• Title/Summary/Keyword: 통증관리효과

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Panperitonitis with Advanced Gastric Cancer - Based on Seminar of Korean Family Medicine Palliative Medicine Research Group - (진행된 위암 환자에게 발생한 범복막염 치료의 완화의학적 접근 - 대한가정의학회 완화의학연구회 세미나를 기초로 하여 -)

  • Jung, Yun-Joo;Kim, Dae-Kyun;Choi, Youn-Seon;Korean Palliative Medicine Research Group, Korean Palliative Medicine Research Group;Shim, Jae-Yong
    • Journal of Hospice and Palliative Care
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    • v.9 no.1
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    • pp.35-39
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    • 2006
  • A 77-year-old female presented panperitonitis due to advanced gastric ranter during palliative care. In the case of panperitonitis following obstruction or perforation, surgical treatment is vital to avoid fatal sepsis and dehydration. However, the risk of surgery and the residual life of a patient must be carefully considered because of high mortality and complication rate in those patients with advanced disease due to the poor condition. The therapeutic value of aggressive hydration, nasogastric tube insertion, and the use of antibiotics is also questionable. Palliative surgery was not performed on this case, and she passed away peacefully in the presence of family after 4 days of palliative medical care. Here is the appropriate management for this kind of patients we would like to recommend through review of relevant references and long discussions. Firstly, we need to predict survival time using clinical variables. Secondly, considering patient status and risk of surgery, non surgical palliative care such as pain control, transient nasogastric tube insertion, and parenteral hydration is recommended. Minimal use of fluid is desirable to minimize complications such as edema and dyspnea if massive hydration in the beginning of treatment is not proved to be effective. Even though started earlier in the course of disease, discontinuation of antibiotics could be discussed with patients and their caregiver if patient status is not improved.

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Effects of Self Help Program for Pain, ADL, Exercise Self-Efficacy, and Knowledge about Arthritis in Patients with Osteoarthritis (자조관리 과정이 골관절염 환자의 통증, 일상생활 활동 운동효능감, 관절염 지식에 미치는 효과)

  • Park, Sang-Youn;Son, Jung-Tae;Park, Du-Hee;Lee, Kyung-Hee;Kim, Jin-Suk
    • Journal of muscle and joint health
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    • v.11 no.1
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    • pp.31-41
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    • 2004
  • Purpose: The purpose of this study was to test the effects of self-help program offered to patients with arthritis. Method: A quasi-experimental study design with nonequivalent groups was employed for the study. The subjects in the experimental group were 19 residents of K City who visited K Health Center with chief complaints of osteoarthritis and who agreed to participate in the self-help program from January through April 2003. The subjects in the control group were 18 patients with arthritis, selected among patients on the waiting list of self-help program using random sampling method. Data related to pain, ADL, exercise self-efficacy, and knowledge about arthritis were obtained from both groups. SPSS Win 11.5 was used for the data analysis. Results: The results of this study were as follows. 1. The pain score and exercise self-efficacy of the study group were significantly higher than the control group. 2. The ADL score and knowledge about arthritis were not significantly higher than the control group. Conclusion: Based on the study results, self-help program was proved to be effective in alleviating pain, and promoting exercise self-efficacy related to arthritis.

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Effect of Evidence-based Clinical Practice Guidelines for Promotion of Postoperative Nausea and Vomiting of Patients with Laparoscopic Hysterectomy (복강경 수술 환자의 수술 후 오심과 구토 관리를 위한 근거중심 실무 가이드라인 적용 효과)

  • Lee, Sung-Hee;Hong, Sung-Jung;Kim, Hwa Sun;Jeon, Younghoon
    • Korean Journal of Adult Nursing
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    • v.27 no.5
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    • pp.481-492
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    • 2015
  • Purpose: The purpose of this study was to examine the effects of the evidence-based clinical practice guidelines on Postoperative Nausea and Vomiting (PONV). Methods: The research design was a non-equivalent control group with a non-synchronized design. The participants were the patients undergoing gynecologic laparoscopy. Data were collected from July, 2014 through January, 2015. The participants in the experimental group (n=35) received an assessment of risk factors of PONV, aroma therapy, and P6 acupressure method as recommended in the guidelines. Those in the control group (n=35) received usual nursing care. Data were analyzed by mean, standard deviation, t-test, ${\chi}^2$-test using SPSS/WIN 19.0 program. Results: The occurrence of nausea and vomiting, the level of nausea and vomiting, and the need for antiemetic medicine in the experimental group were significantly less than those in the control group after surgery. The levels of postoperative pain and the amounts of time for nursing activities in the experimental group were significantly reduced than those in the control group after surgery. The levels of satisfaction were significantly higher in the experiment group than that of the control group. Conclusion: The evidence-based guidelines is recommended for nursing practice as a guidance for managing PONV and helping the recovery of patients after laparoscopic surgery.

