• Title/Summary/Keyword: Aged chronic pain patients

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The effects of pain, sleep, and depression on quality of life in elderly people with chronic pain (만성통증 노인의 통증, 수면 및 우울이 삶의 질에 미치는 영향)

  • Choi, In Suk;Park, Kyungsook
    • Journal of Digital Convergence
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    • v.15 no.8
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    • pp.289-299
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    • 2017
  • This study was conducted to investigate the effect of pain, sleep, and depression on quality of life in elderly patients with chronic pain. The subjects of this study were 170 elderly aged over 65 years. Data collected from July 1 to September 30 in 2016 at local community center were analysed by multiple regression. As a result, the pain, sleep, depression and quality of life of elderly significant difference by general characteristics and pain-related characteristics. In addition, In this study, the positive correlation between sleep (.471, p<.001) and quality of life, and negative correlation between quality of life and each of pain (-.332, p<0.001) and depression (-.720, p<0.001) were presented. The factors affecting the quality of life of the elderly with chronic pain were subjective health status (${\beta}=.236$, p=.001), depression diagnosis (${\beta}=.123$, p=.048), and depression (${\beta}=-.526$, p<.001), and depression related factors were most influential factor. Therefore, in order to improve the quality of life of elderly people with chronic pain, nursing and management programs should be prepared to reduce depression and pain.

Clinical Epidemiology for Elderly Patients of Oral Medicine Clinic (구강내과에 내원하는 노인 환자들의 임상 역학 연구)

  • Oh, Hyun-Sun;Kim, Hye-Kyoung;Park, Jo-Eun;Kim, Ki-Suk;Kim, Mee-Eun
    • Journal of Oral Medicine and Pain
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    • v.38 no.1
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    • pp.19-28
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    • 2013
  • With Korea's rapid entry to aged society, elderly population has become a major age group both in the whole society and medical field and its importance will be constantly stressed out. Elderly population is also important in the field of oral medicine which deals with chronic and recurrent diseases in the orofacial region of non-dental origin but there exist few studies indicating epidemiology of elderly patients in this regards. This study aimed to investigate change of age distribution of new patients in a university-based dental hospital and oral medicine clinic for last decade and to investigate clinical epidemiology of elderly patients (${\geq}$ 65 years) of oral medicine clinic. This study was performed retrospectively using medical records of the new patients in Dankook University Dental Hospital in 2001 and 2011. According to the study, percentage of elderly new patients increased in both dental hospital and oral medicine clinic and degree of the increase was greater in oral medicine clinic than in the whole hospital (p=0.000). 13.5% of adult patients ${\geq}$ 18 years of oral medicine clinic were elderly patients ${\geq}$ 65 years. 83% of elderly patients were suffering from one or more systemic diseases. Although TMD was the most common reason for elderly patients who visited oral medicine clinic, oral soft tissue diseases, dry mouth, burning mouth syndrome and oromandibular dystonia was more frequently diagnosed in elderly patients compared to adult patients aged 18 to 64 years. Pain severity and interference of Brief Pain Inventory and depression and anxiety scores of Hospital Anxiety Depression Scales were higher in elderly patients than in the adult patients (p<0.05). Increase of elderly patients with chronic oral diseases and pain needs more attention of dentists and specialists of oral medicine to improvement of assessment and development of tailored management because large portion of the elderly patients have systemic diseases, polypharmacy and impaired communication, possibly restricting treatment options.

