritis Associated with Pneumococcus and Influenza A Virus Infection in a Child: a Case Report and Literature Review

  • Huh, Homin;Lee, Joon Kee;Yun, Ki Wook;Kang, Hee Gyung;Cheong, Hae Il
    • Pediatric Infection and Vaccine
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    • v.26 no.2
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    • pp.118-123
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    • 2019
  • Postinfectious glomerulonephritis (PIGN) is most commonly caused by Streptococcus pyogenes in children, but PIGN associated with other pathogens has been described in the literature. A previously healthy 6-year-old boy was admitted with complaints of cough, fever, and right chest pain. The patient was diagnosed with pneumococcal bacteremia and influenza A virus infection and treated with antibiotics and antiviral agent. During hospitalization, generalized edema, hematuria, proteinuria, and increased blood pressure were observed; therefore, we started administering diuretics. The boy was discharged with gross hematuria, and even microscopic hematuria disappeared 14 weeks after discharge. We report a case of PIGN associated with bacteremic pneumococcal pneumonia and influenza A virus infection in children. A urine test and blood pressure measurement should be considered for the early detection of PIGN in children with pneumococcal or influenza A virus infection when they present with nephritic symptoms.

United Kingdom pediatric dentistry specialist views on the administration of articaine in children

  • Ezzeldin, Maryam;Hanks, Gemma;Collard, Mechelle
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.20 no.5
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    • pp.303-312
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    • 2020
  • Background: Lidocaine is the gold standard local anesthetic (LA) for UK pediatric dental treatment. Recent reports suggest frequent Articaine use in Europe and Canada, with evidence indicating more profound anesthesia. The aim of this study was to examine pediatric dentistry specialist experiences and practices relating to Articaine administration in the UK. Methods: A literature review was followed by a survey using an anonymous 15-item electronic questionnaire, which was sent to 200 registered British Society of Pediatric Dentistry (BSPD) specialists. Descriptive analyses, Z score, chi-squared test, Fisher's exact test, and Spearman's correlation test were performed. Results: Sixty-one (30.5%) participants responded, and 12 (19.7%) indicated Articaine as their first line anesthetic. Articaine was used daily or weekly by 38 (62.3%) respondents, depending on the clinical context. Articaine was commonly used to avoid inferior alveolar nerve blocks and gain more profound anesthesia in abscessed or hypomineralized teeth. Participants reported significantly more adverse effects with lidocaine (Fisher's exact test, P < 0.0001) than with Articaine. Articaine was most often administered in children aged > 4 years via infiltration techniques. Only 15 (24.6%) respondents reported awareness of guidelines for Articaine use in pediatric patients. Conclusions: Articaine use in pediatric dentistry is common; however, evidence supporting its practice is limited. Several specialists follow conventions based on anecdotal evidence. Formulating guidance to aid decision-making when treating pediatric patients under LA would be beneficial.

Calcified Macroplastique Substance: A Rare Cause of Recurrent Gross Hematuria after Endoscopic Injection

  • Seo, Min Hae;Song, Ji Yeon;Chung, Jae Min;Lee, Sang don;Kim, Su Young;Kim, Seong Heon
    • Childhood Kidney Diseases
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    • v.22 no.2
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    • pp.71-74
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    • 2018
  • Endoscopic subureteral injection for treatment of vesicoureteral reflux (VUR) is known to be safe and efficient due to its minimal invasive nature. Being non-migratory, non-antigenic, and biocompatible, Macroplastique (Polydimethylsiloxane) is likely to be stable over time. A 5-year-old boy with a past history of subureteral administration of Macroplastique for unilateral Grade V VUR 4 years ago presented with recurrent gross and microscopic hematuria, along with suprapubic pain. On computed tomography (CT) abdomen, calcified material, suspected to be a stone, was visualized in the bladder. On diagnostic cystoscopy, calcification was seen around the orifice site where Macroplastique injection had been performed. We removed the calcific material by Holmium laser. Endoscopic subureteric implantation has several advantages, but nevertheless, vigilance is needed to detect long-term complications, especially in patients with gross or microscopic hematuria.

Enterourachal Fistula as an Initial Presentation in Crohn Disease

  • Sankararaman, Senthilkumar;Sabe, Ramy;Sferra, Thomas J.;Khalili, Ali Salar
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.22 no.1
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    • pp.90-97
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    • 2019
  • Crohn disease has a wide spectrum of clinical presentations and rarely can present with complications such as a bowel stricture or fistula. In this case report, we describe a 17-year-old male who presented with a history of recurrent anterior abdominal wall abscesses and dysuria. He was diagnosed with Crohn disease and also found to have a fistulous communication between the terminal ileum and a patent urachus. An ileocecectomy with primary anastomosis and complete resection of the abscess cavity was performed. He is on azathioprine for maintenance therapy and currently in remission. Clinicians should have a high index of suspicion for this complication in Crohn disease patients presenting with symptoms suggestive of urachal anomalies such as suprapubic abdominal pain, dysuria, umbilical discharge, and periumbilical mass.

A Clinical Study on the Effects of Jungjangyobup on 5 Constipation Children (대편난(大便難)을 주소로 하는 소아 환자 5례에 대한 정장요법의 치료 효과에 대한 임상적 고찰)

  • Suk, Yun-Hee;Min, Sang-Yeon;Kim, Jang-Hyun
    • The Journal of Pediatrics of Korean Medicine
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    • v.25 no.3
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    • pp.27-34
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    • 2011
  • Objectives: The purpose of this study is to report the clinical effects of Jungjangyobup on children's constipation. Methods: We treated the 5 case with Jungjangyobup, one of retention enema therapies with Gwakhyangjunggisan. We observed its effects since March 2010 up to November 2011. Results 4 cases out of 5 cases improved constipation and other constipation-related symptomssuch as vomiting, and abdominal pain. Conclusions: This study has shown that oriental medical treatment on children's constipation was effective. The more clinical cases like this case might be needed to confirm this effectiveness of Jungjangyobup.