Effects of Structured Exercise Program on Hip Pain, Physical Function and Quality of Life in Patients with Total Hip Arthroplasty (구조화된 운동 프로그램이 인공고관절 전치환술 환자의 고관절 통증, 신체기능 및 삶의 질에 미치는 효과)

  • Kwon, Eunhee;Lee, Haejung;Lee, Sunghwa
    • Journal of muscle and joint health
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    • v.25 no.2
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    • pp.122-134
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    • 2018
  • Purpose: The purpose of this study was to develop a 12-week structured exercise program (12-week-SEP) and evaluate its effects on pain, physical function and quality of life in patients with total hip arthroplasty (THA). Methods: A nonequivalent control group non-synchronized design was utilized to examine the effects of the 12-week-SEP on patients' outcomes after THA. A total of 46 adult patients (experimental group=25, control group=21) who had THA were recruited for the study. The 12-week-SEP consisted of education, exercise (muscle strengthening and progressive walking), and feedback. Data were analyzed by SPSS/WIN 21.0 using the $x^2$ test and repeated measures ANOVA. Results: The mean age of the participants was 60.9 years and 25 men (54.5%) and 21 women (45.7%) were included in the study. There were significant intervention effects on pain reduction and increased physical function but no effects on quality of life. Conclusion: The 12-week-SEP provided pain relief and enhanced physical function in patients underwent THA. Clinical application of the 12-week-SEP can improve postoperative nursing practices for patients with THA. Future research with larger sample is of necessity to obtain greater generalizability of the empirical evidences of the 12-week-SEP.

Effect of supportive periodontal treatment in the oral lichen planus patients (구강편평태선 환자에서 보조적 치주치료의 효과)

  • Kwon, Eun-Young;Choi, Jeomil;Lee, Ju-Youn
    • Journal of Dental Rehabilitation and Applied Science
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    • v.31 no.2
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    • pp.134-142
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    • 2015
  • Lichen planus is an immune-mediated mucocutaneous disease, affects more frequently middle-aged Caucasian women and makes signs and symptoms in the oral mucosa. Cutaneous lichen planus lesions cause itching but they are self-limiting, oral lichen planus lesions are usually chronic, recalcitrant to treatment and potentially premalignant in some cases. Although, oral lichen planus is non-plaque related disease, they possess particular problems because plaque control is complicated by pain and bleeding and might cause plaque-related disease. The resulting condition comprises accumulations of plaque, which again can influence the progress of oral lichen planus with burning sensation, spontaneous gingival bleeding. Thus, it should be noted that both medication and supportive periodontal treatment are essential for the remission of the lesions. This case report introduces topical corticosteroid therapy and supportive periodontal treatment including intensive oral hygiene procedures to obtain an improvement of subjective symptoms and objective changes and to prevent relapse the lesions.

Effects of the New Version of the Arthritis Self-management Program in Patients with Osteoarthritis ('골관절염 환자를 위한 스스로 관절관리' 프로그램의 효과검증)

