• Title/Summary/Keyword: pain management

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Sufficient explanation of management affects patient satisfaction and the practice of post-treatment management in spinal pain, a multicenter study of 1007 patients

  • Kim, Jae Yun;Shim, Jae Hang;Hong, Sung Jun;Yang, Jong Yeun;Choi, Hey Ran;Lim, Yun Hee;Moon, Ho Sik;Lee, Jaemoon;Kim, Jae Hun
    • The Korean Journal of Pain
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    • v.30 no.2
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    • pp.116-125
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    • 2017
  • Background: Spinal pain is most common symptom in pain clinic. In most cases, before the treatment of spinal pain, physician explains the patient's disease and treatment. We investigated patient's satisfaction and physician's explanation related to treatments in spinal pain patients by questionnaires. Methods: Anonymous questionnaires about physician's explanation and patient's satisfaction in each treatment and post-treatment management were asked to individuals suffering from spinal pain. Patients who have spinal pain were participated in our survey of nationwide university hospitals in Korea. The relationships between patient's satisfaction and other factors were analyzed. Results: Between June 2016 and August 2016, 1007 patients in 37 university hospitals completed the questionnaire. In the statistical analysis, patient's satisfaction of treatment increased when pain severity was low or received sufficient preceding explanation about nerve block and medication (P < 0.01). Sufficient explanation increased patient's necessity of a post-treatment management and patients' performance rate of post-treatment management (P < 0.01). Conclusions: These results show that sufficient explanation increased patients' satisfaction after nerve block and medication. Sufficient explanation also increased the practice of patients' post-treatment management.

Nurses' Knowledge and Performance of Pain Management at a General hospital (일 개 종합병원 간호사의 통증관리 지식과 통증 관리 수행)

  • Han, Ji-Young;Park, Hyun-Sook;Jin, Mi-Jung
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.23 no.1
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    • pp.6-11
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    • 2016
  • Purpose: This study was done to describe level of knowledge and performance of pain management by nurses in general hospitals. Methods: The study was conducted from August 1 to 28, 2014 with 141 nurses from a general hospital in B city. Data were analyzed using descriptive statistics, t-test, one-way ANOVA, and Pearson correlation coefficient with SPSS 20.0. Results: Average correct response rate for knowledge was 62.7%, indicating poor knowledge of pain management. Mean score for knowledge of pain management was $31.33{\pm}3.24$ out of 50(general knowledge about pain $14.02{\pm}2.18$ out of 20, knowledge on use of analgesics $9.21{\pm}1.97$ out of 20, knowledge on analgesic classification $8.16{\pm}1.00$ out of 10). Mean score for performance of pain management was $3.19{\pm}.44$ out of 4. There was significant difference in knowledge of pain management by age. Performance of pain management differed significantly according to age and type of working unit. No significant relationship was found between knowledge and performance of pain management. Conclusion: These findings show that nurses who have good knowledge do not always have good performance of pain management. Therefore, it is necessary to develop new strategies to promote performance as well as continued pain management education to increase ability of nurses to manage pain.

Comparison of Pain Management between before and after the Application of Guidelines in Cancer Emergency Room (암성통증관리지침 적용 전후 긴급진료실 내원 환자의 통증관리 비교)

  • Won, Young-Hwa;Kim, Yeon-Hee;Park, Jeong-Yun
    • Asian Oncology Nursing
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    • v.12 no.3
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    • pp.230-236
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    • 2012
  • Purpose: This study was to investigate the effect of the application of cancer pain management guidelines on pain management among patients in Cancer Emergency Room. Methods: This study was a retrospective descriptive study. Before application, data were collected by analyzing the Electronic Medical Record in Cancer Emergency Room in September, 2011, and after application in February, 2012. The subjects of this study consisted of 231 patients (pre-application group 83, post-application group 148), who stayed over 24 hours and complained of pain higher than Numeric Rating Scale score 4. The post-test was conducted after educating the nurses about the application of the pain management guidelines in the Electronic Medical Record. Results: This survey showed that, as the cancer pain management guidelines were applied for cancer patients with above moderate pain, the pain intensity decreased, the number of patients reaching the treatment goal score increased. Furthermore, the estimated time to reach the treatment goal decreased significantly. Conclusion: Pain intensity of the cancer patients was decreased through regular pain assessments by nurses and the medication of analgesics according to the cancer pain management guidelines. Therefore, it is necessary to develop the pain management program and to provide the physicians and nurses with intensive education about the pain management guidelines for systematic and effective pain management.

