• Title/Summary/Keyword: non-pharmacological intervention

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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.

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.

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.

Effects of Pain Management Education on Pain of the Terminal Cancer Patients at Home (통증관리 교육이 재가 말기암 환자의 통증에 미치는 효과)

  • Kwon, In-Gak;Whang, Moon-Sook;Kim, Ji-Hyeon
    • Asian Oncology Nursing
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    • v.2 no.1
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    • pp.36-49
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    • 2002
  • The purpose of this study was to evaluate the effects of the pain management education on pain of the terminal cancer patients at home. For evaluating the effectiveness of the intervention modified Patient Outcome Questionnaire (APS, 1995) including patients concerns with cancer pain management, pain intensity, and interference of daily activities related to pain were measured before and after the education in control group and experimental group and the differences were compared with each other. Satisfaction with pain management was measured after the intervention. Pain management education was delivered to 16 experimental group patients by home care nurses, who were provided with 3-hour education on cancer pain management by one of the researchers. Pain management education included common misconceptions about cancer pain control and pharmacological and non-pharmacological interventions and emphasis was put on the importance of pain reports and patients' active participation in pain management. The results of the study were as follows. Patients concerns with pain management were decreased more greatly in the experimental group than those of the control group. The worst, average, and present pain intensities during the last 24 hours were decreased more greatly in the experimental group, and total score and each subcategory of the interference of daily living, except walking, were decreased more greatly in the experimental group. And satisfaction score with total pain management and nurses response to the pain reports were higher in the experimental group. The results of this study suggest that pain management education given to the patients by home care nurses is a very useful intervention to improve pain of the cancer patients at home. This positive result is thought to derive from patients' active pain report and participation in pain control and the use of powder form sustained release morphine for breakthrough pain control in part. Further studies with increased sample size from more institutions are recommended and early introduction of short acting morphine is strongly suggested for effective cancer pain control.

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Addition of Myofascial Release Therapy to Therapeutic Exercise for Management of Nonspecific Neck Pain

  • Ha, Yangsun;Hahm, Suk-Chan
    • Journal of The Korean Society of Integrative Medicine
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    • v.9 no.2
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    • pp.35-41
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    • 2021
  • Purpose : It is necessary to demonstrate the effect of non-invasive and non-pharmacological interventions such as manual therapy and therapeutic exercise for the management of nonspecific neck pain. In the present study, we aimed to investigate the efficacy of myofascial release therapy plus therapeutic exercise for disability owing to neck pain and quality of life in individuals with nonspecific neck pain. Methods : Eighteen participants with nonspecific neck pain were randomly allocated to intervention (n=9) and control groups (n=9). The intervention group received a myofascial release therapy for 20 min and performed neck stabilization exercises for 30 min twice a week for 4 weeks. The control group performed neck stabilization exercises for 30 min twice a week for 4 weeks at the same time points as the intervention group. Disability owing to neck pain and quality of life were quantified using the neck disability index (NDI) and the Korean version of the World Health Organization Quality of Life Brief Version (WHOQOL-BREF), respectively. NDI and WHOQOL-BREF were assessed before and after intervention. Results : The disability owing to neck pain significantly changed between the groups over time (total score of NDI, p=.049). There were significant time and group interactions in pain (pain intensity of NDI, p=.035) and concentration (concentration of NDI, p=.049). Personal care, lifting, reading, headaches, work, driving, sleeping, and recreation did not show significant improvement between the groups over time. Total score, overall quality of life and general health, physical health domain, psychological domain, social relationships domain, and environmental domain quantified by WHOQOL-BREF did not show significant improvements between the groups over time. Conclusion : These results suggest the clinical use of myofascial release therapy in addition to therapeutic exercise for the management of nonspecific neck pain. Further studies are needed to generalize the findings of this study.

Effect of Cognitive Improvement Programs for Mild Cognitive Impairment in Korean Elderly: A Meta-Analysis (한국 경도인지장애 노인을 위한 인지기능 향상 프로그램의 효과: 메타분석)

  • Kim, Kyoungyun;Lee, Eunjoo
    • Korean Journal of Adult Nursing
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    • v.29 no.2
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    • pp.177-189
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    • 2017
  • Purpose: A meta-analysis was conducted to identify the effect of cognitive improvement programs for the elderly with mild cognitive impairment (MCI) in Korea. Methods: Five databases, as well as relevant reference lists, of studies published from 2000 to 2016, were searched. Fourteen studies were identified. Quality assessments of included studies were conducted using the Scottish Intercollegiate Guidelines Network checklist. An R program was used to analyze effect sizes and to identify possible sources of heterogeneity among studies. The potential for publication bias was investigated using a funnel plot, Egger's regression test and sensitivity analysis. Results: The total effect size was large (Standardized Mean Difference [SMD]=1.44, 95% CI: 1.11~1.77), with cognition based intervention (SMD= 1.77, 95% CI: 1.26~2.29) and exercise intervention (SMD=1.13, 95% CI: 0.82~1.44). Statistically significant moderators were identified intervention type by meta-ANOVA analyses. Finally, no significant evidence of publication bias was found. Conclusion: There is clear evidence that cognitive improvement programs can greatly enhance cognition in elderly with MCI. Future research should examine the effects of non-pharmacological interventions targeting elderly populations with mild-to-severe cognitive impairment in order to develop and enhance the effectiveness of cognitive improvement programs in Korea.

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.

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.

Effects of Music Therapy on Agitation in Dementia: Systematic Review and Meta-analysis (음악요법이 치매의 초조행동에 미치는 효과: 체계적 문헌고찰 및 메타분석)

  • Kong, Eun-Hi;Park, Myonghwa
    • Korean Journal of Adult Nursing
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    • v.27 no.1
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    • pp.106-116
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    • 2015
  • Purpose: The purpose of this review was to assess the quality and to evaluate the effectiveness of music interventions in reducing agitation in older adults with dementia. Methods: Randomized controlled studies and randomized crossover studies were identified by searching MEDLINE, EMBASE, CINAHL, PsycINFO, AGELINE, Cochrane Central Register of Controlled Trials, Korea Med, Kmbase, RISS, National Assembly Digital Library, KISS, and RICH. Two reviewers independently retrieved articles, extracted data, and assessed the quality of studies. Results: In total, 10 studies were selected from 1095 unique citations. All included studies were conducted in long term care settings. Overall, risk of bias for included studies was low to moderate. The weighted average effect size across studies was -0.39 (95%CI [-0.69, -0.10], p=.009, $I^2=63%$). Music therapy was effective to reduce agitation of the older adults with dementia. Conclusion: Music intervention can be an effective non-pharmacological intervention for the reduction of agitation in dementia. Future studies need to use rigorous research method and to provide description of research methods in greater detail. In addition, future studies are required to explore the effects of music therapy according to severity of agitation and dementia.