• Title/Summary/Keyword: pain intervention

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Comparative Study on Surgical and Conservative Management of Bisphosphonate-related Osteonecrosis of the Jaw (BRONJ) in Disease Stage 2 (비스포스포네이트 관련 악골괴사(BRONJ)의 병기 2기에서의 외과적, 보존적 치료에 대한 비교 연구)

  • Lee, Ho Kyung;Seo, Mi Hyun;Pang, Kang Mi;Song, Seung Il;Lee, Jeong Keun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.35 no.5
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    • pp.302-309
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    • 2013
  • Purpose: This study evaluated the prognosis of conservative and surgical treatment according to the staging of bisphosphonate-related osteonecrosis of jaw (BRONJ) by American Association of Oral and Maxillofacial Surgeons and American Society for Bone and Mineral Research. Methods: We evaluated 53 patients of BRONJ who visited Department of Dentistry, Ajou University School of Medicine from May 2007 to February 2013. Twenty eight patients in stage 2, were divided into surgical and conservative groups with cessation of bisphosphonate therapy. Fifteen patients belonged to the conservative treatment group, in which mouth rinsing and antibiotics medication were done. Thirteen patients were treated with debridement or sequestrectomy, in the surgical treatment group. Each study list was analyzed by SPSS ver. 14.0 (SPSS Inc., USA) software and the favorable rate was verified by the Fisher exact test. P-values less than 0.05% were deemed significant. Results: Clinical outcome was evaluated on the basis of both clinical and radiographic findings. Of all the 28 patients of stage 2, 15 patients underwent conservative treatment and 13 patients received surgical treatment. In the surgical group, 9 of 13 (69.2%) showed good prognosis, 4 of 13 (30.7%) showed recurrence. In the conservative group, 13 of 15 (86.6%) showed no change duting the follow-up period. Two of 15 patients even showed a bad prognosis, such as pain and pus discharge, which are criteria for stage 3. P-value was 0.067 (>0.05). Conclusion: The results of the present study suggests that surgical intervention is good choice against the conservative treatment, after proper drug holidays period, while further investigation is needed for a definite solution to BRONJ.

Trends in Research on Hospice Care in Korea (호스피스 간호 관련 국내 연구 동향)

  • Lee, Young-Eun;Choi, Eun-Joung
    • Journal of Hospice and Palliative Care
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    • v.14 no.3
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    • pp.152-162
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    • 2011
  • Purpose: This study was conducted to analyze a trend in studies of hospice care in Korea and to suggest future research directions. Methods: This study analyzed a total of 183 studies related to hospice care which were found at http://www.riss.kr. Results: Of the 183 studies, 62 (33.9%) were for thesis studies for a degree, 121 (66.1%) for academic journals. There were 159 (87.8%) quantitative studies, 18 (8.9%) qualitative studies, and 6 (3.3%) Q-Method studies. The most frequently used study design was a descriptive study. The majority of study participants were terminal cancer patients, patients' family members and health care personnel. The thesis articles were searched by using key words as follows: health, nursing, environment, children's hospice, and others. Conclusion: The number of studies of hospice care has increased, and research key words varied. Furthermore, more experimental research is needed on nursing intervention such as pain relief, alternative therapies and hospice care for children.

Active Coping Strategy Model for Chronic Arthritis : Appling Internal Model of World and Coping Resource (내적모형과 대응자원을 이용한 만성관절염 환자의 적극적 대응전략모형)