Effects of Cervical Mobilization and Craniocervical Flexion Exercise on the Dynamic Balance and Gait Variability in Chronic Neck Pain Patients: Randomized Controlled Trial (목뼈 가동 운동과 머리목 굽힘 운동이 만성 목통증 환자의 동적균형과 보행변인에 미치는 영향: 무작위 임상시험)

  • Choi, Tae-Seok;Ryu, Byeong-Ho;Lee, Sang-Bin
    • Journal of the Korean Society of Physical Medicine
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    • v.15 no.2
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    • pp.31-38
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    • 2020
  • PURPOSE: The aim of this study is to find a more efficient intervention method through a study of the gait variables and dynamic balance of chronic neck pain patients. METHODS: Forty subjects aged between 40 and 60 years were allocated randomly to two groups; The first group performed PA (Posteroanterior Mobilization), and the second group conducted CCF (Craniocervical Flexion Exercise). The gait variability measured the speed, cadence, and dynamic balance in the forward, leftward, rightward, and rearward directions. An independent t-test, Wilcoxon signed-rank test, and paired t-test were used for statistical analysis. RESULTS: In the dynamic balance measurements, the variability of PA (p < .000) and CCF (p < .000) in the rightward direction, PA (p < .004) in leftward direction and forward direction increased significantly (p < .013). In an analysis of the gait variability, the cadence increased significantly in the PA group (p < .022) and not significantly in the CCF group (p < .056). On the other hand, there was no increase in the speed variable, in the PA group (p < .437). In the CCF group, the cadence increased significantly (p < .022). The differences in the PA and CCF group differences were not significant. CONCLUSION: The PA group showed a significant increase in the forward (p < .013), leftward (p < .004), and rightward directions (p < .000). Speed was significant in the CCF group, and cadence was significant in the PA group. The dynamic Balance was effective in the rightward direction in both groups, but there was no significant difference between the two groups.

The Effects of Segmental Instability and Muscle Fatigue after Applying Sabilization Exercise Program In Degenerated Disc Disease Patients of Aged (노인 퇴행성디스크 환자의 안정화운동이 척추불안정과 피로도에 미치는 영향)

  • Kim, Hee-Ra
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.13 no.2
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    • pp.12-20
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    • 2007
  • The purpose of this study was designed to find out the effectiveness of vertebral segment instability, muscle fatigue response on lumbar spine after apply lumbosacral stabilization exercise program to 4 patients with chronic low back pain and for 12 weeks. In this study, the lumbar spine motion with blind by MedX test machine and the difference of instability to lumbar vertebra segments in flexion, extension test of standing position and spinal load test(Matthiass Test) by Spinal Mouse. The stabilization exercise program was applied 2 times a week for 12 weeks in hospital and 2 times a day for 20 minutes at home. The results of the present study were as follows: 1. Instability test of lumbar vertebra segment is 2 type differential angle test between vertebrae segment and loading test of spine(matthiass) by Spinal Mouse. It appeared to improve stability of segments in sagittal plane after applying program. So lumbar spine curve increased lordosis toward anterior and was improved of the lumbar spine flexibility in flexion and extension. Specially, in matthiass test, (-) value was increased between lumbar vertebra segment when was the load on spine. And so applying stability improved after program. 2. Fatigue response test(FRT) results, in male, was raised muscle fatigue rate during increase weight, on the other hand female appeared lower than male. As a results, lumbosacral stabilization exercise was aided to improvement of lumbar spine vertebra segments stabilization. Spine instability patients will have a risk when in lifting a load or working with slight flexion posture during the daily of living life and it is probably to increase recurrence rate. Thus, not only lumbar extension muscle strength but also stability of vertebra segments in lumbar spine may be very important.

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The Effects of Segmental Instability and Muscle Fatigue after Stabilization Exercise Program in Degenerated Disc Disease Patients of Aged (노인 퇴행성디스크 환자의 안정화운동이 척추불안정과 피로도에 미치는 영향)