A Study on Patients' Concerns about Management of Cancer Pain and Related Factors (종양통증관리를 방해하는 환자의 염려와 관련요인 연구)

  • Kim, Hong-Soo;Suh, Moon-Ja
    • The Korean Journal of Rehabilitation Nursing
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    • v.3 no.1
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    • pp.43-58
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    • 2000
  • Pain management is a major issue in caring of cancer patients. Patients' concerns for reporting pain and taking analgesics are patient-related barriers to the management of cancer pain. Since such study has not been done at all in Korea, it is clearly needed to study on these problems. The purpose of this study is to attain basic data in order to improve cancer pain management in Korea. This is done by: 1) examining the extent of patients' concerns that might be barriers to the optimal pain management, and the extent of related factors (pain management hesitancy, adequacy of using analgesics, pain severity and pain interference); 2) identifying the relationship between patients' concerns and the related factors. The data has been collected from 180 cancer patients who were hospitalized in medical wards of one university hospital in Seoul, Korea during the period from November 1, 1997 to February 28, 1998. The data has been collected through interviews with (1) Barriers Questionnaire - Korean Version (BQ-K); (2) Hesitancy Experience Questionnaires (HQ); (3) Pain Management Index (PMI); (4) Brief Pain Inventory (BPI); and (5) Demographic Data. The data were analyzed by descriptive statistics and by t-test, One-way ANOVA, Pearson correlation using SPSSWIN program. The Results are as following: 1) The mean scores of Pain Management Concerns (PMC) by BQ-K were toward the moderate with a little high points(2.59). Most of the patients (99.4%) had some extent of concerns (over lout of maximum 5 points). Among the eight subscales of BQ-K, the Pain Management Concerns (PMC) about 'Fear of tolerance' was the highest (3.80) and 'Worry about side effects' was the least (1.40). 2) The extent of Pain Management Hesitancy (PMH) by HQ of wnom had pain on the day of the interview was a little higher than moderate score(5.53 out of maximum 10 points). 6.7% of the patients with experiencing pain used less adequate analgesics for the severity of pain than they were expected. 27.8% of them never used any analgesics at all. The mean score of pain severity by BPI was 16.59 (maximum: 40), and that of the interference with daily life by BPI was 32.03 (maximum: 70). 3) The patients who were older, less educated, and in low socio-economic status were likely to have more concerns. Pain Management Concerns (PMC) was positively correlated with Pain Management Hesitancy (PMH) (r=.75), pain severity (r=.44) and pain interference (r=.50). Those who were not using adequate analgesics had higher Pain Management Concerns (PMC) than did those who were using adequate analgesics (t=-5.42). The patients who had more Pain Management Concerns (PMC) tended to hesitate more to report pain and to use analgesics. They used more inadequate analgesics for the severity of pain and also had experienced more pain severity and interference with daily life. In conclusion, the patients' concerns for reporting pain and for using analgesics are major patient-related barriers to cancer pain management in Korea. The patients' concerns were correlated significantly with the level of the hesitancy experience, inadequate use of analgesics, the pain severity and the interference with daily life. Considering this, an educational program for cancer patients under the treatment with analgesics should be developed in order to solve these problems.

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Clinical Nurses' Knowledge and Attitudes on Pain Management (임상간호사의 통증관리에 대한 지식과 태도)

  • Hyun, Ju;Park, Kyung Sook
    • Korean Journal of Adult Nursing
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    • v.12 no.3
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    • pp.369-383
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    • 2000
  • The purpose of this study was to understand clinical nurses' knowledge and attitudes on pain management. The subject of the study were 254 nurses working at two hospitals affiliated with a university in Seoul. The questionnaires included four areas: general knowledge on pain, knowledge on the use of analgesia, knowledge and implementation on the pain assessment scales and pain interventions and nurses' general characteristics. The data were analyzed with descriptive statistics, analysis of variance, LSD test and t-test using SPSS statistical package. The results were as follows. 1. The mean score of the general pain knowledge was 61.46 and that of knowledge on the use of analgesia was 52.19. 2. Most nurses(74%) answered with hesitation about injecting narcotic analgesia to patients. 3. The pain assessment scale which nurses knew (57.5%) and used(48.0%) extremely was a simple descriptive scale. 4. The pain intervention which nurses knew (94.5%) and implemented(92.1%) extremely was to inject analgesia. 5. The number of nurses who had learned about pain management was 49 of 254(19.3%). 6. Nurses' knowledge on the use of analgesia was of relevance to having learned pain management, but general pain knowledge was not so relevant. According to this research, I suggest the following. 1. It is necessary to develop an education program with actual practice and intervention which nurses can perform for themselves. 2. It is necessary to continuously educate about pain management in clinical wards.

