• The Korean Journal of Pain
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• v.11 no.2
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• pp.214-219
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• 1998

Pain is one of the most frequent and disturbing symptom of cancer patients. And almost of cancer patients are afraid of a attacks of pain related to cancer. Caring for the cancer patient can be divided into two phases. The phase of "active treatment" involves various interventions-surgical, chemical or radiological- that are designed to prolong the patient's life. "Terminal care" is the period from the end of active treatment until the patient's death. But in the majority of clinical settings, cancer pain is not being managed adequately results from a lack of education about how to treat the cancer pain management in the safest and most effective way during terminal phase. Althought organic factors represent the most important cause of their pain, it is also important to deal with the patient's psychological reactions and to take account of his or her social and family environment if treatment for chronic cancer pain is to prove adequate. Thus we try to evaluate a kinds of cancer related to pain, degree of pain, effectiveness of drugs, and patient's responses to management. In regard to the satisfaction for pain relief in pain clinics at Pusan National University Hospital(PNUH) are about 70% in patients and 90% in family. Average life expectancy in cancer patients are about 140 days (3 days- 5.7 years). Cancer patients are complained of several discomfortness (above 30 kinds) such as, pain associated with cancer (75%), nausea and vomitting (38%), sleeping disorder (38%), anorexia (38%), dyspnea (32%), constipation (31%), etc. Distributions of cancer associated with pain are stomach cancer (21%), lung cancer (16%), cervix cancer (10%), anorectal and colon cancer (8.6%), hepatoma (8%), pancreatic cancer (3%). About 1/3 of patients are suffer from incident pain in 3~5 times in a day especially in moving, coughing, and exercise. Methods for drug delivering system before death are transdermal fentanyl patch (42%), intravenous PCA (21%), oral intake of opioid (17%), epidural PCA (14%), etc.

• Journal of Hospice and Palliative Care
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• v.25 no.3
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• pp.99-109
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• 2022

Purpose: More than 60% of patients with advanced cancer experience pain, and uncontrolled pain reduces the quality of life. Nurses are the closest healthcare providers to the patient and are suitable for managing cancer pain using pharmacological and non-pharmacological interventions. This study aimed to identify factors affecting the performance of cancer pain management among nurses. Methods: This study was conducted among 155 participating nurses working at a tertiary hospital who had experience with cancer pain management. Data collection was performed between October 18, 2021 and October 25, 2021. Data analysis was conducted using descriptive statistics, the independent-sample t-test, one-way analysis of variance, and hierarchical regression analysis. Results: There were 110 subjects (71.0%) who had no experience of cancer pain management education. The results of regression analysis indicated that barriers included medical staff, patients, and the hospital system for cancer pain management (𝛽=0.28, P<0.001). The performance of cancer pain management was also affected by experience of cancer pain management training (𝛽=0.22, P=0.007), and cancer pain management knowledge (𝛽=0.21, P=0.006). The explanatory power of the variable was 16.6%. Conclusion: It is crucial to assess system-related obstacles, as well as patients and medical staff, in order to improve nurses' cancer pain management performance. A systematic approach incorporating multidisciplinary interventions from interprofessional teams is required for effective pain management. Furthermore, pain management education is required both for cancer ward nurses and nurses in other wards.

• The Korean Journal of Rehabilitation Nursing
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• v.6 no.1
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• pp.90-103
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• 2003

Pain management is a major issue in caring of cancer patients. Because pain management cancer patient of does not control effectively, it is important to educate reporting pain and using analgesics for having cancer patient's concerns and anxiety. The purpose of this study was to identify the effect of cancer pain management education on the pain and concerns of pain management in cancer patients. This study was a quasi-experimental as nonequivalent control pretest-post test design. The subjects of this study consisted of 50 (experimental group 25, control group 25) patients hospitalized in K university hospital in Busan. The data were collected from December 1, 2001 to April 12, 2002. The measurement tool for the concerns of pain management had used questionnaires interpretated by Kim(1999) developed by based Ward(1993) and pain nominal scale. The collected data were analyzed frequency, percentage, mean, SD, $X^2$-test, t-test, ANCOVA. The results of this study were as follows: 1. The 1st hypothesis : "The experimental group which had received the cancer pain management education were lower than the control group in the score of pain" was not supported (p>0.05). 2. The 2nd hypothesis : "The experimental group which had received the cancer pain management education were lower than the control group in concerns of pain management" was supported (F=5.285, p<0.01). In conclusion, the cancer pain management education can know what was effective to decrease in the concerns of pain management in cancer patients. Therefore, Pain Management Education must be positively utilized in clinical situation.

