Characteristics and Interventions for Headaches among Inpatients with Subarachnoid Hemorrhage

지주막하 출혈로 입원한 환자가 경험하는 두통의 특성과 중재

  • Yun, Sun-Hee (Neurological care unit, Seoul Saint Mary's Hospital) ;
  • Cho, Ok-Hee (College of Nursing, Jeju National University) ;
  • Yoo, Yang-Sook (College of Nursing, The Catholic University of Korea)
  • 윤선희 (서울성모병원 신경계 중환자실) ;
  • 조옥희 (제주대학교 간호대학) ;
  • 유양숙 (가톨릭대학교 간호대학)
  • Received : 2014.10.22
  • Accepted : 2014.11.30
  • Published : 2014.12.31

Abstract

Purpose: The objectives of this study were to identify interventions and to analyze the characteristics of headaches among hospitalized patients with subarachnoid hemorrhage with moderate or severe headaches. Methods: A retrospective review of the electronic medical records of 210 patients who received treatment for subarachnoid hemorrhage was conducted. Data collection was done using a structured headache record sheet. Data analysis was carried out using the PASW 18.0 version program. Results: There were significant differences in number and duration of headaches of headaches according to the presence of vasospasm, increased intracranial pressure, extraventricular drainage, use of hypertonic solution, and hospitalization period (p<0.05). Patients with vasospasm and extraventricular drainage experienced the most severe headache for a duration of 3 to 7 days. Other patients experienced the most severe headache for around 1-2 days. Conclusion: Hospitalized patients with subarachnoid hemorrhage who had vasospasms experienced more headaches and the duration of these headaches were longer. In particular, the assessment and interventions for headaches should increase and be carried out actively during this time because the intensity of these headaches is severe and lasts for 3-7 days. Additionally, we emphasize the need for regular administration of analgesics in order to promote patients' well-being. On the basis of the results of this study,we suggest that evidence-based interventions for the care of headaches among hospitalized patients with subarachnoid hemorrhage should be developed.

