• Title/Summary/Keyword: Knowledge of pain

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Effects of Patient Controlled Analgesia Convergence Education on Postoperative Pain Management in Spinal Surgery Patients (통증자가조절기 융합교육이 척추수술환자의 수술 후 통증관리에 미치는 효과)

  • Choi, Ga-Young;Kim, Ju-Sung
    • Journal of the Korea Convergence Society
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    • v.9 no.2
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    • pp.371-380
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    • 2018
  • The purpose of this study was to investigate the effects of patient controlled analgesia(PCA) convergence education on postoperative pain management in spinal surgery patients. Sixty spinal surgery patients were included. For the experimental group(n=30), PCA education using video, booklet, and a PCA model practice was provided before surgery. The data were collected using questionnaire and were analyzed using descriptive statistics, ${\chi}^2-test$, Fisher's exact test, t-test and repeated measures ANOVA. PCA knowledge-attitude, PCA satisfaction and pain control satisfaction were higher in the experimental group than the control group(p<.001; p=.001; p<.001). Postoperative pain and frequency of additional analgesia use of the experimental group were significantly lower than those of the control group(p<.001; p=.001). This findings showed that the convergence PCA education of audiovisual aids with PCA practice training could be effective pain management intervention in patients undergoing spinal surgery. These apply to development of convergence nursing interventions in clinical practice.

Influences of Chronic Pain on the Use of Medical Services in South Korea (만성 통증이 한국의 의료 이용 행태에 미치는 영향)

  • Jeong, Eui-Kyun;Kwak, Yeun-Hee;Song, Jae-Seok
    • The Journal of the Korea Contents Association
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    • v.15 no.2
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    • pp.363-369
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    • 2015
  • Chronic pain is one of the leading causes of hospital visits. It not only affects the patients themselves but also has a major negative impact on their families and society. In this study, we investigated epidemiology of musculoskeletal disorders induced chronic pain among general population based on Korea National Health and Nutrition Examination Survey database and also analysed how it influenced on the use of medical services. This study was done by using the data of 5th Korea National Health and Nutrition Examination Survey (KNHANES V), taking aged 20 years and over adults as research subjects. The EuroQoL-5 Dimension Index(EQ-5D) was used as a survey instrument. T-test, chi-square test and multivariate logistic regression were used for statistical analysis. Subjects with chronic pain had a higher likelihood than control group to use medical services(odds ratio : 5.858, confidence interval 3.636-9.438). Controlling for existence of chronic pain, more women were likely to use medical services than men(1.156, 0.707-1.889). Age, gender and household income level did not affect the use of medical services. Proper control of chronic pain is very helpful in improving patient's quality of life and it also accounts for a large proportion in suppressing excessive consumption of medical services. Anesthesia and pain medicine specialists have superior knowledge about analgesics and anticonvulsants than other physicians do and also have specialized skills to perform procedures like nerve blocks in treating chronic pain. Therefore Anesthesia and pain medicine specialists need to play a leading role in managing chronic pain.

Knowledge, Attitudes and Behavior of Bangkok Metropolitan Women Regarding Cervical Cancer Screening

  • Chaowawanit, Woraphot;Tangjitgamol, Siriwan;Kantathavorn, Nuttavut;Phoolcharoen, Natacha;Kittisiam, Thannaporn;Khunnarong, Jakkapan;Supawattanabodee, Busaba;Srijaipracharoen, Sunamchok;Thavaramara, Thaovalai;Pataradool, Kamol
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.3
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    • pp.945-952
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    • 2016
  • Purpose: To assess knowledge, attitudes and cervical cancer screening behavior of Bangkok Metropolitan women. Materials and Methods: Thai women, aged 25-to-65 years old, having lived in Bangkok for 5 years or more were invited to participate in the study. After signing informed consent, all women were asked to complete a self-questionnaire (Thai language) with literate assistance if needed. The questionnaire was divided into 3 parts: (I) demographic data; (II) knowledge about cervical cancer screening; and (III) behavior and attitudes, towards cervical cancer screening. Adequate screening was defined as women who had ${\geq}$two cervical cancer screening tests except women aged 25-30 years who may have only one screening, and the last screen was within 5 year or had had regular screening. Results: Of 4,339 women, there were 1,857 (42.8%) with adequate screening and 2,482 (57.2%) with inadequate screening. Significant factors associated with inadequate screening included age < 45 years, pre-menopausal status, family monthly income <625 USD, no reported sexual intercourse, nulliparous, no knowledge, lack of awareness and poor attitudes. Three major reasons provided by women for inadequate screening were no symptoms (54.4%), fear of pain (33.2%), and embarrassment (34.6%). Conclusions: Personal features, knowledge, and attitudes influence screening behavior of Bangkok Metropolitan women. The three most common reasons of women for not undergoinging screening are no symptoms, fear of pain, and embarrassment. These factors should be the focus of attention to improve coverage of cervical cancer screening in Bangkok.