  • Mun, Mi-Sook;Lim, Nan-Young
    • Journal of muscle and joint health
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    • v.6 no.1
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    • pp.100-135
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    • 1999
  • Typical symptoms of rheumatic disease affect overall daily living and cause severe stress. Individuals afflicted with rheumatic disease have many illness-related stresses. Pain was the predominantly perceived stress followed by limitation in mobility, difficulties in carrying out activities of daily living. helplessness, dependency on others, threat to self-esteem, interference in social activity, interference in family relationships. difficulties performing at work, and discomfort of the treatment. Patients with chronic arthritis are subjected to long periods of continuous stress, which may require the management by the health care provider. In these cases, the purpose of the nursing is helping to promote health through supporting patient's coping. Therefore, for the nursing intervention to be effective, it is critical to build a theoretical framework that describes stress-coping for chronic arthritis. Thus, the purpose of this dissertation is to present a theoretical framework which describes the stress-coping processes and to empirically test pathos of this framework for the people with chronic arthritis. The foundation upon which this framework is built in the Erickson, Tomlin, and Swain(1983) theory of Modeling and role-Modeling. The subjects were 275 patients with rheumatoid arthritis or osteoarthritis who visited the outpatient clinic. A hypothetical model of stress-coping was tested by covariance structure analysis with PC-LISREL 8.12 program. As a result, the overall fit was good(Chi-square=94.49, P=0.00, RMR=0.067, GFI=0.95, AGFI=0.91, NNFI=0.93, NFI=0.91) for the hypothetical model. The results of hypothesis testing were as follows : Basic need satisfaction had a statistically significant influence on illness-related experience, emotional stress and coping resources. Internal health locus of control had a statistically significant influence on coping resources. However, independent variables(basic need satisfaction, internal health locus of control, illness-related experience, emotional stress and coping resource) did not have significantly influence on coping. And then, the hypothetical model was modified by considering both the theoretical implication and statistical significance of the parameter estimates. The revised model had a better fit to the data(Chi-square=83.11(P=0.00), RMR=0.061, GFI=0.96, AGFI=0.92, NNFI=0.95, NFI=0.92). Hypothesis emerged from the revised model was tested. The results of hypothesis testing were as follows : Basic need satisfaction had a statistically significant influence on illness-related experience, emotional stress and coping resources. Internal health locus of control had a statistically significant influence on illness-related experience and coping resources. Internal health locus of control, illness-related experience, emotional stress and coping resources had a significantly influence on coping. According to the results of this dissertation, basic need satisfaction and internal health locus of control play a central role in appraisal of illness-related experience and coping resources. And illness related-experience, emotional stress, and coping resources affect on coping activities. In summary, nursing interventions to enhance basic need satisfaction and internal health locus of control will decrease illness related experience and emotional stress and increase coping resources. Increased coping resources will prompt coping activities.

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Disease Characteristics and Behavior Pattern of Treatment for Patient with Fibromyalgia (섬유조직염 환자의 질병 특성과 치료행태)

  • Han, Sang-Sook;Kang, Hyun-Sook
    • Journal of muscle and joint health
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    • v.6 no.1
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    • pp.22-36
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    • 1999
  • The purpose of the study was to identify disease characteristics and behavior pattern of treatment for patients with Fibromyalgia. This study was carried out between May to Aug. in 1998 through direct interview in Rheumatism clinic at H. University Hospital and subject in this study were 125 outpatients diagnosed with Fibromyalgia. Collected data were analyzed by descriptive statistics and t-test, ANOVA using SPSS Window program. The results of this study are as follows. 1. General Characteristics : All of the persons with Fibromyalgia were female who were mostly in their forties(37.5%). A third of them(38.4%) were graduated from high school. The greatest part of them(54.4%) were christians but little part of them(16.8%) were employed 2. Disease Characteristics : They have struggled with Fibromyalgia for 10 years on an average. About half of them(56.9%) suffered from Fibromyalgia only but the others had another diseases which were in greatest part occupied by Osteoarthritis. The number of tender point which is a feature of Fibromyalgia differed according to measuring criteria. Yunus criteria. however, was proved to be the most proper measuring criteria than any other method as it showed high correlations between symptoms and physical activities. The most serious symptoms that complained the patients among subjective symptoms are pain, sleep disorder, and fatigue in sequence, and activities most hard to do among physical activities are washing by hand, scrubbing by hand, and shopping in sequence. 3. Behavior Pattern of Treatment : The largest part of them(42.4%) had received medical treatment after they were determined to have the disease and most of them were taking medicine as prescribed by physician(88.8%) or other medicines(16.8%), Of them, two thirds stated that the medicine they took were effective. Around a third of them took exercises mostly composed of swimming. The medical institution they visited in the past were orthopedic surgical department, Oriental hospital, physical therapy department in sequence and, in a slight percent(11.4%), psychiatric department. 4. Relations between Disease Characteristics and Behavior pattern of Treatment : It shows that number of tender point and level of symptom are significantly different according to duration of disease and medical intervention. As a results, it can be suggest that persons with Fibromyalgia need to take exercises and medicine continually regardless of medical treatment as it is a chronic disease whose symptoms are hardly mitigated.

