• Title/Summary/Keyword: pain assessment

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The Relationship Between Resting Scapular Position and Pain Level in Unilateral Shoulder Pain (편측 견부 통증 환자의 안정시 견갑골 자세와 통증수준과의 상관성 연구)

  • Jung, Young-Min;Choi, Jong-Duk
    • Physical Therapy Korea
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    • v.17 no.2
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    • pp.25-32
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    • 2010
  • The purpose of this study was to investigate the most effective and comprehensible method for the assessment of resting scapular position (RSP) and pain level (PL) in unilateral shoulder pain (USP). Fifty volunteers with USP were involved in the study. Resting scapular assessments of the patients' pain sides (PS) and non-pain sides (NPS) were evaluated. The assessment tools for RSP are: 1) sternal notch (SN) to coracoid process (CP) distance 2) 3rd thoracic spinous process (T3S) to posterolateral angle of acromion (PLA) distance 3) scapular index 4) 8th thoracic spinous process (T8S) to inferior angle of scapular (IAS) distance 5) supine measurement of pectoralis minor (PM) distance 6) standing PM distance 7) PM index (PMI) and 8) PM pain. The paired t-test was used to compare PS and NPS in RSP. Pearson correlation analysis was used to confer a relationship between the PL and RSP. The results of this study indicated that: 1) all the variables between the PS and NPS for RSP were statistically significant(p<.05) and 2) the PMI showed the strongest relationship in the correlation analysis between RSP and PL(p<.05, r=.37). Therefore, it can be concluded that there is a relationship between PMI and PL and it is suggested that an assessment tool using PMI to diagnose shoulder pain would be clinically effective.

Development of a Pain Assessment Tool for Critically Ill Patients (중환자 통증사정 도구 개발)

  • Choi, Eun Hee;Kim, Jin Hee;Choi, Kyung Ok;Yoo, Jung Sook;Kim, Mi Soon;Kim, Pil Ja;Jang, In Sun
    • Journal of Korean Clinical Nursing Research
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    • v.18 no.1
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    • pp.136-148
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    • 2012
  • Purpose: The purpose of this study was to develop a reliable and valid pain assessment tool suitable for critically ill patients with communication problem in Korean intensive care unit. Methods: This pain assessment tool, Critical Care Non-verbal Pain Scale (CNPS), was developed based on review of national and international researches. Data were collected from ten intensive care units at five major general hospitals in Seoul. Reliability and validity were tested during performance of position change and endotracheal suctioning. Pain was measured before, during, and 20 minutes after the two procedures. Results: Interrater reliability of the CNPS was analyzed by ICC (Intraclass correlation coefficients). ICC values were significant from .833 to .883. Significant correlation between the FPS (Face Pain Scale) scores and the CNPS scores verified concurrent validity of the CNPS. For position change, CNPS scores increased significantly between before and during (t=-23.399, p<.001) and decreased significantly between during and 20 minutes after (t=22.760, p<.001). For endotracheal suctioning, CNPS scores increased significantly between before and during (t=-29.064, p<.001) and significantly decreased between during and 20 minutes after (t=28.194, p<.001), verifying construct validity of the CNPS. Conclusion: Results indicate that the CNPS can be used to assess pain of critically ill patients who have communication problem.

Effects of Pain, Sleep Disturbance, and Fatigue on the Quality of Life in Patients with Pancreatic Cancer Undergoing Chemotherapy (항암화학요법을 받는 췌장암 환자의 통증, 수면장애, 피로가 삶의 질에 미치는 영향)

  • Kim, Gyung-Duck;Jang, Hyun-Jin
    • Asian Oncology Nursing
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    • v.12 no.2
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    • pp.117-124
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    • 2012
  • Purpose: The purpose of this study was to assess pain, sleep disturbance, fatigue, and the quality of life and to identify the impact of pain, sleep disturbance and fatigue on the quality of life in patients with pancreatic cancer undergoing chemotherapy. Methods: Data were collected from June to July, 2010. Participants were recruited from Y university hospital in Seoul. Research instruments included numeric rating scale for pain, Functional Assessment Chronic Illness Therapy-Functional Well-Being (FACIT-FWB): General Factor 5 (GF5) for sleep disturbance, Functional Assessment of Cancer Therapy-General (FACT-G) for quality of life, and FACT-Fatigue for fatigue. Results: The quality of life for cancer patients had a significant relationship with pain, sleep disturbance, and fatigue. The significant factors influencing quality of life were pain, sleep disturbance, and fatigue that explained 52.6% of the variance. Conclusion: Patients with pancreatic cancer undergoing chemotherapy experienced pain, fatigue, and sleep disturbance which led to a negative effect on quality of life. The results suggest that intervention program to improve quality of life could reduce pain, fatigue, and sleep disturbance of pancreatic cancer patients undergoing chemotherapy.