An Analysis of the Surface Anatomical Location of the Posterior-inferior Margin of the Sacroiliac Joint (천장관절 후하연의 표면해부학적 위치 분석)

  • Cho, Kwang Yeon;Kim, Bum Su;Kim, Won Oak;Yoon, Duck Mi;Yoon, Kyung Bong
    • The Korean Journal of Pain
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    • v.22 no.1
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    • pp.47-51
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    • 2009
  • Background: The blind sacroiliac joint (SIJ) block cannot always be performed accurately; it is commonly performed in the office based setting because intraarticular and periarticular injections are effective for SIJ pain. However, knowledge on the surface anatomy of the SIJ is lacking. The purpose of this study was to analyze the surface anatomical location of the posterior-inferior margin of the SIJ. Methods: After informed consent was obtained, fifty patients undergoing SIJ block in the prone position were examined. The oblique angles where the anterior-inferior margin and the posterior-inferior margin of the SIJ overlap on X-ray were evaluated. In addition, the surface anatomical relationships between the posterior-inferior margin of the SIJ on X-ray and the posterior superior iliac spine (PSIS) and sacral hiatus by palpation were assessed. Results: The oblique angle was $5.4{\pm}2.9^{\circ}$. The vertical and transverse distance between the posterior-inferior margin of the SIJ and PSIS were $3.8{\pm}0.8cm$ and $0.9{\pm}0.6cm$, respectively. The vertical and transverse distance between the posterior-inferior margin of the SIJ and the midpoint of the sacral hiatus were $3.4{\pm}0.7cm$ and $3.9{\pm}0.6cm$, respectively. Only the vertical distance between the posterior-inferior margin of the SIJ and PSIS showed significant difference between the male and the female groups (P = 0.0016). Conclusions: The measurements in this study can be used as a reference standards for the blind SIJ block.

Implementation of contextualized, emergency management cognitive aids in a periodontics clinic

  • Siemens, Mikaela J.;Rice, Andi N.;Jensen, Trenton F.;Simmons (Muckler), Virginia C.
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.21 no.3
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    • pp.227-236
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    • 2021
  • Background: Emergencies in outpatient clinics are rare. However, potentially catastrophic events can be challenging to manage due to a variety of factors, including limited equipment and staff. The purpose of this quality improvement project was to improve the staff knowledge and familiarity with critical performance elements for emergencies encountered in the setting of a periodontics clinic. Methods: Emergency cognitive aids tailored to the clinic's resources were created for anaphylaxis, airway obstruction, and sublingual hemorrhage. The project pre-post-test repeated measures design evaluated the effectiveness of cognitive aids using a combination of hands-on simulation, written knowledge assessments, and self-efficacy surveys. Training sessions and simulations were provided to the clinic's existing care teams made up of a periodontist and two dental assistants with an anesthetist who was present for simulations involving sedation. Due to the small sample size (N = 14) and non-normal distribution, all metrics were evaluated using non-parametric statistics. Results: Significant improvements were found in knowledge assessment (-2.310, P = 0.021) and self-efficacy (-2.486, P = 0.013) scores when retention after a training session before and after the introduction of cognitive aid was compared. The mean simulation scores and times improved steadily or reached maximum scores during the project progression. Conclusion: Training sessions before and after cognitive aid introduction were effective in improving knowledge, self-efficacy, and simulation performance. Future projects should focus on validating the process for creating contextualized cognitive aids and evaluating the effectiveness of these cognitive aids in larger samples.

