Purpose: This study was designed to describe outcomes of pain management, to identify pain intensity, pain management and barriers to pain management, and to test correlation among the variables in cancer patients who are registered in public health centers. Methods: By using a descriptive survey design, 3 instruments were used to collect data: the Numeric Rating Scale for pain, the Barriers Questionnaire-Korean version, and a one-item self-report tool about patient satisfaction. A sample of 190 patients with cancer was recruited from a public health center. Results: The mean rating for pain during the past 24 hours was mild and the mean score of barriers to pain management was 3.20. Patients were satisfied with pain management but they also had concerns it. A negative correlation was found among pain severity, pain relief and satisfaction of pain management. However, there was not significant correlation between the patient-related barriers to pain management and other variables. Conclusion: These results suggest that the intervention for cancer patients should focus not only on patient-related barriers to pain management, but also address health-care system related barriers.
Purpose: This study is part of questionnaire survey concerned with the views of nursing staff for cancer patients. This study was done to describe cancer pain management problem, pain management knowledge. Methods: The participants were 188 nurses at cancer ward. Data were collected from July 2003 to August 2003. Data were collected with multiple-choice items and one open-ended question, which were constructed structured questionnaire. The data were analyzed by means of SPSS statistical software and content analysis. Results: Experiences of pain education are 53.7%, pain assessment sheet not use 86%, pain management status are partial. Education need of pain management was 87.8% patients in pain were very often(23.9%) or rather often (35.1%) cancer patients. The nurses are respond to open question. Pain management problems as assessed by nurses are categorized 11 item. The health professional problems are Knowledge deficit pain management, Incontrollable pain, Doctor's busy. The patient problems afraid of narcotics for addiction, side effect, distinguishing between physical and suffering, economical problem. The scores of knowledge about pain was average 16.7 score. The pain knowledge showed significant correlation education need(r=.180, p=.013). The effective variable was need of $education({\beta}=.163)$. Conclusion: It was found that pain knowledge was middle score and pain management problem was multiple. The study highlights the need to increase pain education for health professional. Therefore, This study suggest that health professionals education should be done to improve pain management problem.
Kim, Hyungtae;Kim, Youngjun;Kim, Beum Jin;Shin, Sung In;Yim, So Mang;Lee, Ju-Hyung
Journal of the Korean Society of Radiology
/
v.79
no.6
/
pp.323-331
/
2018
Purpose: The purpose of this study was to evaluate the effectiveness of thoracic paravertebral block (TPVB) for management of pain during and after percutaneous radiofrequency ablation (RFA) of hepatic tumor. Materials and Methods: All patients were divided into non-TPVB (4 patients, 4 sessions of RFA for 4 tumors) and TPVB group (5 patients, 7 sessions of RFAs for 7 tumors). Ultrasound (US)-guided TPVB was performed at T7 level. The 15 mL of 0.375% ropivacaine was injected into right paravertebral space before RFA. If patients complained pain and asked analgesics or experienced pain with verbal numerical rating scale (VNRS) of more than 4, fentanyl $25{\mu}g$ (up to $100{\mu}g$), pethidine 25 mg, and midazolam 0.05 mg/kg (up to 5 mg) were sequentially given intravenously during RFA. Results: Total intravenous morphine equivalence of analgesics before, during, and after RFA was 129.1 mg and 0.0 mg in non-TPVB and TPVB group, respectively. Conclusion: US-guided TPVB may be an effective and safe anesthetic method for decreasing or eliminating pain during and after RFA for hepatic tumor and helpful in decreasing the usage of opioids.
Purpose: The purpose of this study was to examine the effects of preoperative pain management education on postoperative pain control in patients with uterine tumor using patient controlled analgesia. Methods: This study used non-equivalent control group non-synchronized design. Data were collected from September, 2008 to March, 2009 at one university hospital in Daegu, Korea. There were 60 participants, 30 in both the experimental and control group. The experimental group was given preoperative pain education using videos, leaflets, and a PCA model. Postoperative pain intensity, frequency of the PCA button being pressed, and doses of additional analgesics were observed through 24 hours postoperative and knowledge of pain and attitude about the use of the pain medicine were measured at 3 days postoperative. Collected data were analyzed using t-test, ${\chi}^2$ test, repeat measured ANOVA, and Bonferroni methods. Results: There were no significant differences in the postoperative pain level between the experimental and control group. Postoperative frequency of the PCA button pressed, doses of additional analgesics, pain knowledge and attitude about the use of the pain medicine of the experimental group were significantly higher than those of the control group. Conclusion: Pain management education is an effective nursing intervention for pain control after surgery.
