• Title/Summary/Keyword: pain intervention

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Hemorrhagic Complications Following Ultrasound-Guided Breast Biopsy: A Prospective Patient-Centered Study

  • Heera Yoen;Hyun-Ah Chung;So-Min Lee;Eun-sung Kim;Woo Kyung Moon;Su Min Ha
    • Korean Journal of Radiology
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    • v.25 no.2
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    • pp.157-165
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    • 2024
  • Objective: We aimed to evaluate the clinical and imaging factors associated with hemorrhagic complications and patient discomfort following ultrasound (US)-guided breast biopsy. Materials and Methods: We prospectively enrolled 94 patients who were referred to our hospital between June 2022 and December 2022 for US-guided breast biopsy. After obtaining informed consent, two breast radiologists independently performed US-guided breast biopsy and evaluated the imaging findings. A hemorrhagic complication was defined as the presence of bleeding or hematoma on US. The patients rated symptoms of pain, febrile sensation, swelling at the biopsy site, and dyspnea immediately, 20 minutes, and 2 weeks after the procedure on a visual analog scale, with 0 for none and 10 for the most severe symptoms. Additional details recorded included those of nausea, vomiting, bleeding, bruising, and overall satisfaction score. We compared the clinical symptoms, imaging characteristics, and procedural features between patients with and those without hemorrhagic complications. Results: Of 94 patients, 7 (7%) developed hemorrhagic complications, while 87 (93%) did not. The complication resolved with 20 minutes of manual compression, and no further intervention was required. Vascularity on Doppler examination (P = 0.008), needle type (P = 0.043), and lesion location (P < 0.001) were significantly different between the groups. Patients with hemorrhagic complications reported more frequent nausea or vomiting than those without hemorrhagic complications (29% [2/7] vs. 2% [2/87], respectively; P = 0.027). The overall satisfaction scores did not differ between the two groups (P = 0.396). After 2 weeks, all symptoms subsided, except bruising (50% 2/4 in the complication group and 25% [16/65] in the no-complication group). Conclusion: US-guided breast biopsy is a safe procedure with a low complication rate. Radiologists should be aware of hemorrhagic complications, patient discomfort, and overall satisfaction related to this procedure.

Dental treatments under sedation-analgesia in patients who are unable to collaborate: a prospective observational study

  • Carlos M. Cobo Vazquez;Ma Carmen Gasco
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.24 no.3
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    • pp.173-185
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    • 2024
  • Background: Excessive fear of dental procedures leads to disruptive behavior during dental examinations and treatments. Dental examinations and treatments of these patients usually require additional techniques, such as sedation. The most commonly used techniques are inhalation of nitrous oxide, infusion of propofol with fentanyl, and premedication and infusion of midazolam. Methods: A prospective observational epidemiological study was conducted on patients who required sedoanalgesia techniques for dental exploration and procedures. The reasons for the inability of patients to cooperate (excessive fear or intellectual disability), age, sex, weight, systemic pathology, oral pathology, treatment performed, time of intervention, anesthetic technique performed, and occurrence of complications were recorded. Results: In total, 218 patients were studied. Sixty-five patients came for fear of dental treatment and 153 for presenting with a diagnosis of intellectual disability and not collaborating in the treatment with local anesthesia. The average age of all patients was 30.54±17.30 years. The most frequent oral pathologies found in patients with excessive fear were tartar (6.8%) and wisdom teeth (6.4%), followed by missing teeth (5%). In patients with disabilities, a combination of tartar and cavities appeared most frequently (41.3%), followed by cavities (15.6%). The most frequently used sedoanalgesia technique was the infusion of propofol with fentanyl in both groups of patients, followed by nitrous oxide. Conclusion: The combination of propofol and fentanyl was the most frequently used alternative in patients who were unable to collaborate because of intellectual disability or carry out longer or more complex treatments. Inhaled nitrous oxide and midazolam were the sedative techniques of choice for simpler oral treatments, such as tartrectomies, shallow obturations, and shorter interventions, or in younger patients.