Effects of Pain Neuroscience Education on Pain, Body Function, Activity Disorders, and Depression in Patients with Chronic low back Pain: Randomized Controlled Trail

  • Kyoung-Gon Oh;Min-Ji Lee;Byoung-Hee Lee
    • Journal of Korean Physical Therapy Science
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    • v.31 no.2
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    • pp.1-14
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    • 2024
  • Background: Many patients with chronic low back pain have reduced movement due to pain. For that reason, muscle strength weakens, which leads to pain again. The pain caused by such a vicious circle is not only caused by structural problems, but also by physical function, activity disorder, or psychological depression due to biopsychosocial approaches and pain neuroscience education was applied as an intervention to find out its effect. Therefore, this study was experimented with to find out the effects of pain neuroscience education on pain, physical function, activity disorder, and depression in patients with chronic low back pain. Design: Randomized control trial Method: The study subjects were 39 patients with chronic low back pain, and the study subjects were randomized through computers to the experimental group applying pain neuroscience education and the control group applying only general physical therapy and myofascial release techniques, and the experiment was conducted for 4 weeks. Pressure Pain Threshold , Schober test, Korean Roland-Morris Disability Questionnaire, Korean Oswestry Disability Index, and Korean Depression Screening Assessment were measured. Results: As a result of the study, there was no significant difference in pain neuroscience education compared to the group that applied only general physical therapy and myofascial release techniques in both lumbar pressure pain thresholds, Schober test, Korean Roland-Morris disability questionnaire, and Korean Oswestry disability questionnaire. However, the Korean Depression Screening Assessment which is the result of measuring depression, showed significant results(p<0.05). Conclusion: Therefore, it is believed that it can be a way to mediate the psychological part through pain neuroscience education for patients with chronic low back pain in the future.

The Assessment Tools in Palliative Medicine (완화 의학에서의 평가도구)

  • Gwak, Jung-Im;Suh, Sang-Yeon
    • Journal of Hospice and Palliative Care
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    • v.12 no.4
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    • pp.177-193
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    • 2009
  • The assessment of patient status in palliative medicine is essential for determining treatments and for clinical outcomes. The objective of assessment tools is to raise the quality of care for individual patients and their families. There are a number of tools available to assess pain, non-pain symptoms and quality of life. The tools are either uni-dimensional or multi-dimensional measures. Unfortunately, however, no single tool is recommended to be a superior to others in symptoms or quality of life assessment. Therefore, to select an appropriate assessment tool, one should consider the time frame and unique characteristics of tools depending on purpose and setting. The combination of prognostic index is highly recommended in prognostication, and web-based prognostic tools are available. Recently, a new objective prognostic score has been constructed through multicenter study in Korea. It does not include clinicalestimates of survival, but includes new objective prognostic factors, therefore, anyone can easily use it. For beginners in palliative medicine, relatively easy-to-use tools would be convenient. We recommend Eastern Cooperative Oncology Group performance status to assess functional status, numeric rating scale for pain assessment and the Korean version of brief pain inventory for initial pain assessment. Asking directly with numeric rating scale or the Korean version of MD Anderson Symptom Inventory would be desirable to assess various symptoms together. We think that European Organization Research and Treatment Quality of Life Questionnaire Core 15 for Palliative Care is good to assess the quality of life, while Objective Prognostic Score is convenient as prognostic index for beginners.

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Practical Management of Cancer Pain (암성 통증의 관리)

  • Jin Seok Jang
    • Journal of Digestive Cancer Research
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    • v.2 no.2
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    • pp.56-63
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    • 2014
  • Cancer pain is one of the most serious undesirable and unsolved complications for the cancer patients. Despite significant improvements in the management of cancer pain through past decades, it is still perceived as insufficient. Effective management of pain starts on a comprehensive assessment to identify the origin and characteristics of the pain. Then, appropriate multidisciplinary medical and surgical interventions could provide optimal treatments. With intensive attentions, complete or partial pain relief with tolerable side effects of the medication will be obtained and it will improve the quality of life of cancer patients.

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Analysis of Medical Records and Development of Chest Pain Care Record in the Emergency Department (의무 기록 분석을 통한 응급실 흉통 간호 기록지 개발)

  • Choi, Gui Yun;Moon, Young Sook;Hong, Eun Seog
    • Korean Journal of Adult Nursing
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    • v.18 no.4
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    • pp.533-542
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    • 2006
  • Purpose: The purposes of this study were to investigate medical records and to develop care records for management of patients with chest pain in the emergency department. Method: Retrospective review of the 42 medical chart of patients presented to the emergency department with chest pain were used. The collected data were analyzed with a frequency of items in the medical records. Results: In a frequency analysis of recorded items for doctors' chest pain assessment during history taking, the history/risk factors was the highest rank. The following ranks were 'commenced with when/timing, extra symptoms, place, nature, stay/radiate, alleviate/aggravate, intensity' in sequence. In a frequency of recorded items in nurse's progress notes according to nursing actions, the 'checking/monitoring' was the highest rank. The following ranks were 'performing, administering/injecting, referring/arranging, testing, preparing/catheterizing, teaching/informing' in sequence. Chest pain care records for the emergency department was designed, based upon data analysis and literature review. Conclusion: The designed records can be a rapid and effective approach tool for assessment and recording of patients with chest pain. Further research is necessary for evaluating the designed chest pain care records.