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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Effects of Education on Primiparas' Postpartial care (초산모를 위한 산후간호 교육의 효과)

  • Shin, Hye-Sook;Kim, Sung-Hee;Kwon, Sook-Hee
    • Women's Health Nursing
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    • v.6 no.1
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    • pp.34-45
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    • 2000
  • The study was to find whether the educational program contributed to increase of knowledge and self-efficacy of the postpartal primiparas. This study aimed at improvement of the educational effect for postpartal primiparas. The Subjects were 34 primiparas who were admitted to the obstetric ward in a University hospital from November 15th to December 9th, 1999. The Subjects were those who had no labor pain at the admission time, had no complications during labor and delivery and, gave birth to a healthy baby. They were tested on knowledge and self-efficacy two times, one at the admission time and prior to discharge. After the first test nurses in a maternity ward taught them on postpartal care. Two tools were developed by authors based on literature review. The test tool fr knowledge of postpartal car consisted of 23 items. The test tool for self-efficacy of postpartal care consisted of 16 items. Analysis of demographic data were analyzed with calculation of percentage. Score differences between the first test and the second test were analyzed with paired t-test. The Spss (Win 8.0) program was used for data analysis. The results are as follows. 1. There were not significant influencing general characteristics of primiparous to pre-educational knowledge. There were significant influencing general characteristics of primiparous to post-educational knowledge : occupation(t=13.04, p=0.00), postpartal education(t=5.51, p=0.02). 2. There were not significant influencing general characteristics of primiparous to pre-educational self-efficacy. There were significant influencing general characteristics of primiparous to post-educational self-efficacy : antenatal education(t=5.53, p=0.02) 3. Primiparas' knowledge of postpartal care increased significantly after education(t=13.04, p=0.00). 4. Primiparas' self-efficacy of postpartal care increased significantly after education(t=5.51, p=0.02). 5. Correlation between knowledge and self-efficacy was r=.360(p=0.03). We suggest follow-up studies to find whether primiparas' self-efficacy will last after discharge or not.

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Variations in Entrance of Vertebral Artery in Korean Cervical Spine: MDCT-based Analysis

  • Shin, Hye Young;Park, Ji Kang;Park, Sun Kyung;Jung, Gyu Seo;Choi, Yun Suk
    • The Korean Journal of Pain
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    • v.27 no.3
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    • pp.266-270
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    • 2014
  • Background: Knowledge of the anatomical variation of the vertebral artery has clinical importance not only for the performance of interventional or surgical procedures itself but also to ensure their safety. We conducted a study of the anatomical variation by reviewing multi-detector computed tomography (MDCT) images of the cervical spine from 460 Korean patients. Methods: 16-row MDCT data from 460 patients were used in this study. We observed 920 vertebral arteries. Examination points included level of entrance of the artery into the transverse foramen of the cervical vertebra, origin site of the vertebral artery, course of a vertebral artery with aberrant entrance. Result: The vertebral artery in 2 (0.2%) cases in this study entered into the transverse foramen of the 7th cervical vertebra from the left. In 45 (4.9%) cases, the vertebral artery entered into the transverse foramen of the 5th cervical vertebra. Of these, the entrance was on the right in 15 (1.6%) and on the left in 30 (3.3%). We found 17 (1.8%) cases in which the artery entered into the transverse foramen of the 4th cervical vertebra, 10 (1.1%) on the right and 7 (0.7%) on the left side. As is commonly acknowledged, the 6th cervical vertebra was the most common site of entry; the vertebral artery entered the transverse foramen of the 6th cervical vertebra in the remaining 855 (93.0%) cases, on the right in 434 (47.2%) and on the left in 421 (45.8%). Conclusions: In conclusion, the possibility of an atypical course of the vertebral artery in segments V1 and V2 should be evaluated with magnetic resonance imaging (MRI) or CT images before carrying out procedures involving the anterior cervical vertebrae.