The Effect of the Active Release Technique on Balance and Functional Movement in Youth Basketball Players

  • Kwang-Nam Kim;Byoung-Hee Lee
    • Journal of Korean Physical Therapy Science
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    • v.31 no.1
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    • pp.1-15
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    • 2024
  • Background: This study was conducted to apply active release techniques to male youth basketball players to help improve physical development and damage prevention and improve performance through improved balance and functional movement. Design: Randomized control trial. Methods: The subjects included 33 youth basketball players who were randomly assigned to the experimental group (n=17) and the control group (n=16). For the experimental group, the active release technique was applied to the hip muscles, calf muscles, posterior thigh muscles based on the distribution of injuries surveyed in youth basketball players in the Korean Basksetball League. The Y-balance test and the functional reach test (FRT) were used to assess balance and the Functional Movement Screen (FMS) was used to assess functional movement. Interventions were conducted twice a week for 4 weeks at 40 minutes per session. The experimental group was the active release technique group, and static stretching, a common exercise therapy technique, and self-myofascial release using a foam roller were applied for 20 minutes. The control group received general exercise therapy and placebo active release technique. The placebo active release technique applies pressure only. results:The experimental group showed a greater improvement in balance, as evidenced by the FRT, compared to the control group, which received general exercise treatment. However, there was no statistically significant difference in improvement between the 2 groups. In the case of the experimental group, the difference in the Y balance test before and after the intervention was larger than that of the control group, but there was no statistically significant difference. Significant improvement was found in functional movement, as evidence by the FMS, for the trunk stability test (p < 0.05), in-line lunge test (p < 0.05), rotational stability test (p < 0.05), total score (p < 0.05). Conclusion: In this study, the active release technique improved the balance and functional movement of young basketball players more than general exercise therapy. The application of the active release technique is therefore expected to assist in physical development, prevent damage, and improve the performance of youth basketball players.

Effects of Exercise and Neuromuscular Electrical Stimulation on Lower Trapezius Muscle Activity in Individuals with Round Shoulder Posture

  • Jeong Pyo Seo;Heun-Jae Ryu
    • The Journal of Korean Physical Therapy
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    • v.36 no.2
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    • pp.71-77
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    • 2024
  • Purpose: The prolonged use of digital devices has led to the widespread adoption of poor postures, particularly rounded shoulder posture (RSP), associated with shoulder impingement and pain. This study investigates the effects of neuromuscular electrical stimulation (NMES) on RSP in healthy adults. Methods: Thirty adults with RSP were randomly assigned to NMES only, exercise only, or NMES with exercise groups. NMES was applied to the lower trapezius, which was the target muscle in this study, for a total of 2 weeks, 5 times per week, 20 minutes per session. The exercise program included pectoralis minor stretching, wall-slide exercise, dynamic hug exercise with band, and Brugger stretching for upper body with band, which were performed for a total of 2 weeks, 5 times per week, 20 minutes per session. Outcome measures, including the Supine Method (SM) for posture and surface electromyography (EMG) of the lower trapezius for muscle activity, were assessed before the intervention, after 5 sessions, and after 10 sessions. Results: All the groups showed significant changes in the SM and % maximal voluntary isometric contraction (%MVIC) over time (p<0.05). The NMES group had significantly reduced SM at 1 week, while the exercise and combined groups had reduced SM at 2 weeks (p<0.017). All the groups had increased %MVIC at 2 weeks (p<0.017), with no significant differences observed between groups. Conclusion: NMES alone can be as effective as exercise in improving RSP. NMES combined with exercise also showed positive outcomes, thus offering diverse treatment options for this condition.

Clinical review of Typhoid Fever Patients (장티브스에 관한 임상적 관찰)