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A Comparison of Three Low Back Disability Questionnaires With Rasch Analysis (라쉬분석을 이용한 세 가지 요통 장애 설문지의 비교)

  • Kim, Gyoung-Mo;Park, So-Yeon;Yi, Chung-Hwi
    • Physical Therapy Korea
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    • v.18 no.3
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    • pp.94-102
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    • 2011
  • The purpose of this study was to review existing assessment tools for patients with low back pain and improve them through combination. A total of 314 patients with low back pain participated. Their condition was assessed using the Oswestry Disability Questionnaire (ODQ), the Quebec Back Pain Disability Scale (QBPD), and the Back Pain Functional Scale (BPFS). Rasch analysis was applied to identify inappropriate items, item difficulties, and the separation index. In this study, the 'sex life' item of the ODQ (10 items) and the 'sleeping' item of the BPFS (12 items) showed misfit statistics, whereas all items of the QBPD (20 items) were appropriate. After combining the ODQ, QBPD and BPFS, Rasch analysis was applied. The 'pain intensity', and the 'sex life' item of the ODQ and the 'throw a ball' item of QBPD showed misfit statistics. These 3 items were retained for further analysis. The remaining 42 combined ODQ-QBPD-BPFS items were arranged according to difficulty. For all subjects, the most difficult item was 'pain intensity', whereas the easiest was 'take food out of the refrigerator'. As the separation index of 42 combined ODQ-QBPD-BPFS was higher than that of the three questionnaires separately, difficulty of items varied with some need for rearrangement. The results of this study confirmed the possibility and need for a new back pain disability assessment tool, and produced one. Further study is needed to refine the questionnaire in consideration of psychosocial and occupational factors.

Reliability and Validity of Nonverbal Pain Assessment Scale for Patients who Stayed a Intensive Care Units (무의식 중환자의 비언어적 통증사정 도구의 신뢰도와 타당도 검증)

  • Kim, Jung-Soon;Kang, In-Soon;Park, Kyu-Hyun
    • The Korean Journal of Health Service Management
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    • v.9 no.2
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    • pp.89-102
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    • 2015
  • Patients unable to speak are at higher risk for untreated pain. Use of valid behavioral and physiologic measures for pain is highly recommended for uncommunicative patients. This study was performed to compare the reliability and validity of NVPS-K and CPOT-K for pain assessment of nonverbal patients. This study was conducted from July to November 2011. A total of 29 nonverbal adult patients admitted to a university hospital intensive care unit participated in this study. Interrater reliability of the NVPS-K and CPOT-K had intermediate to high intraclass correlation coefficients (NVPS-K 0.680 ~ 0.921, CPOT-K 0.710 ~ 0.896). Discriminant validity was supported with higher instrument scores during turning and endotracheal suctioning than that of NIBP. For criterion validity, the NVPS-K scores were correlated to the self-reported pain of the patients but not the CPOT-K scores. The areas under the ROC curve for the NVPS-K and CPOT-K were 0.748 and 0.696 with cutoff points of 1 and 2, respectively. Thus, the NVPS-K and CPOT-K had a sensitivity and specificity of 94.7% and 45.0%, and 60.5% and 75.0%, respectively. The NVPS-K and CPOT-K are reliable and valid tools to assess pain in nonverbal patient and thus, are recommended for the assessment of the pain in nonverbal patients.

Effectiveness and Safety of Korean Medicine for Trigeminal Neuralgia: A Case Report

  • Bae, Ji Min;Kim, Dae Hun;Lee, Byung Ryul;Yang, Gi Young
    • Journal of Acupuncture Research
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    • v.34 no.1
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    • pp.59-66
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    • 2017
  • Objectives : This study aims to report the effectiveness and safety of Korean medicine with thread embedding acupuncture in the treatment of trigeminal neuralgia (TN). Methods : A 73-year-old man who had suffered from severe facial pain for one year and who had had a healthy tooth extracted due to the pain is reported. He could not eat or sleep due to the severe pain. Acupuncture, thread embedding acupuncture, cupping, herbal steam, and herbal medicines were used for the treatment. Numeric Rating Scale (NRS) and adverse events were checked daily, and other outcomes (Baseline Evaluation, Visual Analogue Scale [VAS], Short Form Health Survey 36-Bodily Pain [SF-36 BP], and Patient Global Assessment [PGA]) were measured at hospital admission and discharge. During the follow-up examinations, his pain was evaluated roughly, without using any formal measurements, on the basis of a global assessment. Results : All measured parameters, including pain, quality of life, and patient satisfaction were noted to have improved at the time of discharge compared to admission: VAS from 10 to 1.5, NRS from 7-8 to 1-2, and SF-36 BP from 0 to 22.5, and the patient's global assessment was somewhat improved. He did not take any analgesics after discharge and noted only mild adverse events, like pain where the acupuncture and thread embedding acupuncture needles were inserted. His pain relief was maintained for 6 months. Conclusion : Korean medicine with thread embedding acupuncture might be a safe and effective treatment for TN. In the future, larger sample sizes and high quality randomized clinical trials are warranted to confirm its efficacy and safety.