• Title/Summary/Keyword: Coping of Pain

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Chronic pain control in patients with rheumatoid arthritis (만성통증 환자의 통증 조절)

  • Eun, Young
    • Journal of muscle and joint health
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    • v.2 no.1
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    • pp.17-40
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    • 1995
  • Rheumatoid arthritis is the one of the chronic diseases, one of its major symptoms is a chronic pain. Despite developing medical treatment and surgical techniques, it is suggested that to control the pain is the goal of the treatment. But pain is an inner experience and even those closest to the patient cannot truly observe its progress or share in its suffering. The National Academy of Sciences Institute of Medicine's report on Pain and Disability concluded that there is no objective measure of pain-(exactly) no pain thermometer-nor can there ever be one, because the experience of pain is inseparable from personal perception and social influence such as culture. To explore chronic pain experience is to understand the process and property of the patient's perception of pain through the response to pain, the coping with pain, and the adaptation to pain. Therefore a qualitative study was conducted in order to gain an understanding of pain experience of patients with RA in korea. I used naturalistic inquiry as a research methodology, which had 5 axioms, the first is that realities are multiple, constructed, and holistic, the second is that knower and known are interactive, inseparable, the third is only time and context bound working hypotheses(idiographic statements) are possible, the forth is all entities are in a state of mutual simultaneous shaping, so that it is impossible to distinguish causes from effects and the last is that inquiry is value-bound. Purposive sampling was conducted as a sampling. 20 subjects who experienced pain over 10 years, lived in middle-sized city and big city in Korea, and 17 women and 3 men. The subject's age was from 32 to 62 (average 48.8), all were married, living with their spouse and children, except two-one divorced and the other widow before they became ill. I collected data using In depth structured interview. I had interviews two or three times with each subject, and the interviews were conducted at each subject's home. Each interview lasted about two hours an average. A recording was taken with the consent of the subject. I used inductive data analysis-such as unitizing and categorizing. unitizing is a process of coding, whereby raw data are systematically transformed and aggregated into units. Categorizing is a process wherby previously unitized data are organized into categories that provide descriptive or inferential information about the context or setting from which the units were derived. This process is used constant comparative method. The pain controlling process is composed of behavior of pain control. The behaviors of pain control are rearranging of ADL, hiddening role conflict, balancing treatment, and changing social relation. Rearranging of ADL includes diet management, sleep management, and the adjustment of daily life activities. The subjects try to rearrange their daily activities by modified style of motions, rearranging time span & range of activities, using auxillary facilities, and getting help in order to keep on the pace of daily life. Hiddening role conflict means to reduce conflicts between sick role and their role as a family member. In this process, the subjects use two modes, one is to control the pain complaints, and the other is to internalize the value which is to stay home is good for caring her children and being a good mother. To control pain complaints is done by 'enduring', 'understanding' the other family members, or making them undersood in order to reduce pain. Balancing treatment is composed of two aspects. One is to keep the pain within the endurable level, the other is to keep in touch with medical personnel in order to get the information of treatment and emotional support. Changing social relation is made by information seeking and sharing, formation of mutual support relation, and finally simplification of social relationships. The subjects simplify their social relationships by refraining from relations with someone who makes them physically and psychologically strained. In particular the subjects are apt to avoid contact with in-laws, and the change of relation to in-laws results in lessening the family boundary. In the course of this process, they confront the crisis of family confict result in family dissolution. This crisis is related to the threat of self-existence. Findings from this study contribute to understanding the chronic pain experience. To advance this study, we should compare this result with other cases in different cultural contexts. I think to interpret these results, korean cultural background should be considered. Especially the different family concept, more broader family members and kinship network, and the traditional medical knowledge influences patients' behavior.

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A Qualitative Interpretative Meta-Synthesis(QIMS) Study on the Experience and Coping of Client Violence in Social Workers (사회복지사의 클라이언트 폭력경험과 대처에 관한 질적 해석적 메타통합(QIMS) 연구)

  • Kil, Tae-Young
    • The Journal of the Korea Contents Association
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    • v.21 no.10
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    • pp.738-752
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    • 2021
  • This study was to applied QIMS(Qualitative Interpretive Meta-Synthesis) which was newly introduced in the field of social science recently to explore the client violence experience and coping in the social workers in a new way and in depth. The integrated analysis of the results of qualitative individual studies published in Korea so far has resulted in abundant results with accumulated knowledge and synergistic understanding paths of existing research results, and the limitations of qualitative research have been overcome. Eight published papers from 2013 to 2020 were included in the final analysis, and a total of 85 social workers analyzed the statements. The newly important themes created through the process of reducing the scope of data and the repetition of theme extraction and integration were divided into four categories: (1) violence and pain that can not be removed, (2) duality experienced as a result of occupation, (3) continuous attempts to change, (4) manifestation of sense of duty and job meaning. Based on the results of the integrated themes derived from this study, this study aims to present practical and policy alternatives to the prevention and coping of client violence experienced by social workers in various social welfare practice fields.