  • 최정신
    • Journal of Korean Academy of Nursing
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    • v.6 no.1
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    • pp.60-71
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    • 1976
  • The author reviewed the medical records of 96 typhoid fever patients who were diagnosed, admitted, and treated at Sea grave Memorial Hospital from January 1 , 1973 through August 31, 1975. Diagnosis was determined by clinical observation, aerology and bacteriology, eighty patients were treated medically, the remaining 16 patients required surgical intervention. The following results were obtained: 1) The age distribution of the patients revealed that 33.3% wert between 10 and 19 years old 21.9% were between 20 and 29, and 19.8% were between 30 and 39. The majority of patients were from these more active age groups. Male to female sex ratio was 1.3 : 1 2) Seasonal distribution was observed. Most illness occurred in the summer and autumn month 5. 3) 84. 3%of the patients came from farm families. 4) Duration between onset and admission averaged 16.0 days. The group without compilations was admitted after an average of 15. 1 days; The group with complications was ad-matted after an average of 19.4 days. 5) Methods of treatment before admission were as follows: 10.4% at medical clinics, 61, 5% at pharmacies (antibiotics 47.9%, other. drugs 13.5%), 7.3% by herb medications, 20.8% had no treatment. 6) Main clinical symptoms were as follows: fever 93.8%, headache 47.9%, abdominal pain 47.9%, chills 38.5%, cough 36.5%, general weakness 26.0%, nausea e vomiting 24.0% and generalized pain 21.9%. 7) Temperature of patients on admission: 22.9% were 39f or more, 67.6% were between 37℃ and 38℃, and 9.4% were 37℃ or less. 8) Occurrence of intensional bleeding after onset of disease averaged 9.3 days; perforation occurred at an average of 19. 1 days. 9) Interval between onset of major complication and surgical intervention averaged 2.8 days. 10) Among the 68 patients who underwent the bacteriological test the positive rate was 44.1% (30). The positive ,ales to, each separate culture method were as follows: 20.4% in the blood culture, 40.4% in the stool culture and 6.7% in the urine culture. Among these bacteriological positive patients 15 patients had a negative results or less than 160 titer of vidal reaction. 11) The initial vidal test of the total group showed a counts of 160 titer or more in 60.4% and less than 160 titer in 39.6%, 12) W. B. C. Counts in the uncomplicated group indicated that 32.5% were 6,000/㎣ or less, 47.5% were between 6,000 and 10,000, arid 20.0% were 10,000/㎣ or more. In the complicated group, 37.6% were 6,000/㎣ or less, 25,0% were 6,000-10,000/㎣ and 37.6% were 10,000/㎣ or more. 13) Duration of hospital stay of the patients averaged 6.4 days in the uncomplicated group and 12.7 days in the complicated group. 14) Subdiaphragmatic free air simple X-ray was found in 91.7% of the perforated cases. 15) Duration of antibiotic therapy until an febrile state was attained averaged 4.8 days in the uncomplicated group and 6.5 days in the complicated group. 16) Operative procedures were as follows: one layer simple closure of their perforation with or without debasement in 56.3%, drainage only in 6.3%, small bowel resection with primary anastomosis in 18.8% , externalization in 6.3%, cholecystectomy in 6.3%, The clinical findings of this study suggest the following recommendations. According to Top's report; 1% of typhoid fever patients treated with chlorarnphenicol and 2% of patients treated with other drugs become chronic carriers. Therefore, importance should be given to the strict control of these carriers. Immunization, improvement of sanitation and living standards are all needed for the prevention and treatment of disease, but a more serious problem is a lack of knowledge on the part of patients and their families. Thus it is most urgent to enlighten the citizens about the transmission and hygiene related to contagious disease. Legal restriction of sale of antibiotics at drug stores without a physician's prescription is an urgent matter for public health administrators. An even more important nursing responsibility is the reemphasis on health education both in the clinical setting and in the home.

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The Fusion Effect of Deep Transverse Stroking, Manual Stretching Exercise and Active Muscle Release Technique on Psoas Major Muslce Thickness and Muscle Tone and Pelvic Angle of Non-specific Low Back Pain Patient (비특이성 허리통증환자 큰허리근의 근두께와 근긴장도, 골반각도에 심부횡적강찰법과 수동신장운동, 능동적근육이완기법이 융합적으로 미치는 영향)

  • Lee, Ho-Jae;Shim, Jae-Hun;Kim, Ji-Won;Kim, Ki-Song
    • Journal of the Korea Convergence Society
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    • v.9 no.3
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    • pp.137-144
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    • 2018
  • The purpose of this study was to investigate the fusion effects and difference them of the deep transverse stroking, manual stretching exercise and active muscle release technique on psoas major muscle thickness and muscle tone, and pelvic angle in non-specific low back pain patients. Psoas major muscle thickness was significantly decreased after the application of the deep transverse stroking $0.19{\pm}0.16cm$ (p <0.05), manual stretching exercise $0.18{\pm}0.14cm$ (p <0.05), and active muscle release technique $0.43{\pm}0.35cm$ (p <0.05). The pelvic angle was significantly decreased after the application of the deep transverse stroking $4.48{\pm}1.63^{\circ}$ (p <0.05), manual stretching exercise $5.36{\pm}2.04^{\circ}$ (p <0.05), and active muscle release technique $7.24{\pm}2.23^{\circ}$ (p <0.05). The Psoas major muscle tone was significantly decreased after application of the deep transverse stroking $0.96{\pm}0.93Hz$ (p <0.05), but manual stretching exercise $0.87{\pm}1.20Hz$ (p> 0.05) and active muscle release technique $0.82{\pm}0.98Hz$ (p> 0.05) there was no significant difference after application. There were no significant differences between the three intervention methods in the pelvic angle and psoas major muscle thickness and tone changes. In order to change psoas major muscle thickness and pelvic angle, three intervention methods should be applied appropriately according to the condition and environment of the patient, and deep transverse stroking is more effective for changing psoas major muscle tone.

