• 감성과학
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• 제24권2호
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• pp.39-48
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• 2021

국제통증연구학회(IASP)에 따르면, 신경병증성 통증은 정상 조건에서 중추신경계에 유해한 정보를 전달하는 신경계 기능 장애로 특징 지워진다. 이런 통증은 말초 혹은 중추 신경계에 확인 가능한 병변이 있는 질환과 어떠한 신경에도 병변이 없는 상태에서 발생하는 상황으로 나누어 볼 수 있다. 두 가지 상황 모두 장기적이고 만성적인 변화과정을 겪게 되며, 결과적으로 신경계가 부적절하게 적응하여 치유되기 어려운 만성통증 증후군으로 발전할 수 있다. 그러나 이러한 통증 치료는 진단에서부터 치료까지의 과정이 어려운 탓에 현재까지도 특별한 해결방안이 부족한 실정이다. 최근 자기공명영상(fMRI), 양전자방출단층촬영법(PET), 광영상(optical imaging) 등 영상분석기술이 발달함에 따라 통증을 유발할 수 있는 유해 자극에 대한 중추신경계의 반응을 영상화하는 연구가 증가하고 있다. 이러한 영상 기법들을 통해 통증을 해석하고 처리하는 뇌 영역에서 시냅스 간 가소성 변화가 일어나고 있음을 확인하였으며, 신경병증성 통증을 비롯한 만성통증과 학습과의 상호 작용을 이해하는 데 많은 도움을 주고 있다. 본 연구는 병리적 통증의 기전과 통증 자극에 따른 뇌의 구조적, 기능적 변화에 대해 최근까지 밝혀진 연구들을 소개하고자 한다. 만성적 통증의 정의와 발생기전을 되짚고 새로운 연구 동향을 살펴보는 것은 통증을 완화할 수 있는 방안을 강구하는 데 도움이 될 것으로 사료된다.

• 임상간호연구
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• 제22권2호
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• pp.152-160
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• 2016

Purpose: The purpose of this study was to evaluate the effects of real PCA education with practice on postoperative pain, consumption of analgesics, and anxiety for elderly patients with total hip arthroplasty. Methods: This study utilized a non-equivalent control group pretest-posttest design. The participants were 52 elderly patients (${\geq}65$) with total hip arthroplasty at the G. hospital in Seoul. The participants were recruited from December 3, 2014 to April 30, 2015. Twenty six of them were assigned to the experimental group and the other to the control group. Preoperative real PCA education with practice was performed individually with the experimental group by the author. Results: There were statistically significant differences in 24 and 48 hour postoperative pain (t=-2.59, p=.012; t=-3.80, p<.001 respectively), and in consumption of analgesics at 24 and 48 hours after operation between the two groups (t=-3.61, p<.001; t=-4.19, p<.001 respectively). However, no significant difference in anxiety (t=-1.03, p=.308) at 48 hour after operation. Conclusion: This study has confirmed that the individualized real PCA education with practice contributes to relieve postoperative pain and reduce analgesic uses of the elderly with total hip arthroplasty. Thus, it is highly recommended that this education program could be applied in clinical settings as a nursing intervention in reducing postoperative pain for the elderly with total hip arthroplasty.

• 기본간호학회지
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• 제24권4호
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• pp.255-264
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• 2017

Purpose: The purpose of this study was to develop a smartphone app for use in patient controlled analgesia (PCA) education and to identify PCA knowledge and pain management following lower extremity orthopaedic surgery under spinal anesthesia in patients who received smartphone app education. Methods: Participants were 150 patients in an orthopaedic hospital located in Busan. The measurement variables used in this study were PCA knowledge, pain management and pain level. For data analysis, SPSS/WIN 21.0 program was used in the analysis of the relation of frequencies. In addition, percentage, mean and standard deviation, t-test, ANOVA, Duncan, Pearson's correlation coefficients were also assessed. Results: The score for knowledge regarding PCA was $4.27{\pm}1.64$. The correlations between knowledge and pain management (button push times

• 한국보건간호학회지
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• 제22권2호
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• pp.177-185
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• 2008