Effect of Immediate Dynamic Balance Ability of Chronic Low Back Pain on Maitland's Manual Therapy (메이트란드 도수치료가 만성 요통환자의 즉각적인 동적 균형능력에 미치는 영향)

  • Hyong, In-Hyouk;Ha, Mi-Sook
    • The Journal of the Korea Contents Association
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    • v.9 no.6
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    • pp.207-215
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    • 2009
  • There has been a diversity of therapeutic interventions for patients with chronic low back pain. However most of them have been focused on only pain. But the patients usually have a kind of structurally abnormal have fixed in lumbar vertebrae, which can decrease range of joint movement and, what is worse, reduce immediate dynamic balancing ability(IDBA). The reduced IDBA can increase the risk of injury and decrease coping ability in dangerous situation. So we introduced Maitland's manual therapy in this study in order to recover the IDBA in patients with chronic low back pain. Sixty-four patients diagnosed with chronic low back pain were included for the study. Among them, thirty-two patients(experimental group) were managed by Maitland's manual therapy, another thirty-tow patients(control group) were treated by physical science methods(H/P, TENS, U/S). Each group made use of highly reliable(0.81$\sim$0.96) star excursion balance test(SEBT) to compare the possible changes of IDBAs in two groups after treatment. In experimental group, IDBA has increased in forward, rightward, leftward, and backward, but in control group, not changed. According to the results, we concluded that Maitland's manual therapy is effective for increasing IDBA by making joints more flexible in lumbar vertebrae.

Smartphone Overuse and Upper Extremity Pain, Anxiety, Depression, and Interpersonal Relationships among College Students (대학생의 스마트폰 중독사용 정도에 따른 상지통증, 불안, 우울 및 대인관계)

  • Hwang, Kyung-Hye;Yoo, Yang-Sook;Cho, Ok-Hee
    • The Journal of the Korea Contents Association
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    • v.12 no.10
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    • pp.365-375
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    • 2012
  • This study aimed to survey the impact of smartphone overuse on upper extremity pain, anxiety, depression, and interpersonal relationships among college students. Subjects completed a structured questionnaire consisting of the Smartphone Addiction Inventory, the Musculoskeletal Symptom Checklist, the State-Trait Anxiety Inventory, the Beck Depression Inventory-II, and the Relationship Change Scale from May to June 2012. We analyzed the survey data from 525 responses, excluding unreturned or incomplete surveys. Data were analyzed using the $x^2$ test and t-test to determine the differences in smartphone overuse and its impact on upper extremity pain, anxiety, depression, and interpersonal relationships between two groups: the overuse and normal use groups. Moreover, Pearson's correlation coefficient was used to examine the correlation between smartphone overuse and upper extremity pain, anxiety, depression, and interpersonal relationships. The results placed 62 people (11.8%) in the smartphone overuse group. The extent of smartphone overuse was more severe among female than male college students, and longer time spent using smartphones per day was directly related to smartphone overuse. The smartphone overuse group evidenced higher shoulder pain than the normal use group did, but no differences were found in other sites of the upper extremities. State anxiety, trait anxiety, and depression were higher in the smartphone overuse group than in the normal use group. Subjects with a higher extent of smartphone overuse experienced increased state-anxiety, trait-anxiety, and depression. Moreover, subjects with higher state-anxiety, trait-anxiety, and depression scores were more likely to have poor interpersonal relationships. Therefore, early screening for smartphone overuse should be evaluated, because it can be useful in developing addiction prevention programs to improve posture, stress coping, positive mental health, and effective interpersonal relationships.

The Prediction Model of Adaptation in Patients with Rheumatoid Arthritis - Propositional Synthesis of Roy's and Lazarus & Folkman's Theory - (류마티스 관절염 환자의 적응 예측모형 -Roy이론과 Lazarus 및 Folkman 이론의 명제 합성-)