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.
Purpose: The purpose of this study was to compare and check the levels of cancer pain management knowledge and awareness between doctors and nurses in a tertiary hospital and to develop an intervention program. Methods: Participants were 725 nurses and 95 doctors working in a hospital from May 2 to 29, 2009. Data were analyzed using t-tests, ${\chi}^2$-tests, and ANOVA with SPSS WIN 18.0. Results: In a comparison of the pain management score, nurses showed significant results for age (p<.001), carrier (p<.001), education (p<.001), workplace (p<.001), and doctors showed significant results only for age (p=.032). Doctors' marks were significantly higher than nurses' in pain management scores (p<.001). Knowledge about analgesic medication (t=-5.38, p<.001) and analgesic drug effect (t=-8.59, p<.001) were significantly different in the pain management subcategory score between nurses and doctors. There were four items with different awareness levels related to analgesics between nurses and doctors. Conclusion: The findings of this study demonstrate that it is possible to develop pain education content for nurses and doctors. The findings of this study are useful when seeking to change the awareness level of a medical team regarding opioid analgesics.
Purpose : The purpose of this study was to evaluate the present status of patients' satisfaction and the reasons for any satisfaction or dissatisfaction in cancer pain management Methods : A cross-sectional survey was used to obtain the feedback about pain management. The results of the survey were collected from 59 in- or out-patient who had cancer treatment at two of the teaching hospitals in Seoul from July, 2002 to November, 2002. The data was obtained by a structured questionnaire based on the American Cancer Society Patient Outcome Questionnaire(APS-POQ) and other previous research. The clinical information for all patients were compiled by reviewing their medical records. Resuts : 1) The subjects' mean score of the worst pain was 6.77, the average pain score was 3.80, and the pain score after management was 2.93 for the past 24 hours. The mean score of total pain interference was $25.03{\pm}12.82$. Many of the subjects had false beliefs about pain such as 'the experience of pain is a sign that the illness has gotten worse', 'pain medicine should be 'saved' in case the pain gets worse' and 'people get addicted to pain medicine easily'. 2) 66.1% of the subjects were properly medicated with analgesics. 33.9% of the subjects reported use of various methods in controlling pain other than the prescribed medication. Only 33.9% of the subjects had a chance to be educated about pain management by doctors or nurses. 3) The mean score of patients' satisfaction with pain management was $4.19{\pm}1.14$. 72.9% of the subjects answered 'satisfied' with pain management. The reasons for dissatisfaction were 'the pain was not relieved even after the pain management', 'I was not quickly and promptly treated when I complained of pain', 'doctors and nurses didn't pay much attention to my complaints of pain.', and 'there was no appropriate information given on the methods of administration, effect duration and side effects of pain medicine.' The reasons for satisfaction were: 'the pain was relieved after the pain management.', 'doctors and nurses quickly and promptly controlled my pain.', 'doctors and nurses paid enough attention to my complaints of pain.' and 'trust in my physician'. 4) In pain severity or pain interference, no significant difference was found between the satisfied group and dissatisfied group. On the belief 'good patients avoid talking about pain', a significant difference was found between the satisfied group and dissatisfied group. Conclusions : The patients' satisfaction with cancer pain management has increased over the years but still about 30% of patients reported to be 'not satisfied' for various reasons. The results of this study suggest that patients' education should be done to improve satisfaction in the pain management program.
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.
Mouth opening limitation is generally caused by masticatory muscle or temporomandibular joint pain, disc dislocation without reduction, adhesion or ankylosis of the temporomandibular joint, and muscle contracture. But otorhinolaryngologic disease, neurologic and vascular disease, tumor, inflammation and infection may cause pain and mouth opening limitation which mimics temporomandibular disorders. Re-evaluation for possibilities of inflammation, infection and tumor should be in cases that do not show symptom improvement or appear with continuous aggravation despite of proper treatment. In this case, we report of medial pterygoid muscle pain and mouth opening limitation caused by periapical abscess of third molar spread to the pterygomandibular space.
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