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Analysis of Nursing Records for Pain Management in Intensive Care Unit Patients (내·외과계 중환자의 통증간호기록 분석)

  • Im, Young-Sk;Yi, Yeo-Jin
    • Journal of muscle and joint health
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    • v.19 no.2
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    • pp.173-183
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    • 2012
  • Purpose: The purpose of this study was to analyze nursing records for pain management in intensive care unit (ICU) patients. Methods: Nursing process for pain management were analyzed retrospectively by 180 ICU patients' nursing records. Instruments consisted of 3 questionnaires (pain assessment, intervention, and evaluation). Results: For assessment, there was different pain intensity between cancer patients (7.95) and non-cancer patients (7.20). Also pain intensity was lower in PCA group (5.08) than in PCA with PRN group (8.27). Common pain site was surgical areas, along with 17 kinds of words expressed for pain, and mean of pain intensity was 7.47 by numeric rating scales (NRS). For intervention, the patients received pharmacologic interventions (99.4%) such as narcotic analgesics (38.3%) intermittently (70.5%) without side effects (94.4%). For evaluation, mean of pain intensity was decreased to 3.14, but a few patients (12.8%) experienced pain over 5 points despite the intervention. Nurses evaluated the degree of pain relief after the intervention in 87.2% of patients. Conclusion: Nurses do assess patients' pain by using objective tool, intervene, and evaluate for effective pain management. Nurses should make an individual approach and record all nursing activities for pain management.

Paroxetine, as an Adjuvant Analgesic for the Management of Neuropathic Pain Syndrome (신경병증성 통증 증후군의 관리를 위한 부가적 진통제로서의 Paroxetine)

  • Han, Tae-Hyung;Eun, Jong-Shin;Lee, Sang-Min;Shin, Baek-Hyo
    • The Korean Journal of Pain
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    • v.11 no.2
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    • pp.201-209
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    • 1998
  • Background: Tricyclic antidepressants (TCA) have been used for various pain syndromes for their analgesic effects. They, however, often have anticholinergic side effects and therefore search for more selective drugs with fewer side effects is justified. Paroxetine, a selective serotonin reuptake inhibitor devoid of autonomic side effects, was evaluated for its role as an analgesic adjuvant in the management of neuropathic pain. Method: According to individual diagnostic group as diabetic neuropathy, postherpetic neuralgia, central pain syndrome and cancer related plexopathy, 10 patients per each group were equally accumulated. Patients have been stabilized in their analgesic regimen at least four weeks prior to enrollment into study. TCA, if taken, was discontinued for two weeks for wash out period. Baseline four point verbal pain intensity score was obtained and oral administration of paroxetine 20 mg was initiated. At two weeks follow-up visit, pain intensity scores, pain improvement scores judged by family, drug efficacy, tolerability and overall evaluation were assessed. The incidence of side effects were also obtained. Result: After two weeks of treatment, pain intensity scores decreased in 77.5% of patients and no patients experienced aggravation. These findings were objectively reflected in pain improvement scores judged by family members. But, the number of nonresponders was different among groups. In drug efficacy, tolerability and overall evaluation, the proportions of patients who scored as excellent or good were 75%, 80% and 80% respectively. Incidence of side effects was 27.5%, but the side effects spontaneously disappeared after discontinuation of medication. Conclusion: Paroxetine, a selective serotonin reuptake inhibitor, appears to be effective as adjuvant analgesic for the management of various neuropathic pain syndromes.