Purpose: To investigate the degree of pain, and to identify barriers to and satisfaction with pain management, in an effort to provide baseline data for effective pain management interventions. Methods: The study design was descriptive and correlational. A total of 100 cancer patients who were cared for at home participated in this study. Questions regarding self-rated pain, as well as barriers to and satisfaction with pain management were included in the study instruments. The data were collected by nurses using a face-to-face interview method in May of 2008. Results: Thirty six percent of the participants were in their 70's and 18.0% suffered from cancer of the large intestine. The usual degree of pain was reported as 3.43 out of 10 points, and the study patients were generally moderately satisfied with their pain management (M=$3.15{\pm}0.78$; range, 1-5). The mean barrier score was $3.24{\pm}0.52$ (range, 1-5) and concerns regarding the progress of cancer was the most highly evaluated barrier. There was a negative relationship between the degree of pain and satisfaction with pain management, and between barriers to and satisfaction with pain management. Conclusion: The precise evaluation of pains is crucial to the proper management of pain, and the education and promotion of proper pain management practices may help to overcome barriers to pain management for cancer patients.

• 기본간호학회지
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• 제15권2호
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• pp.161-170
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• 2008

Purpose: The purpose of this study was to provide basic data for proper pain management. Method: Data were collected from 85 hospitalized patients with cancer pain. A retrospective chart review of level of pain, source of pain, verbal expression of pain, and pain management was done. The data were analyzed with the SPSS program. Results: The level of pain measured by NRS at the three time points was as follows Time 1 ($4.40{\pm}2.25$), Time 2 ($0.61{\pm}1.30$), Time 3 ($2.47{\pm}2.75$). The kinds of pain were somatic pain (51.8%), visceral pain (37.6%), neuropathic pain (12.9%). The analgesic amount measured by OME (oral morphine equivalent) was as follows: Time 1 ($70.85{\pm}69.65$), Time 2 ($91.61{\pm}89.20$), Time 3 ($96.71{\pm}94.25$). Degree of pain had significant differences according to type of cancer (F=-3.286, p= .002), cancer origin (F=2.906, p= .018), and metastasis (F=2.906, p= .018) at Time 2. Best control period had significant difference according to type of cancer (F=2.373, p= .023), and origin of cancer (F=2.466, p= .040) at Time 2 Conclusion: These finding will enable the application of nursing interventions for pain control in cancer patients, identification of kinds of nursing compared to priorities, and increased levels of comfort in cancer patients in clinical settings.

• 종양간호연구
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• 제12권3호
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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.

• 임상간호연구
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• 제20권1호
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• pp.28-39
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• 2014

Purpose: The purpose of this study was to investigate the effect of preoperative education about patient controlled analgesia (PCA) on postoperative pain control for elderly after total knee arthroplasty. Methods: The study applied a quasi-experimental design. To prevent communication between experimental group and control groups, data from control group were collected before provision of preoperative education for the experimental group. A total of 50 elderly patients who underwent total knee arthroplasty and older than 65 years old participated in this study. The preoperative education about PCA was provided for the experimental group before surgery. The preoperative education program consisted of fifteen minute education about pain control, and PCA use, as well as demonstration of PCA use. Results: The experimental group had higher knowledge score about pain and PCA use, and more positive attitudes toward pain and use of analgesics after surgery than the control group. There was no significant difference in use of additional analgesics after surgery between the two groups. The experimental group had significantly lower pain score at 8, 24 and 36 hours after surgery than the control group. The experimental group had higher level of satisfaction about PCA use than the control group. Conclusion: The preoperative education about PCA, customized for elderly patients could be an effective nursing intervention for postoperative pain control after total knee arthroplasty.

• 한국융합학회논문지
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• 제13권1호
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• pp.375-386
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• 2022