• Journal of Physiology & Pathology in Korean Medicine
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• v.21 no.2
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• pp.548-553
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• 2007

In general, cancer pain is neither fully recognized nor adequately treated. The inadequate pain control is due to failure of accurate assessment of cancer pain. This study was aimed to understand various characters of cancer pain and investigate available assessment scales which have been designed for, or frequently used with people with cancer pain. A total of 23 articles were selected from two different databases. The selected articles were analyzed according to three aspects of initial assessment, patient self-report and assessment of the outcomes of pain management. The characters of cancer pain is complex and includes physical, psychosocial, and spiritual dimension. Also, subjective pain can be classified into at least four specific factors, such as pain intensity, pain affect, pain relief, and pain quality. Based on various classification, the pain assessment scales can be divided into unidimensional or multidimensional. Among the more commonly used clinical tools are numeric rating scales, verbal rating scales, visual analog scales, and picture scales. Above all, in order to assess cancer pain objectively, the clinician must select appropriate assessment instruments which reflect pain definition and clinical purpose.

• The Korean Journal of Pain
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• v.26 no.1
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• pp.65-71
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• 2013

More than 80% of cancer patients experience cancer pain. Among them, more than 50% experience moderate to severe pain. To control cancer pain, a variety of methods have been used, including medications and nerve blocks. In some patients, however, it is impossible to perform nerve blocks due to caner metastasis into the epidural space, while in other patients, opioid dose escalation is impossible due to opioid side effects; thus, cancer pain management is difficult. Scrambler therapy is a novel approach for pain control that uses EKG-like pads, which are applied above and below the site of pain. Scrambler therapy synthesizes 16 different types of nerve action potentials that provide "non-pain" information via cutaneous nerves. The advantages of this treatment are that it is non-invasive and safe and has no significant side effects. In this case series, we report the treatment results of using scrambler therapy in three cancer patients with intractable pain.

• Asian Oncology Nursing
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• v.2 no.1
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• pp.36-49
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• 2002

The purpose of this study was to evaluate the effects of the pain management education on pain of the terminal cancer patients at home. For evaluating the effectiveness of the intervention modified Patient Outcome Questionnaire (APS, 1995) including patients concerns with cancer pain management, pain intensity, and interference of daily activities related to pain were measured before and after the education in control group and experimental group and the differences were compared with each other. Satisfaction with pain management was measured after the intervention. Pain management education was delivered to 16 experimental group patients by home care nurses, who were provided with 3-hour education on cancer pain management by one of the researchers. Pain management education included common misconceptions about cancer pain control and pharmacological and non-pharmacological interventions and emphasis was put on the importance of pain reports and patients' active participation in pain management. The results of the study were as follows. Patients concerns with pain management were decreased more greatly in the experimental group than those of the control group. The worst, average, and present pain intensities during the last 24 hours were decreased more greatly in the experimental group, and total score and each subcategory of the interference of daily living, except walking, were decreased more greatly in the experimental group. And satisfaction score with total pain management and nurses response to the pain reports were higher in the experimental group. The results of this study suggest that pain management education given to the patients by home care nurses is a very useful intervention to improve pain of the cancer patients at home. This positive result is thought to derive from patients' active pain report and participation in pain control and the use of powder form sustained release morphine for breakthrough pain control in part. Further studies with increased sample size from more institutions are recommended and early introduction of short acting morphine is strongly suggested for effective cancer pain control.