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Identification of Knowledge Structure of Pain Management Nursing Research Applying Text Network Analysis (텍스트네트워크분석을 적용한 통증관리 간호연구의 지식구조)

  • Park, Chan Sook;Park, Eun-Jun
    • Journal of Korean Academy of Nursing
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    • v.49 no.5
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    • pp.538-549
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    • 2019
  • Purpose: This study aimed to explore and compare the knowledge structure of pain management nursing research, between Korea and other countries, applying a text network analysis. Methods: 321 Korean and 6,685 international study abstracts of pain management, published from 2004 to 2017, were collected. Keywords and meaningful morphemes from the abstracts were analyzed and refined, and their co-occurrence matrix was generated. Two networks of 140 and 424 keywords, respectively, of domestic and international studies were analyzed using NetMiner 4.3 software for degree centrality, closeness centrality, betweenness centrality, and eigenvector community analysis. Results: In both Korean and international studies, the most important, core-keywords were "pain," "patient," "pain management," "registered nurses," "care," "cancer," "need," "analgesia," "assessment," and "surgery." While some keywords like "education," "knowledge," and "patient-controlled analgesia" found to be important in Korean studies; "treatment," "hospice palliative care," and "children" were critical keywords in international studies. Three common sub-topic groups found in Korean and international studies were "pain and accompanying symptoms," "target groups of pain management," and "RNs' performance of pain management." It is only in recent years (2016~17), that keywords such as "performance," "attitude," "depression," and "sleep" have become more important in Korean studies than, while keywords such as "assessment," "intervention," "analgesia," and "chronic pain" have become important in international studies. Conclusion: It is suggested that Korean pain-management researchers should expand their concerns to children and adolescents, the elderly, patients with chronic pain, patients in diverse healthcare settings, and patients' use of opioid analgesia. Moreover, researchers need to approach pain-management with a quality of life perspective rather than a mere focus on individual symptoms.

Assessment of pain and adequacy of pain management in hospitalized cancer patients

  • Shin, Yeonghee
    • Journal of Korean Academy of Nursing
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    • v.29 no.5
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    • pp.1113-1122
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    • 1999
  • The author investigated pain experiences of 90 cancer patients and the adequacy of pain treatment they have received during their stay at a large medical center in T city between October 1994 and August 1995. Pain was assessed by the Shortened BPQ and results are summarized as follows: As for ratings of “worst pain” during the 24 hour period, 70% of the patients reported they had “severe” pain. As for ratings on “pain now,” 43% of the cancer patients reported “moderate to severe” pain. Over 46% of the patients reported a pain relief score of 0(not at all) or 1(somewhat) even after receiving pain medication. Adequacy of analgesic treatment was evaluated by comparing the patient's reported level of pain and the analgesic use, namely, the pain management index(PMI). The PMI indicated that 58% of the patients were undertreated for the pain control. In review of nurse's notes. systematic pain assessment was scarcely recorded, although pain documentation appeared in 70% of the notes; and the contents were mostly simple description. In conclusion, the results of patient's pain ratings, the PMI and poor pain documentation in the nurse's notes implied poor pain assessment and management.

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A Study for Assessing Pain Intensity and Investigating Factors of Satisfaction with Postoperative Pain Management (복부 수술 환자의 통증 정도 및 통증관리 만족도 영향 요인 - 통증 자가조절기 사용 환자를 중심으로 -)

  • Lee, Jong Kyung
    • Korean Journal of Adult Nursing
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    • v.18 no.1
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    • pp.125-135
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    • 2006
  • Purpose: The purpose of this study was to identify pain intensity according to activities over postoperative days and to identify factors of patient satisfaction with pain management after abdominal surgery. Methods: The subjects were 123 patients who were admitted at a general surgical ward and had abdominal surgery from Mar. 2005 to June 2005. The collected data were analyzed using the SPSS 12.0 program. Results: The average postoperative pain scores were 6.13 at POD 1, 5.46 at POD 2, and 4.22 at POD 3. In stepwise multiple regression analysis a total of 40% of variance in satisfaction with pain management was accounted for by pain intensity on POD 3 at rest (29.4%) and attitude toward using pain medicine (6.6%), and side effects of pain medicine (4.0%). Conclusion: According to the findings of this study, patients had inadequate pain management after abdominal surgery. Therefore, nurses need to provide educational programs focused on changing attitudes toward using pain medicine, to reduce side effects of pain medicine, and to develop nursing intervention for relieving pain.

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