  • Kim, Hee-Ra
    • Journal of Korean Physical Therapy Science
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    • v.13 no.4
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    • pp.7-16
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    • 2006
  • The purpose of this study was designed to find out the effectiveness of vertebral segment instability, muscle fatigue response on lumbar spine after apply lumbosacral stabilization exercise program to 4 patients with chronic low back pain and for 12 weeks. In this study, the lumbar spine motion with blind by MedX test machine and the difference of instability to lumbar vertebra segments in flexion, extension test of standing position and spinal load test(Matthiass Test) by Spinal Mouse. The stabilization exercise program was applied 2 times a week for 12 weeks in hospital and 2 times a day for 20 minutes at home. The results of the present study were as follows: 1. Instability test of lumbar vertebra segment is 2 type differential angle test between vertebrae segment and loading test of spine(matthiass) by Spinal Mouse. It appeared to improve stability of segments in sagittal plane after program. So lumbar spine curve increased lordosis toward anterior and was improved of the lumbar spine flexibility in flexion and extension. Specially, in matthiass test, ( - ) value was increased between lumbar vertebra segment when was the load on spine. And so stability improved after program. 2. Fatigue response test(FRT) results, in male, was raised muscle fatigue rate during increase weight, on the other hand female appeared lower than male. As a results, lumbosacral stabilization exercise was aided to improvement of lumbar spine vertebra segments stabilization. Spine instability patients will have a risk when in lifting a load or working with slight flexion posture during the daily of living life and it is probably to increase recurrence rate. Thus, not only lumbar extension muscle strength but also stability of vertebra segments in lumbar spine may be very important.

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Pain Disability of Orofacial Pain Patients (구강안면통증 환자의 통증활동제한)

  • Choi, Se-Heon;Kim, Ki-Suk;Kim, Mee-Eun
    • Journal of Oral Medicine and Pain
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    • v.34 no.2
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    • pp.217-225
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    • 2009
  • As Pain is a comprehensive, biopsy chosocial phenomenon, improved understanding and successful management of pain need assessment of health-related quality of life and psychological states. The purpose of this study was to evaluate pain severity and pain-related interference to daily lives for patients with non-dental, orofacial pain(OFP) and a possible relation of OFP with psychological morbidity. Relation with such factors as gender, age, pain duration and diagnosis was also assessed. Inclusion criteria was all new patients with non-dental OFP attending the oral medicine.orofacial pain clinic of Dankook University Dental Hospital over 3 months' period, who completed the questionnaires of the Brief Pain Inventory (BPI) and Hospital Anxiety and Depression Scale (HADS). Prior to the first consultation, the patients were asked to fill out the questionnaire in the waiting room and were diagnosed through consultation and clinical examination. Total subjects were 163 with M:F ratio of 1:1.5 and mean age of 34.6${\pm}$17.7 years. Mean duration of pain was 13.3${\pm}$26.2 months and all patients were divided into; Trigeminal Neuralgia group (TN, N=8), Neuropathic Pain group (NeP, N=9), Persistent Idiopathic Facial Pain group (PIFP, N=8), and Temporomandibular Disorders group (TMD, N=138), subdivided into muscle problem (TMD-m, N=73), joint problem (TMD-j, N=24) and muscle-joint combined problem (TMD-c, N=41). OFP patients showed moderate pain severity and moderate pain-related interference. There was no gender difference in overall pain severity and interference and levels of anxiety and depression. Elderly patients aged ${\geq}$ 60 years showed higher pain severity (p<0.05). Patients with chronic pain ${\geq}$ 3 months reported more increased level of anxiety and depression than those with acute pain (p<0.05). Compared to TMD patients, patients with TN, NeP and PIFP suffered from higher level of pain and pain-related interference and reported higher level of anxiety and depression (p<0.05). Pain interference was closely correlated with their pain severity and with psychometric properties such as anxiety and depression. Pain severity was weakly correlated with levels of anxiety and depression. The results suggest a need for psychosocial assessment and support for successful management of OFP in addition to control of pain itself.