오랫동안 서 있거나 걷는 등의 작업 후에 흔히 중력으로 인한 체내순환이 영향을 받아 하지의 부종, 통증, 피로 등이 발생할 수 있다. 본 연구는 보완대체요법으로 아로마테라피 에센셜 오일을 이용하여 족욕 또는 스프레이로 적용하였을 때 하지부종 및 하지통증, 피로에 미치는 효과를 확인하기 위한 연구이다. 본 연구는 무작위통제연구이며, 연구 참여자는 2018년 8월 15일부터 2018년 10월 11일까지 D광역시 소재 E 대학교병원에서 연구 참여자 모집공고에 자원한 간호사 78 명을 대상으로 동질성을 유지하기 위한 낮번 근무를 하는 간호사로 하였다. 실험 중재는 그레이프후룻과 페퍼민트를 1:1로 블렌딩한 에센셜 오일을 0.5ml 넣은 9L의 물에 족욕을 하거나 3%로 희석하여 분사하는 스프레이 방법을 적용하였다. 자료는 ANOVA, Repeated Measures ANOVA로 분석하였다. 아로마 테라피 족욕군과 스프레이군의 종아리 둘레가 대조군에 비해 유의하게 감소하였다(F = 14.053, p <.001). 하지 통증 (F = 42.497, p <.001)과 피로 (F = 20.641, p <.001)도 실험 중재 후 아로마테라피 족욕군과 스프레이군에서 대조군보다 유의하게 감소하였다. 하지의 부종과 통증을 완화하기 위해 족욕을 권장하며, 적용 수월성을 고려할 때 아로마 스프레이를 적극 권장한다.

• 여성건강간호학회지
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• 제25권1호
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• pp.4-18
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• 2019

Purpose: The purpose of this study was to investigate the effects of thermotherapy on gas pain, post-operative resilience, and body temperature discomfort among patients who received laparoscopic myomectomies. Methods: The experimental group consisted of 62 patients with thermotherapy and the control group consisted of 60 patients. Thermotherapy was applied individually to the experimental group four hours after surgery. The collected data was analyzed using descriptive statistics, t-tests, ${\chi}^2$-tests, and repeated measures of analysis of variance, using IBM SPSS Statistics version 18. Results: The results showed no significant interaction effect between the group and time of measurement in gas-related pain in the experimental group. For gas-related pain, there was significant difference in right shoulder pain at 24 hours (t=-4.222, p=.000), 48 hours (t=-3.688, p=.000), 72 hours (t=-2.250, p=.028), and left at 24 hours (t=-3.727, p=.000), 48 hours (t=-4.150, p=.000), and 72 hours (t=-2.482, p=.016) and both shoulders at 24 hours (t=-2.722, p=.009) and 48 hours (t=-2.525, p=.014). There was no significant difference in epigastric pain, excluding both epigastric pain at 48 hours (t=2.908, p=.005), 72 hours (t=3.010, p=.004), but there was a significant difference in objective body temperature discomfort (t=2.895, p=.008). Conclusion: Thermotherapy relieved shoulder gas-related pain and objective body temperature discomfort. It needs to be developed and applied to improve post-operative discomfort in patients with laparoscopic hysterectomies.

• 지역사회간호학회지
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• 제30권1호
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• pp.79-89
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• 2019

Purpose: The purpose of this paper is to determine effects of auricular acupressure on knee pain, range of motion, and sleep in the elderly with knee osteoarthritis. Methods: This is an experimental study designed with randomization and single-blind in a placebo-control approach. The subjects included the elderly with knee osteoarthritis who were using an elderly welfare facility. In each of the groups, 28 subjects were assigned. For the experimental group, auricular acupressure was applied to five pressure points related to the pain caused by osteoarthritis and sleep. In the case of the placebo-control group, auricular acupressure was applied to other five points than the former. The intervention lasted eight weeks. In order to examine intervention effects of auricular acupressure, joint pain, Pressure Pain Thresholds (PPTs), and extension and flexion range of motion (ROM) were measured weekly. As for the preand post-examinations, pain, sleep quality, and the time-by-sleep stage of the patients with knee osteoarthritis were measured. Results: The VAS scores in the experimental group with auricular acupressure significantly decreased through time (p<.001) and WOMAC also significantly decreased (p<.01) compared with the placebo-control group. However, there were no significant differences in PPTs. The flexion (p<.01) and extension (p<.001) ROMs measured for eight weeks improved over time. Meanwhile, sleep quality improved significantly after the intervention termination (p<.01), but there was no significant difference found in the time-by-sleep stage. Conclusion: Auricular acupressure applied for eight weeks was found to be effective in reducing joint pain, improving knee ROM, and improving sleep quality in patients with degenerative knee arthritis.