  • Kim, In-Ja;Suh, Moon-Ja
    • Journal of muscle and joint health
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    • v.4 no.2
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    • pp.197-220
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    • 1997
  • The lack of a comprehensive theory describing the mechanism of adaptation scientifically has been one of the limiting factors for the development of nursing intervention of patients with chronic illness. Since Roy's theory provides the general conceptual framework depicting adaptation process with structural stimuli and control mechanism, it is appropriate to understand the process of adaptation. But in Roy's theory, the propositions about cognator and regulator as control mechanisms are not clearly defined. For this reason, most of the previous researches applying the Roy's theory have disregarded the study of cognator and regulator. For the patients with chronic illness such as rheumatoid arthritis, it was reported that adaptation states were different for the same stimuli due to the difference of the control mechanism. Moreover in nursing it is important to identify the control mechanism which can be and must be intervened by nurses. It was the Lazarus and Folkman's theory that proposed the control mechanism. They suggested that individual differences in the reaction against the perceived stress are due to the difference in appraisal and coping. Therefore, the synthesis of Roy's and Lazarus and Folkman's propositions might help to clearly understand the mechanism of adaptation. From this point, a theoretical framework has been developed and tested. The subjects were the 297 patients who had been diagnosed rheumatoid arthritis and attended the outpatient clinic. A hypothetical prediction model of adaptation was tested by the covariance structure analysis with PC-LISREL 7.13. As a result, the overall fit was good($x^2$=78.83, p=0.00 ; GFI=0.96 : AGFI=0.90 ; RMR=0.04) for the hypothetical model. In the final model added GA(5, 1), the overall fit was increased ($x^2$=57.82, p=0.003 ; GFI=0.97 ; AGFI=0.93 : RMR=0.036). Except the fact that illness symptoms affected physical adaptation directly, it was supported that focal and contextual stimuli affected physical and psychosocial adaptation through appraisal and coping. Therefore, it was asserted that the synthesis of two theory's propositions was appropriate. So this model would be useful for the theoretical framework in the nursing practice. And this study synthesizing and testing the theory might contribute to establish nursing's scientific base.

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A study on menopausal symptoms and health needs among middle aged women. (중년여성의 갱년기 증상과 건강요구에 대한 기초조사)

  • Cha, Young-Nam;Jang, Hyo-Soon;Kim, Keum-Ja;Han, Hae-Sil;Lim, Hye-Kyung;Chung, Young-Hae
    • The Korean Nurse
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    • v.34 no.4
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    • pp.70-82
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    • 1995
  • During the middle age of a woman's life cycle. several health changes and problems occur. Therefore. middle aged women must manage their health and maintain quality life by coping with bodily changes. However. today there is not enough research and health programs for middle aged women. Data from the study will be used for health promotion program development of middle aged women. Data was collected from January 21 to 24. 1995 by telephone interview. Four hundred middle aged women between 40 and 59 years old and living in Chon Ju City were interviewed. The results of this study were as follow: 1. Frequency rate of menopausal symptoms was 38.4%. The most serious menopausal symptom was psychosomatic symptom. Mean score orders of experienced symptoms were back pain, joint pain(1.80). nervousness(1.80). general weakness(1.67). 2. The most important problems as perceived by the clients were children(45.8%), health (24.0%) and economics(7.8%). The most serious health problems were concerning the muscle-skeletal system(45%) such as arthritis. spinal disk problems and osteoporosis. Adult diseases04.S%) such .as hypertension and diabetes were also health concerns. Health management activities reported were exercise(22.5%), social activity02%) and inactivity(53%)' 33% of clients were interested in health groups and they wanted a program of health education, exercise and social activity to be provided. 3. General characteristic variables were significantly related to the level of menopausal symptoms as follows: age(t=-2.06, p=0.040), status of marriage(t=-3.56, p=0.000), educational level (F=4.35. p=0.05) and menopausal status(t=4.37, p=0.000).

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Analysis of Nursing Interventions used in Orthopedic Nursing Unit (정형외과 간호단위에 적용되는 간호중재 분석)

  • Kim Hye-Suk;Choi Soon-Hee
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.13 no.1
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    • pp.33-41
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    • 2006
  • Purpose: This study was done to identify the Domains, Classes, labels and nursing activities of nursing interventions used with 117 patients who were admitted to orthopedic nursing units. Method: Data were collected in January and February, 2004 using a computerized nursing process program that contained nursing diagnosis-outcome-intervention (NNN) linkages. The program was developed by the researcher. Frequencies and percentages were used in the analysis. Results: Sixty-five nursing intervention labels were identified. The Domains of the nursing interventions showed higher percentages for 'physiological: basic' (75.9%), 'physiological: complex' (12.9%), 'behavioral'(7.8%) 'family'(1.3%), and 'safety'(1.1%). The Classes of nursing interventions showed higher percentages for 'activity and exercise management'(30.8%), 'physical comfort promotion'(19.3%), 'immobility management'(14.5%), 'drug management'(8.1%), and 'coping assistance'(5.6%). Nursing intervention labels showed higher percentages for 'pain management'(14.7%), 'body mechanics promotion'(8.0%), 'exercise therapy : ambulation'(7.2%), 'splinting'(5.4%), and 'positioning'(5.1%). In the comparison of numbers between performed nursing activities and nursing activities of NIC according to nursing intervention label, the mean of combined rate was 52.3%. Conclusion: These findings will help in building of a standardized language for orthopedic nursing units and enhance the quality of nursing care.