Keywords

References

  1. Byun, H. S., & Kim, G. D. (2012). Impacts of fatigue, pain, anxiety, and depression on the quality of life in patients with breast cancer. Asian Oncology Nursing, 12(1), 27-34. https://doi.org/10.5388/aon.2012.12.1.27
  2. Casetta, I., & Granieri E. (2004). Subarachnoid hemorrhage presenting as chest pain. The American Journal of Emergency Medicine, 22(3), 227-228. http://dx.doi.org/10. 1016/j.ajem.2004.02.041. https://doi.org/10.1016/j.ajem.2004.02.041
  3. Claassen, J., Bernardini, G. L, Kreiter, K., Bates, J., Du, Y. E., Copeland, D., et al. (2001). Effect of cisternal and ventricular blood on risk of delayed cerebral ischemia after subarachnoid hemorrhage: the Fisher scale revisited. Stroke, 32(9), 2012-2020. http://dx.doi.org/10.1161/hs0901.095677.
  4. de Rooij, N. K., Linn, F. H., van der Plas, J. A., Algra, A., & Rinkel, G. J. (2007). Incidence of subarachnoid haemorrhage: a systematic review with emphasis on region, age, gender and time trends. Journal of Neurology, Neurosurgery and Psychiatry, 78(12), 1365-1372. http://dx.doi.org/10.1136/jnnp. 2007.117655.
  5. Edlow, J. A. (2005). Diagnosis of subarachnoid hemorrhage. Neurocritical Care, 2(2), 99-109. http://dx.doi.org/10.1385/ NCC:2:2:099
  6. Gordon, D. B., Dahl, J. L., Miaskowski, C., McCarberg, B., Todd, K. H., Paice, J. A., et al. (2005). American pain society recommendations for improving the quality of acute and cancer pain management: American pain society quality of care task force. Archives of Internal Medicine, 165(14), 1574-1580. http://dx.doi.org/10.1001/archinte.165.14.1574.
  7. Goudas, L. C., Bloch, R., Gialeli-Goudas, M., Lau, J., & Carr, D. B. (2005). The epidemiology of cancer pain. Cancer Investigation, 23(2), 182-190. https://doi.org/10.1081/CNV-50482
  8. 8. Han, H. L., & Kim, K. S.(2013). Correlation between postoperative pain, daily activity disturbance, military-life satisfaction and social support. Journal of Militry Nursing Research, 31(1), 120-134.
  9. Hyun J, & Park, K. S. (2000). Clinical nurses' knowledge and attitudes on pain management. The Journal of Korean Academic Society of Adult Nursing, 12(3), 369-383.
  10. Jung, S. S. (2005). Clinical usefulness of magnetic resonance angiography in patient with risk factors of cerebrovascular disease. Unpublished master's thesis, Yonsei University, Seoul.
  11. Kim, H. K., Lee, H. S., Hwang, K. H., Yoo, Y. S., & Lee, S. M. (2006). Positive and negative determinants for pain management in both cancer patients and their nurses. The Korean Journal of Fundamentals of Nursing, 13(1), 68-75.
  12. Kim, T. H., & Kim, G. T. (2012). Comparison of magnetic resonance imaging with computed tomography in subarachnoid hemorrhage. Journal of the Korean Society of Emergency Medicine, 23(3), 373-382.
  13. Komotar, R. J., Schmidt, J. M,, Starke, R. M., Claassen, J., Wartenberg, K. E., Lee, K., et al. (2009). Resuscitation and critical care of poor-grade subarachnoid hemorrhage. Neurosurgery, 64(3), 397-410. http://dx.doi.org/10.1227/01. NEU.0000338946.42939.C7.
  14. Lee, B. N., & Lee, G. E. (2006). Effects of pain control education on pain control barrier, postoperative pain and pain control satisfaction in gynecological patients. Journal of Korean Academy of Nursing, 36(6), 968-975. https://doi.org/10.4040/jkan.2006.36.6.968
  15. Lee, J. K. (2006). A study for assessing pain intensity and investigating factors of satisfaction with postoperative pain management. The Journal of Korean Academic Society of Adult Nursing, 18(1), 125-135.
  16. Lynn, M. R. (1986). Determination and quantification of Content Validity. Nursing Research, 35(6), 382-385.
  17. Okuyama, T., Wang, X. S., Akechi, T., Mendoza, T. R., Hosaka, T., Cleeland, C. S. et al. (2004). Adequacy of cancer pain management in a Japanese Cancer Hospital. Japanese Journal of Clinical Oncology, 34(1), 37-42. http://dx.doi.org/ 10.1093/jjco/hyh004
  18. Park, I. S., Jang, M., Rew, S. A., Kim, H. J., Oh, P. J., Jung, H. J. (2010). Analysis of pain records using electronic nursing records of hospitalized patients in medical units at a university hospital. Journal of Korean Clinical Nursing Research, 16(3), 123-132.
  19. Park, J. S. (2000). Literature review of nonpharmacologic pain management and pain management program. Keimyung Nursing Science Journal, 4(1), 53-54.
  20. Park, K. H. (2003). Acute cerebral hemorrhage patient's medical examination record according to the time transported to general hospital-on the basis of spontaneous subarachnoid hemorrhage patient. Unpublished master's thesis, Ajou university, Suwon.
  21. Park, K. S., Song, M. S., & Kim, K. H. (2001). A study on the subjectivity of pain management of nurse. The Journal of Korean Academic Society of Adult Nursing, 13(1), 123-135.
  22. Seo, B. R., Kim, T. S., Joo, S. P., Jang, S. J., Lim, J. S., & Oh, C. W. (2010). Incidence rate of aneurysmal SAH in gwangju city and jeollanamdo province in 2007. Journal -Korean Neurosurgical Society, 47(2), 124-127. https://doi.org/10.3340/jkns.2010.47.2.124
  23. The Council for the Critical Care Nursing Curriculum. (2010). Neuroscience critical care nursing(2th Ed.). Koonja Publishing Company; Seoul.
  24. The Korean Headache Society(2009). The headache. Koonja Publishing Company; Seoul.
  25. The Korean Neurosurgical Society (2012). Neurosurgery(4rd Ed). Joongangcopy; Seoul.
  26. Yu, S. J., & Kim, H. S. (2000). The study of pain and depression in elderly cancer patients. Journal of Korean Gerontological Nursing, 2(1), 154-166.
  27. Woo, Y. J. (2009). Youth headache. Journal of the Korean Medical Association, 52(8), 768-778. https://doi.org/10.5124/jkma.2009.52.8.768