Needs of Patients and their Families in Hospice Care Unit (일 호스피스 병동 입원 환자와 가족의 요구도)

  • Kim, Hyung-Chul;Kim, Eun-Sook;Park, Kwang-He
    • Journal of Hospice and Palliative Care
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    • v.10 no.3
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    • pp.137-144
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    • 2007
  • Purpose: The purpose of this study is to identify and assess the needs of the cancer patients and their families and provide basic data to meet with their needs. Methods: This is a descriptive study using questionnaire method. Questionnaire were collected by mail from 76 discharged patients from a hospice ward from May until the end of October, 2004, and data were analyzed by SPSS 10.0. Results: Admitted patients had needs of pain control (85.5%), non-pain symptoms (63.2%) such as vomiting, dyspnea, ascites, etc, and emotional and spiritual problem solving (28.9%, 14.5%). Interests of patients were health care of himself/herself (65.8%), concern for their spouses left alone (32.9%), and future of their children (15.8%). In families' needs of care of 5 areas, "information on patient's status and treatment/nursing care" was shown most high score ($3.48{\pm}0.62$). In detailed questions, they request most 'to inform the prognosis of patients' and the next is 'to inform the reasons that nursing care was required'. The next highest score was to 'inform family roles' ($3.39{\pm}0.64$), and next was spiritual support ($3.11{\pm}0.79$), and emotional support ($3.08{\pm}0.72$). Expectations of family on the treatment were comfortable dying (73.4%) scored the highest. Patients' families were satisfied with volunteer service most in service area (97.4%). The next was pain control (89.5%) and nursing service (77.6%). Conclusion: Health care staff should identify the actual needs of families caring cancer patients and they should operate realistic programme which can give continuous and assistance by reflecting individual needs and characteristics. With these srategies, the quality of life of patients and families can be improved. And then the intervention programme should be developed to measure subjective nursing care needs of terminally ill cancer patients and their families.

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A Descriptive Statistical Analysis of the Hospitalized Patients with Low Back Pain in Departments of Korean Rehabilitation Medicine of Korean Medicine Hospitals (한국의 5개 한의과대학 부속한방병원 재활의학과의 요통 입원 환자에 대한 후향적 기술통계분석 - 입원 기간, 상병명, 치료 방법을 중심으로 -)

  • Maeng, Tae-Ho;Kim, Jongyeon;Yi, Woon-Sup;Chung, Won-Seok;Ko, Youn-Seok;Lee, Jung-Han;Shin, Byung-Cheul;Cha, Yun-Yeop;Go, Ho-Yeon;Sun, Seong-Ho;Jeon, Chan-Yong;Jang, Bo-Hyoung;Song, Yun-Kyung;Ko, Seong-Gyu
    • Journal of Korean Medicine Rehabilitation
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    • v.23 no.4
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    • pp.213-223
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    • 2013
  • Objectives Low back pain (LBP) is one of the most common reason for people in Korea to visit Korean medical institutions. To assess actual amounts of use in the treatment of LBP in Korean medicine and to provide objective base line data for policy decision making, research regarding the current state of LBP patients' treatment in Korean medical institutions are in need. Methods The current study was designed as a retrospective chart review to investigate descriptive characteristics of LBP patients. The clinical records of 304 patients who were hospitalized for the treatment of LBP in Korean rehabilitation medicine inpatient clinics of five different Korean medicine hospitals were analyzed. The percentage of patient characteristics such as sex, age, average duration of admission, insurance type, diagnosed LBP related disease code, and rates of interventions applied were assessed. Results 1. The female sex was significantly predominant among patients with LBP : 105 patients (34.5%) were male and 199 patients (65.5%) were female. Percentage of the patients' age appeared as followed : 76 people (25.0%) were in their 50s, 64 people (21.1%) were in their 40s, 51 people (16.8%) were in their 30s, 37 people (12.2%) were in their 60s, and 33 people (10.9%) were in their 70s. Approximately half of the total LBP patients investigated were older than 50. 2. The average duration of admission was 16.2 days. Approximately one third (30.3%) of the patients were hospitalized for 8 to 14 days. 3. Female patients tended to stay admitted in hospitals slightly longer than male patients. Elderly (age 60~79) patients stayed in hospitals longer (17.8 days) compared to younger (age 20~39) patients (13.5 days). 4. More than half of the patients (171 cases, 56.3%) had their hospital bills covered with automobile insurance. 40.1% (122 cases) of the patients had medical insurance to cover their hospital bills. The average duration of admission of patients who had automobile insurance was 14.2 days, while that of the patients who had medical insurance was 18.4 days. 5. "Sprain and strain of the lumbar spine and pelvis" was the most commonly used (195 cases, 64.1%) disease code in patients with LBP. Patients diagnosed as "lumbar and other intervertebral disc disorders with radiculopathy" required the longest admission duration (22.1 days). 6. Herbal medication was applied to all of the patients during admission. Acupuncture was applied to all of the patients except one case diagnosed as spinal stenosis. Physical therapy, cupping therapy, moxibustion therapy, chuna therapy, and pharmacopuncture therapy were applied to 94.7, 92.8, 85.2, 83.9, and 49.7% of the patients, respectively. 7. There were certain differences among Korean medicine hospitals in terms of the LBP patients' duration of admission, type of insurance, frequency of the disease code use, type of intervention applied. Conclusions It is thought that the current study can be used as reference data in assessing the current state of LBP treatment in Korean rehabilitation medicine and a basis for future research. Provided improvements of certain limitations of the current study in future researches, such data would act as better base line data in policy decision making.