  • Lee, Eun Nam;Lee, Kyung-Sook;Lee, Inok;Bak, Won-Sook;Choi, Hee Kwon;Cho, Kyung-Sook;Eun, Young;Choi, Mi-Kyung;Min, Hye Sook;Song, Rhayun;Shin, Gyeyoung;Kim, Minju;Lee, Myung Sook;Kim, Ju Sung;Chung, Yeo Sook
    • Journal of muscle and joint health
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    • v.22 no.2
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    • pp.105-113
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    • 2015
  • Purpose: The purpose of this study was to examine the effects of the new version of the arthritis self-management program (ASMP) developed by the Korean Society of Muscle and Joint Health. Methods: A total of 150 patients with osteoarthritis (OA) were participated in a 6-week self-arthritis management program provided once a week in 3 community health centers. Each session took 1.5 hours. This study measured present health status, frequency of fall during last 3 months, pain, difficulties in activity of daily living, exercise-related efficacy, flexibility of both arms, balance, and health-related quality of life. Results: After a 6-week program, pain, difficulties in ADL, present health status, exercise-related efficacy, health-related quality of life, flexibility of both shoulders, and balance were significantly improved. Conclusion: The results showed the possibility of the 6-week ASMP program in improving health state, physical function, and health-related quality of life in patients with OA.

DENTAL MANAGEMENT OF A PATIENT WITH MOYAMOYA DISEASE UNDER GENERAL ANESTHESIA (모야모야병(moyamoya disease) 환자의 전신마취 하 치과 치료)

  • Sang, Eun Jung;Song, Ji-Soo;Shin, Teo Jeon;Kim, Young-Jae;Kim, Jung-Wook;Jang, Ki-Taeg;Lee, Sang-Hoon;Hyun, Hong-Keun
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.13 no.2
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    • pp.108-113
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    • 2017
  • Moyamoya disease is a disorder in which certain arteries in the brain are constricted. Blood flow can be blocked by the constriction and blood clots. The patients frequently experience transient ischemic attacks (TIA), cerebral hemorrhage, or may not experience any symptoms at all. It is reported that they have a higher risk of recurrent stroke and a distinct underlying pathophysiology. A 3-year-8-month old boy with moyamoya disease experienced cerebral infarctions five times, and he underwent a cerebrovascular anastomosis surgery four years ago. He showed swallow disturbance, general delayed development, hemiplegia, and strabismus. Also he had hypocalcified teeth with or without multiple caries lesions in all dentitions. Dental treatment under general anesthesia using sevoflurane was performed due to his lack of cooperation. Moyamoya disease is associated with various medical conditions requiring a thoughtful deliberation and a careful examination before and during dental treatment. Pain and anxiety control during dental treatment is important because hyperventilation induced by crying has been seen to trigger TIA. Both isoflurane and sevoflurane are commonly used in patients with MMD, but dynamic autoregulation is better preserved during sevoflurane than isoflurane anesthesia. So sevoflurance general anesthesia may be recommendable to manage dental patients having multiple caries with moyamoya disease.

Effect of Chamaecyparis obtusa tree Phytoncide on Candida albicans (편백 피톤치드가 Candida albicans에 미치는 영향에 대한 연구)

  • Kang, Soo-Kyung;Auh, Q-Schick;Chun, Yang-Hyun;Hong, Jung-Pyo
    • Journal of Oral Medicine and Pain
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    • v.35 no.1
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    • pp.19-29
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    • 2010
  • Phytoncide, essential oil of trees, has microbicidal, insecticidal, acaricidal, and deodorizing effect. The present study was performed to examine the effect of phytoncide on Candida albicans, which is a commensal colonizer of the mucous membranes but has become an opportunistic pathogen. C. albicans was incubated with or without phytoncide extracted from Hinoki (Chamaecyparis obtusa Sieb. et Zucc.; Japanese cypress) and then changes were observed in its optical density, cell viability and morphology. As concentrations of phytoncide added to the culture medium increased, optical density and cell viability of C. albicans decreased. Minimum inhibitory concentration of phytoncide for C. albicans was observed to be 0.25%, and minimum fungicidal concentration was 0.5%. Numbers of morphologically atypical cells with electron-dense cytoplasm and granules and increased with increasing concentration of the phytoncide. At higher concentrations of phytoncide, compartments and organelles in the cytoplasm became indistinguishable. The overall results indicate that the phytoncide used for this study has a strong antimicrobial activity against C. albicans. Therefore, the phytoncide may be used as a candidate for prevention and therapeutic agent against oral candidiasis.