A Clinical Evaluation of the Surgical Treatment of Primary Bronchogenic Carcinoma (폐암의 외과적 치료에 대한 임상적 고찰)

  • 김근호
    • Journal of Chest Surgery
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    • v.2 no.1
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    • pp.13-18
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    • 1969
  • A clinical evaluation was done on a total of 41 cases of primary bronchogenic carcinoma, which came to the department of thoracic surgery, Chonnam University Hospital for the period of 5 years from May 1964, and the various factors led the patients to an inoperable stage were searched. The incidence ratio of male to female was 5.8:1 and the age group of fifty and sixty decade occupied 78% of the total. The subjective symptoms of the patients were cough with or without sputum [83%], chest pain or chest discomfort [76%], and a few incidence of bloody sputum and hemoptysis. The histological findings were 40% of squamous cell carcinoma, 35% of adenocarcinoma and 25% of anaplastic carcinoma, including 5 cases of unclassified bronchogenie carcinoma in scalene biopsy. 12 cases [29%] of a total of 41 cases received thoracotomy, but 8 cases among them were operable and 4 cases inoperable. The rest of 29 cases [71%] could not receive thoracotomy because of the various contraindication. 23 cases [70%] out of inoperable 33 cases had wasted time over 2 months duration for an operation owing to physicians` misdiagnosis of bronchogenic carcinoma as pulmonary tuberculosis, chronic lung abscess, asthma, pleurisy, pneumonia. common cold, neuralgia in order. The delaying factors led the patients to an inoperable stage were physicians misdiagnosis of bronchogenic carcinoma due to non-specific symptoms and signs of the patients, old aged patients dependance on herb medicine, and poor economical condition of the patients.

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The Age and Sex-specific Quality of Life by Chronic Disease Using the EQ-5D Index : Based on the 2017-2019 Korea National Health and Nutrition Examination Survey (EQ-5D 지수를 활용한 만성질환별 삶의 질의 성별 및 연령에 따른 변화: 2017~2019년 국민건강영양조사 자료를 이용하여)

  • Gyung-Jun Chae;Se-Ho Park;Seung-A Song;Jun-Kyu Lee;Jong-min Hong;Jae Seok Song;Nam Jun Kim
    • Journal of agricultural medicine and community health
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    • v.48 no.2
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    • pp.81-90
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    • 2023
  • Objectives: This study analyzed the decline in quality of life according to age in the chronic disease patient group, quantified it as a quantitative index, and compared it by sex and chronic disease. Methods: In the 2017-2019 Korea National Health and Nutrition Examination Survey database, 11,473 adults aged 19 years or older, excluding cancer patients, were analyzed for age-specific changes in the EQ-5D Index by chronic disease. The decline in quality of life according to age in patients with chronic diseases was analyzed by linear regression analysis while controlling for general characteristics. Then, linear regression analysis was performed according to sex. Results: In the case of the control group, the quality of life decreased by 0.0004 for every 1-year increase in age(P<0.001). By chronic disease, asthma(β=0.0019, P<0.001), arthritis(β=0.0017, P=0.002), thyroid dis- ease(β=0.0016, P=0.015), dyslipidemia(β=0.0011, P=0.020), and hypertension(β=0.0009, P=0.027) mostly showed a greater decrease in quality of life than the control group. In addition, when divided into two groups by sex, hypertension(β=0.0012, P=0.029), thyroid disease(β=0.0041, P=0.038), and arthritis(β=0.0022, P<0.001) showed a significant decrease in quality of life only in male. Diabetes(β=0.0056, P=0.038), dyslipi- demia(β=0.0022, P=0.001) significantly decreased quality of life only in female. Conclusions: Chronic disease had a negative impact on patients perception of quality of life, and the more severe the pain and activity limitation due to the chronic disease, the more severe it was. It also showed different patterns according to sex. Therefore, it is necessary to allocate more medical resources and provide policy support to prevent chronic diseases, which are serious social problems.