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A Study on the Health as Perceived by the Aged (노인들이 지각하고 있는 건강수준에 관한 연구)

  • Yang, Koung-Hee;Jang, Hey-Sook;Kim, Young-Hee
    • Research in Community and Public Health Nursing
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    • v.7 no.2
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    • pp.229-243
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    • 1996
  • The purpose of this study was to develop a nursing model for the aged. This study was conducted to measure the physical, psychological and mental health status of the aged and to identify relationships between these health levels and various variables. The data were collected from 172 aged(over 60 years old) by interviews. The tools used for this study was a structured questionnaire which was developed and revised by the researchers. The tool consisted of 22 items on physical health assessment, 7 items on psychological health assessment, 9 items on mental health assessment and 10 items on an ADL evaluation. The major results of the study were as follows ; 1. In physical health, the aged complained of visual disturbance(60.5%), incontinence of urine (55.2%), back or muscle pain(73.3%), dizziness(70.3%) and diarrhea or constipation(44.2%). In psychological health, most aged people felt anger when they got some order from an other person(80.2%). Also, they had depression (69.8%) and felt like dying(64.0%). The ADL level was mostly normal for daily life. 2. The aged man was more healthy than the aged woman in physical and mental health especially the 60-64 year old group. The physical, mental health and ADL level had a positive correlation with age(p>.004), but psychological health had a negative correlation with age. 3. The physical, psychological, mental health and ADL level was positively interrelated with each other. 4. The physical, mental health, & ADL level lowered with inceasing age. Physical & psychological health worsened rapidly from 65-69 years, but for 10-15 years, their health level was preserved. Psychological health level was high in 80-84. 5. The physical health was affected by edu cational level, sex and pocket money (R=.4029, 16.24%). The psychological health was affected by the supportive style and pocket money (R=.5128, 26.30%). And the mental health was affected by education level, age, support ive style, sex and job(R=.4377, 19.16%). As seen above, we suggest the intervention of the young for the old to cope with their life and to maintain their healthy late adulthood. Also, if they have received psychological support in the institution, they will maintain healthy life condition. For further studies should be a search for variables that affect aged health, and should contribut to a nursing program better suited for the aged.

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Effects of Dancing Healing on Post-traumatic Growth -Focused on Female Victims of Domestic Violence in Shelter- (춤 치유가 외상 후 성장에 미치는 효과 -쉼터거주 가정폭력 피해여성을 중심으로-)

  • Shin, Woo-Jung;Lim, Dong-Ho
    • The Journal of the Korea Contents Association
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    • v.18 no.2
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    • pp.158-168
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    • 2018
  • The purpose of this study was to investigate the effect of applying physical expression program through dancing on the post-traumatic growth of domestic violence female victims. The subjects of this study were female victims of domestic violence living in shelters (7 facilities) for women victims of domestic violence in Seoul, consisting of 23 experimental groups and 23 control groups. The dancing healing physical expression program applied to the experimental group consisted of 18 sessions, which was conducted three times a week for 6 weeks, and each session was conducted for 90 minutes. This study was aimed to dancing based on physical expression and movement experience, but focuses on improvisational, non-formal and creative expression for inner expression. We referred to the activities and principles of previous studies, and applied characters, which were counseling techniques, interactions, and healing principles of previous counseling psychology studies on domestic violence and trauma, to every stage of the session. As a result of this study, it was found that the dancing healing physical expression program had an effect on the entire post-traumatic growth of the experimental group and lower dimension lists of the depth of interpersonal relationship, self-perception, potential discovery, spiritual interest level, The results of the post - test were compared. There was a significant difference between the experimental and control groups after the test. In conclusion, this study aimed to understand the fundamental and healing attributes of dance, and provided basic data to establish a virtuous intervention strategy that provided opportunities for self-recovery to those who experienced psychological pain, such as women victimized by domestic violence at the social aspect.