Antibacterial Effect of Colloidal Silver on Some Oral Bacteria (콜로이드상 은이 수종의 구강 세균에 미치는 항균 효과)

  • Kang, Kee-Hyun;Lee, Kyong-Eun
    • Journal of Oral Medicine and Pain
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    • v.30 no.1
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    • pp.1-14
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    • 2005
  • The maintenance of good oral health in adults is often hindered by oral malodor and periodontal diseases which are known to be commonly caused by some species of Gram-negative anaerobic bacteria, with low sensitivity to common synthetic antibiotics or antibacterial chemical agents. Therefore the development of a nonharmful natural antibacterial oral rinsing remedy against the causative bacteria is thought to be very important. The purpose of this study is to obtain the basic data for development of a nonharmful natural antibacterial oral rinsing remedy using colloidal silver. The author applied colloidal silver solution with concentration of 10, 30, 50, 80 ppm to some strains in species of Prevotella intermedia, Porphyromonas gingivalis, Fusobaterium nucleatum, and evaluated the effects of colloidal silver on the growth of experimental bacterial strains in aspects of minimal inhibitory concentration (MIC), minimal bactericidal concentration (MBC) and growth pattern after incubation for 24, 48, 72 hours. The obtained results were as follows: MIC of colloidal silver solution against experimental strains was 30 ppm in P. intermedia, 10 or 30 ppm in P. gingivalis, and 30, 50, or 80 ppm in F. nucleatum. And MBC of colloidal silver solution against experimental strains was 30 ppm in P. intermedia, 30 or 50 ppm in P. gingivalis, 30 or 80 ppm in F. nucleatum. Therefore it was concluded that colloidal silver exhibited bacteriostatic or/and bacteriocidal effects against some experimental strain. And the inhibition of growth of experimental strains were markedly or considerably exhibited under 30 ppm$\sim$50 ppm of colloidal silver solution for 48 hours$\sim$72 hours in P. intermedia, 10 ppm$\sim$30 ppm for 24 hours$\sim$48 hours in P. gingivalis, 30 ppm for 24 hours in F. nucleatum. These results indicate that the colloidal silver inhibited effectively the growth of some species of Gram-negative anaerobic bacteria by exhibition of bacteriostatic or/and bacteriocidal effects, and can be used as a possible major ingredient of the nonharmful natural antibacterial oral rinsing remedy to oral malodor and periodontal diseases.

The effects of Moxibustion Therapy on Chronic Low Back Pain, Daily Living Disability and Sleep Pattern in Elderly Women (뜸요법이 여성노인의 만성요통, 일상생활기능장애 및 수면양상에 미치는 효과)

  • Kim, Hye-Jeong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.7
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    • pp.301-310
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    • 2016
  • This is a nonequivalent control group non-synchronized experiment research to verify the effect of moxibustion therapy on efficient management of daily living disabilities and sleep patterns in elderly women with chronic low back pain. Total 12 sessions of moxibustion therapy were applied to elderly women(30 subjects in an experimental group and 30 subjects in a control group) in G City once a week for 12 weeks from March 15th to May $31^{st}$ 2015. Then the follow-up study was conducted 2 weeks after the post survey. For moxibustion, was applied to Shen-shu, Ashi point, Ta chang shu, Yang kuan and Yosu. 5 sheets of moxibustion were applied to 7 acupuncture points of Mugeukboyang moxibustion; Zu san li & Chu chi, Chung wan, Chung chi & Shui tao, Fei shu, Kao hung and Tien shu, Wijung respectively and experimental treatment was conducted. For assessing the degree of back pain, Visual Analog Scale(VAS) developed by Scott & Huskisson(1979) was used and for measuring the degree of daily living disability, Oswestry Disability Index, which was developed by Fairbank et al(1980) and translated and revised by Yim, Hyeon-sul et al.(1998), was used. For measuring sleep patterns, the sleep pattern measurement tool developed by Oh, Jin-su, Song, Mi-soon and Kim, Sin-mi(1998) was used. For data analysis, SPSS/WIN 18.0 was employed and Chi-square test, t-test and repeated measures ANOVA were performed. There were significant differences in pain score(F=2510.32, p<.001), daily living disability score(F=1937.82, p<.001) and sleep pattern score((F=15.54, p<.001) of elderly women that were provided with moxibustion therapy, compared to the control group. Therefore, it was found that moxibustion therapy made a positive contribution to reduction in pain and daily living disabilities and improvement in sleep quality. Based on this study finding, there is a need to apply moxibustion therapy to elderly people with chronic low back pain as a nursing intervention in future.