Short-term safety profile of COVID-19 vaccination in children and adolescents with underlying medical conditions: a prospective cohort study

  • Naye Choi;Seung-Ah Choe;Yo Han Ahn;Young June Choe;Ju-Young Shin;Nam-Kyong Choi;Seong Heon Kim;Hee Gyung Kang
    • Childhood Kidney Diseases
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    • v.27 no.1
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    • pp.34-39
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    • 2023
  • Purpose: This article was to collect data on the safety of coronavirus disease 2019 (COVID-19) vaccines in children with underlying medical conditions. Methods: We constructed a prospective cohort of children and adolescents aged 5 to 19 years who had received at least one dose of COVID-19 vaccine. Patients diagnosed with and treated for chronic kidney disease, autoimmune disease, or other chronic conditions at the Seoul National University Children's Hospital were recruited from June to December 2022. A mobile survey questionnaire was sent to their guardians. The presence of adverse events on the day (day 0), 3 weeks (day 21), and 6 months (day 180) after the 1st dose of COVID-19 vaccine was recorded by the guardians. Results: A total of 73 children participated. The median age was 14 years, and 64.4% of the patients were male. On the day of immunization, 65.8% of the patients reported at least one adverse event. Pain at the injection site, fatigue, headache, arthralgia, and myalgia were the most common symptoms. The prevalence of adverse events decreased over time (65.8% on day 0, 27.4% between days 0 and 21, and 24.6% between days 21 and 180). Severe acute respiratory syndrome coronavirus 2 infection after the 1st dose occurred in 17 patients (23.3%) and one of the patients (5.88%) was hospitalized due to infection. Conclusions: Adverse events after COVID-19 vaccination were generally mild in children and adolescents with underlying medical conditions. Our findings provide evidence for the safety of COVID-19 vaccination in the vulnerable pediatric population.

Study on the Association of DSOM Pathogenic Factor in the Insomnia Patients (불면환자의 수면의 질 척도와 한방진단시스템 병기(病機)와의 연관성 연구)

  • Lee, Dong-Wha;Kim, Bo-Kyung
    • Journal of Oriental Neuropsychiatry
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    • v.21 no.1
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    • pp.89-108
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    • 2010
  • Objectives: This study was to investigate the relation of Pittsburgh Sleep Quality Index(PSQI) and Diagnos system of oriental medicine(DSOM) in the Insomnia Patients. Methods: For this study, we carried out PSQI and DSOM of 92 patients with insomnia who have come to Kijang public health center and Donguei oriental hospital of Donguei university from November 2008 to October 2009. We verified the association of PSQI and DSOM using crosstabulation analysis, independent sample T-test, one-way ANOVA and correlation analysis. Results: 1. Blood-deficiency(血虛) is the most frequent pathogenic factor and frequency of nightmare has positive correlation with that factor including heart(心) in total insomnia patients. 2. Female patients have a higher percentage of chronic insomnia than male patients. 3. As patients aged, maintaining sleep gets harder, sleep time is lessening, taking hypnotics is increasing and quality of sleep gets worse. 4. There is high frequency of chronic insomnia in 40~50 years and over 60 years old. Also, the people who are over 60 years of age tend to sleepless and urinated frequently during the middle of the night. The people with the age of 20~30 years tend to take less sleeping pills and frequency of sleeping during daytime is higher than the other age groups but the quality of sleep is quite good. 5. The patient with over 6 months of chronic insomnia tend to be older in age than the patient with less than 6 months. And the patient with chronic sleeping disorder has frequent pain and the quality of sleep is very poor. 6. The patient who took hypnotics tend to be older than hypnotics non-user and frequency of urination was relatively high. 7. The patient who visited oriental medical hospital were tend to be older and get difficult in maintaining sleep. And frequency of taking hypnotics and urinating during night were tend to be higher and the quality of sleep was poor compared with the patient who visited public health center. Conclusions: This study provides insights into the complicated relations of the associated symptom of insomnia with Diagnos system of oriental medicine. And especially this study showed apparent correlation between nightmare in insomnia patients and pathogenic factor of blood-deficiency and heart. Specific correlations and characteristics in this study could be connect develop of new questionaire of insomnia.