A Contents Analysis of Nursing Needs at Labor Pain (분만통증 관련 간호요구에 대한 내용분석)

  • Yeo, Jung-Hee;Baek, Seol-Hyang
    • Women's Health Nursing
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    • v.7 no.4
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    • pp.499-507
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    • 2001
  • The purpose of this study was to explore nursing needs during labor pain that had been suffered by women who have given birth. It is essential to identify the nursing needs in order to solve nursing problems and to provide better care for the parturients. The sample consisted of 20 women of primiparas and 17 women of multiparas. They underwent normal labor and delivered a healthy baby at term. The data had been collected through the unstructured interviews conducted 1-2 days after delivery in the admission room from March 1998 to March 1999. On average, the interviews lasted for about 30 minutes. Interviews were taken with the consent of the subjects. The data are categorized according to the similarities of their contents. Seventeen subordinate categories and six superordinate categories have been identified. Six superordinate categories are 1) physical nursing needs 2) nursing needs of medical behavior 3) emotional nursing needs 4) informational and teaching nursing needs 5) nursing needs of pain control 6) nursing needs of respect(personality). Seventeen subordinate categories include: comfortable posture, touch, professional knowledge and techniques, duty execution, support, company and talk, stable surroundings, reassurance, information on delivery, explanation of medical behavior, information on surroundings, instruction on the case of pain, arbitrary adjustment, artificial adjustment, respect, interest and reflection of opinions. The result of this research is the same as that of foreign research and the items of the questionnaire in Korea are the same as the foreign one. Despite the same result, however, this dissertation is significant in that the research identifies the parturients nursing needs and classified the data and thus the basis has been formed to develop the tools to assess the nursing needs of the Korean parturients. The findings can be used as the guide for nursing intervention of parturients.

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The Meaning of Chemotherapy in Cancer Patients (암환자가 체험한 화학요범의 의미)

  • Park, Eun-Hee
    • Journal of Korean Academy of Nursing Administration
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    • v.4 no.1
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    • pp.151-181
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    • 1998
  • This study purports to find out the meanings of chemotherapy among cancer patients. The subjects of this study were selected from those patients who have taken chemotherapy at least twice at a hospital affiliated with a university. The twelve subjects agreed to join the present study and had no problem in communication with others. The data were collected through observations and interviews by the researcher. The phenomenological analysis method proposed by Giorgi was adopted for analyzing the data. The experiences of the subjects to chemotherapy were classified into 24 atributes. These attributes were also categorized into four groups such as hope, pain, fear, and ordea according to their meanings. The subjects expressed hope through the attributes such as "the wish for a new life." "the wish for healing." "the plasure form improvement of cancer." "the wish for being discharged form a hospital." "the interest in dietectic treatment." and "the trust in medical staff." Pain was represented by such attributes as "the physical pain", "the suffering from intravenous injection." "the discomfort of hospital environment." and "the economic burden." As for the attributes represention fear, "fear of being hospitalized." "tehr obscurity of uncertain situations." "the fear of side effects." "the fear of recurrence of cancer," "the lack of knowledge of the disease." Finally, nine attributes werw frouped to ordeal "the will endeavouring to recover cancer" "the adaptation to the present situation." "the giving up of being healthy," "the regret of the past life." "the recognition of significant others." "the physical changes." "the emotional changes." "the social changes." "the recollection of illness experiences." The above findings indicate that chemotherapy means hope, pain, fear, and ordeal to those cancer patinests under treatment. Hence, the nursing interventions for those cancer patients need to be directed to maintaining hope, alleviating pain and fear, and overcoming ordeal. There are some suggestions in achieving these goals : (1) the nurses caring for cancer patients need to understand the meaning of chemotherapy experienced by those patients, (2) a nursing specialty of intravenous injection needs to be developed, (3) interventions for providing emotional support should be devised, (4) nursing care should also be available to those cancer patients being dischaged at home.

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