Effects of Healing Beats program on patients' anxiety, stress, systolic blood pressure, heart rate and Bis Index after epidural blocking : A randomized controlled trial (Healing Beats 프로그램이 경막외강차단 시술 후 환자의 불안, 스트레스, 수축기 혈압, 심박동수 및 Bis Index에 미치는 효과 : 무작위대조군)

  • Bae, Ik Lyul;Song, Ji Ah
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.21 no.7
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    • pp.54-65
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    • 2020
  • This randomized pre-post-controlled experimental study determined the effect on patients' anxiety, stress, systolic blood pressure, heart rate and Bis index when the Healing Beats program is applied after epidural blockage. The subjects were selected from the patients who visited the Department of Anesthesiology and Pain for the treatment of epidural blockage and volunteered through the recruitment announcement. A total of 74 sets of data were collected and analyzed with 25 subjects in the experimental group, 24 in the placebo group, and 25 in the control group. The data was analyzed using descriptive statistics, x2-tests, F-tests and repeated measures of ANOVA. As a result of the study, the general characteristics and variables of the experimental group, placebo group, and control group were all the same, and anxiety was measured twice before and after the study. There were significant differences between groups (F=27.175, p<.001), and stress (F=4.78, p<.001), heart rate (F=4.22, p<.001) and the Bis index (F=7.96, p<.001) were analyzed by variance according to population and time. There was a significant difference. However, there was no significant difference in systolic blood pressure (F=1.23, p=.298). In conclusion, the Healing Beats program can be used as an effective and effective intervention for sedation in clinical situations or stressful situations.

Integrative Review of Guidelines Related Symptom Management and Physical Activity for Developing of Self-Care Management Program for Cancer Survivors (암생존자의 자가관리 프로그램 개발을 위한 증상관리 및 신체적 활동 관련 가이드라인의 통합적 고찰)

  • Song, Chi Eun
    • The Journal of the Korea Contents Association
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    • v.18 no.4
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    • pp.586-600
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    • 2018
  • The purpose of this study attempted to collect basic data for development of an integrated self-management program for cancer survivors who completed cancer treatment. Self-management programs are divided into symptom management and physical activity management. Symptom management includes fatigue, sleep disturbance, pain, depression and anxiety. PubMed, CINAHL and EMBASE were used for searching guidelines. Based on the guideline quality evaluation, the final 8 guidelines were analyzed. The structured table was used to extract the screening subjects, timing, contents, subjects for comprehensive assessment and contents, and summarized contents related to the physical activity and exercise in non-pharmacological approach. As a result, after the completion of cancer treatment, all cancer survivors should be screened regularly using reliable and validated tools. In the case of fatigue, physical activity was recommended as the primary intervention, but it was recommended for other symptoms as adjuvant therapy. Therefore, Cancer survivors should be encouraged to be active in their physical activity, and maintain the moderate intensity physical activity as long as they have no complication related to the cancer treatment. Motivation strategies for physical activity need to be developed and applied.