• Journal of Digestive Cancer Research
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• v.2 no.2
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• pp.56-63
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• 2014

Cancer pain is one of the most serious undesirable and unsolved complications for the cancer patients. Despite significant improvements in the management of cancer pain through past decades, it is still perceived as insufficient. Effective management of pain starts on a comprehensive assessment to identify the origin and characteristics of the pain. Then, appropriate multidisciplinary medical and surgical interventions could provide optimal treatments. With intensive attentions, complete or partial pain relief with tolerable side effects of the medication will be obtained and it will improve the quality of life of cancer patients.

• The Korean Journal of Pain
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• v.23 no.4
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• pp.230-235
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• 2010

Background: Bone cancer pain has a disruptive effect on the cancer patient's quality of life. Although ginsenosides have been used as traditional medicine in Eastern Medicine, the effect on bone cancer pain has not been throughly studied. The aim of this study was to determine whether ginsenosides may alter the bone cancer pain at the spinal level. Methods: NCTC 2472 tumor cells ($2.5{\times}10^5$) were injected into the femur of adult male C3H/HeJ mice to evoke bone tumor and bone cancer pain. To develop bone tumor, radiologic pictures were obtained. To assess pain, the withdrawal thereshold was measured by applying a von Frey filament to the tumor cells inoculation site. The effect of intrathecal ginsenosides was investigated. Effect of ginsenosides (150, 500, $1,000{\mu}g$) was examined at 15, 30, 60, 90, 120 min after intrathecal delivery. Results: The intrafemoral injection of NCTC 2472 tumor cells induced a radiological bone tumor. The withdrawal threshold with tumor development was significantly decreased compared to the sham animals. Intrathecal ginsenosides effectively increased the withdrawal threshold in the bone cancer site. Conclusions: NCTC 2472 tumor cells injection into the mice femur caused bone tumor and bone cancer pain. Intrathecal ginsenosides attenuated the bone cancer-related pain behavior. Therefore, spinal ginsenosides may be an alternative analgesic for treating bone cancer pain.

• Journal of Korean Academy of Nursing
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• v.29 no.5
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• pp.1113-1122
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• 1999

The author investigated pain experiences of 90 cancer patients and the adequacy of pain treatment they have received during their stay at a large medical center in T city between October 1994 and August 1995. Pain was assessed by the Shortened BPQ and results are summarized as follows: As for ratings of “worst pain” during the 24 hour period, 70% of the patients reported they had “severe” pain. As for ratings on “pain now,” 43% of the cancer patients reported “moderate to severe” pain. Over 46% of the patients reported a pain relief score of 0(not at all) or 1(somewhat) even after receiving pain medication. Adequacy of analgesic treatment was evaluated by comparing the patient's reported level of pain and the analgesic use, namely, the pain management index(PMI). The PMI indicated that 58% of the patients were undertreated for the pain control. In review of nurse's notes. systematic pain assessment was scarcely recorded, although pain documentation appeared in 70% of the notes; and the contents were mostly simple description. In conclusion, the results of patient's pain ratings, the PMI and poor pain documentation in the nurse's notes implied poor pain assessment and management.

• The Korean Journal of Pain
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• v.12 no.2
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• pp.221-226
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• 1999

Background : Validity of WHO guideline of cancer pain management has been proven and many trials have been done to derive solutions for inadequate cancer pain management. We assessed the severity of pain of terminal cancer patients in a few different ways and patients' characteristics influencing inadequate pain management. Methods : This study was based on 100 adult oncological patients who were confirmed as terminal stage in our institution from 3/1998 to 11/1998. Medical records were reviewed and individual patients were interviewed to obtain demographic information and medical characteristics such as: daily activity performance, metastasis, and drug-adjusted pain severity. Adequacy of prescribed analgesics in accordance with WHO guidelines of pain management and patients' characteristics influencing adequacy of pain management were assessed. Results : Among those cancer patients diagnosed as terminal stage, 85% complained of pain, and 68% of those patients reported pain above moderate severity. 38% of those patients received inadequate pain management resulting in greater severity of pain; the less adequate pain relief was(p<0.01). Sex, age, primary cancer site metastasis, symptoms such as depression and anxiety, and daily activity performance were not significantly related. Conclusions : Despite WHO guidelines for pain management, majority of the terminal cancer patients received inadequate pain management. There is a necessity for education on proper pain evaluation and strict implimentation for WHO guidelines of pain management.