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Effects of a Symptom Focused Self-Management Program on Symptom and Functional status, Health Perception, and Quality of Life of Patients with Chronic Heart Failure (인지적 의사결정에 근거한 증상별 자기관리프로그램이 만성 심부전 환자의 신체·기능상태, 건강지식 및 삶의 질에 미치는 영향)

  • Kim, Gi Yon
    • Korean Journal of Adult Nursing
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    • v.19 no.1
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    • pp.132-143
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    • 2007
  • Purpose: The purpose of this study was to identify effects of a self-management program on symptom and functional status, health perception, and quality of life(QOL) of patients with CHF. Methods: Patients with CHF as defined through clinical judgment using the Framingham criteria and EF<50% were enrolled in the study (experimental: 21, control: 20). The symptom focused self-management program consisted of coping behaviors for symptoms including dyspnea, chest discomfort/pain, dizziness, ankle edema, and basic self-management including medications, diets, activity, lifestyle changes. Experimental group received an educational booklet after survey, and periodic telephone follow-up by a trained nurse. Data were collected the 3rd day after admission and at 1 month, 3 months, and 6 months after discharge using questionnaires. Results: Significant differences were found in the presence of symptoms, health perception, and QOL between groups during follow-up. Although no significant difference was found in functional status, the experimental group reported better functional status than the control group. Conclusion: By facilitating self-management of CHF using tailored interventions including education programs and telephone monitoring, it is expected that patients will be able to monitor their symptoms routinely, adhere to therapeutic regimen, and have a better QOL.

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Narrative Analysis on Survivor's Experience of Daegu Subway Fire Disaster - The Hypothetical Suggestions for Disaster Nursing Practice - (재난 생존자 경험의 내러티브 분석 -재난 간호를 위한 제언-)

  • Choi Namhee
    • Journal of Korean Academy of Nursing
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    • v.35 no.2
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    • pp.407-418
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    • 2005
  • Some fifty survivors participated in the narrative therapy sessions from March 2003 to December 2004, and thirty cases were analyzed using the transcripts. Each participant's surviving story was summarized, and then interpreted and reinterpreted by the survivors themselves in collaboration with the researcher. The two main principles in narrative analysis were hermeneutical distanciation and hermeneutical circulation. Result and Conclusion: First, nursing involvement should play active roles from the early stages of disaster incidents. Specifically, emergency nursing and flexible coping plans are to be available according to the specific properties of each case. Secondly, it is necessary to try to understand the extreme emotional experiences of disaster survival. The horror and pain people feel at an incident cannot simply be generalized, and it requires that each case be approached individually to help stop social alienation. Thirdly, more constant and long-term studies are required to set up nursing strategies for disaster survivors. Forming a trusting relationship with survivors is basic, and formally registering as participants is necessary for continuous interventions. Fourthly, we should deeply appreciate the danger and complexity of modern society and understand the complex nature of disaster. Fifthly, interdisciplinary activities and studies are necessary in combination with various other fields to establish a framework of total nursing care for disaster incidents. Lastly, it is urgently necessary to educate families and friends of the survivors and the society as a whole about life after a disaster.

The Effect of Psychological Counseling using Art Therapy on Improving Worker's Job Efficiency

  • Soomin, HAN
    • The Journal of Industrial Distribution & Business
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    • v.14 no.3
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    • pp.19-26
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    • 2023
  • Purpose: There is little emphasis on alternative forms of communication in psychotherapy, thus leaving a gap in research on the impact and effects of alternatives such as using artistic expressions. The current research, therefore, seeks to address the gap by investigating the effect of psychological counseling using Art Therapy on improving workers' job efficiency. Research design, data and methodology: The present author collected topic related to prior studies in terms of psychological counseling, art therapy, and employee job efficiency. And then, the author conducted clear procedure of the screening to eliminate inappropriate previous works including conference papers and dissertations so that this research could obtain only journal articles and books which have been proven by high degree of reliability and validity. Results: This research has concluded that psychological counselling using art therapy is pertinent to improving the worker's job efficiency in various ways, addressing properly mental health issues ranging from small to complicated or acute issues, thus promoting the well-being of employees to work at their optimum or best possible conditions. Conclusions: Psychological counseling using art therapy improves self-confidence, esteem, and awareness. Further, it enhances their social skills, expression capability, and general work ability. Elsewhere it improves coping with pain and reduces stress and depression.