Effects of Very Low Calorie Diet using Meal Replacements on Weight Reduction and Health in the Obese Adult Women (식사대용식을 이용한 초저열량 식사요법이 성인 비만 여성들의 체중감량과 건강에 미치는 효과)

  • Kim Jiyoung;Kim Sangyeon;Jung Kyung-Ah;Chang Yukyung;Choi Hyeongsuk;Choi Sung;Park Mihyeon;Hong Seonggi1;Hwang Sungjoo
    • Journal of Nutrition and Health
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    • v.38 no.9
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    • pp.739-749
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    • 2005
  • This study was performed to investigate the effects of very low calorie diet (VLCD) using newly meal replacements that contain the wild grass extracts based on Samul-tang ingredients on weight reduction and health in the obese adult women ($BMI{\geq}25\;kg/^2$) for four weeks. Seventy five women participated in this experiment. Subjects were randomly classified three groups: 1) General Diet group (GD group, n=25) consumed 3 regular meals within 600 kcal/day, 2) Meal replacements group (MR group, n=25) consumed 1 regular meal and 2 meal replacements within 600 kcal/day, 3) Herbal Meal replacements group (HMR group, n=25) consumed 1 regular meal and 2 meal replacements within 600 kcal/day. Anthropometric measurements, body composition, biochemical measurements and body symptoms were assessed before (the initial) and after (the 4th week) the study. Anthropometry measurements such as weight, waist and hip circumference, and BMI and body composition such as body fat percent, fat mass significantly decreased in all groups after diet intervention. Anthropometric measurements and body composition of the ]lim group significantly decreased more than those of GD and MR groups. Serum Total cholesterol was significantly decreased in all groups. However, there was no significant difference among three groups during the experimental period. HMR group had significantly less felt a pain than GD and MR groups in body symptoms such as anemia, powerlessness, vomiting, constipation and dryness of skin during the experimental period. Therefore, very low calorie diet (VLCD) using meal replacements that contain the wild grass extracts based on Samul-tang ingredients was very effective on weight reduction and health in the obese adult women.

Laminotomy with Continuous Irrigation in Patients with Pyogenic Spondylitis in Thoracic and Lumbar Spine

  • Kim, Sung-Hyun;Lee, Jung-Kil;Jang, Jae-Won;Seo, Bo-Ra;Kim, Tae-Sun;Kim, Soo-Han
    • Journal of Korean Neurosurgical Society
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    • v.50 no.4
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    • pp.332-340
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    • 2011
  • Objective : Pyogenic spondylitis often results in acute neurological deterioration requiring adequate surgical intervention and appropriate antibiotic treatment. The purpose of this study was to conduct an analysis of the clinical effect of continuous irrigation via laminotomy in a series of patients with pyogenic spondylitis in thoracic and lumbar spine. Methods : The authors conducted a retrospective investigation of 31 consecutive patients with pyogenic thoracic and lumbar spondylitis who underwent continuous irrigation through laminotomy from 2004 to 2008. The study included 22 men and 9 women, ranging in age from 38 to 78 years (mean 58.1 years). The average follow-up duration was 13.4 months (range, 8-34 months). We performed debridement and abscess removal after simple laminotomy, and then washed out epidural and disc space using a continuous irrigation system. Broad spectrum antibiotics were administered empirically and changed according to the subsequent culture result. Clinical outcomes were based on the low back outcome scale (LBOS), visual analogue scale (VAS) score, and Frankel grade at the last follow-up. Radiological assessment involved plain radiographs, including functional views. Results : Common predisposing factors included local injection for pain therapy, diabetes mellitus, chronic renal failure, and liver cirrhosis. Causative microorganisms were identified in 22 cases (70.9%) : Staphylococcus aureus and Streptococcus spp. were the main organisms. After surgery, LBOS, VAS score, and Frankel grade showed significant improvement in most patients. Spinal stability was maintained during the follow-up period, making secondary reconstructive surgery unnecessary for all patients, except one. Conclusion : Simple laminotomy with continuous irrigation by insertion of a catheter into intervertebral disc space or epidural space was minimally invasive and effective in the treatment of pyogenic spondylitis. This procedure could be a beneficial treatment option in patients with thoracolumbar spondylitis combined with minimal or moderate destructive change of vertebrae.