The Relationship between the Stress and Climacteric symptoms of Middle-Aged Women (중년여성의 스트레스와 갱년기 증상과의 관계)

  • Park, Bok-Hee;Lee, Young-Sook
    • Women's Health Nursing
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    • v.6 no.3
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    • pp.383-397
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    • 2000
  • This study of purpose was to define the relationship between the stress and climacteric symptoms of middle-aged women in order to provide basic data for the development of women's health care program as nursing intervention. The research tools used were a Soon-Young Park's stress questionnaire (4 points scale) and a self diagnostic MENSI scale (3 points scale) developed by a research team of Ill-Yang Pharmacy Co. This research was conducted in Korea in Muan-Gun. Chonnam province, from 22th November to 20th December 1999. The research used a survey design. Seven hundred eleven healthy middle-aged women, aged 40 to 64, and were a convenience sample by stratified ratio using the matching fixed residential and aging blocks. The data were analyzed by GLM. Pearson correlation coefficient and Scheffe test using SAS/ PC+. The results were summarized as follows : 1. The percentage of psychological stress with the following items was: fatigue and enervation, 70.0%; nervous, 61.8%; weakness, 58.5%; The percentage of physical stress with the following items were ; fatigue of eye. 82.3%; backache, 78.0%; headache, 73.8%. 2. The level of psychological stress was 40% of below average level (0-5 points), 31.7 of average level (6-12points), 20.8% of precaution level (13-19 points), and 7.5% of warning level (over 20points). The level of physical stress were 20.1% of below average level (0-5 points), 34.8 of average level (6-12 points), 29.4 of precaution level (13-19 points), and 15.7% of warning level (over 20 points). There were higher physical stress level than psychological stress level of the subjects. 3. The percentage of climacteric symptoms with the following items were : numbness, 75.3%; forgetfulness, 71.0%; pain of joints, 71.0%. The level of climacteric symptoms were 61.8% of mild level 1(10-15 points), 33.0% of moderate level (16-30 points), 5.2% of severe level (over 31 points). 4. There were high positive correlations significantly between the climacteric symptoms and the psychological stress (r=.564. P<0.000), and between the climacteric symptoms and the physical stress of the subjects(r=.678, P<0.000). 5. There were significant differences in the climacteric symptoms of the subjects among below average level, average level, precaution level, and warning level of the psychological stress (F=74.108. P<0.000. Scheffe test). 6. There were significant differences in the climacteric symptoms of the subjects among below average level, average level and precaution level, and warning level of the physical stress ((F=128.181, P<0.000, Scheffe test). In summary, climacteric symptoms complained by middle-aged women are high positive correlated to the level of the stress. Also climacteric symptoms were affected by stress.

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Effects of Telephone Counseling on Health and Service Satisfaction after Discharge in Gynecologic Cancer Women (퇴원 후 전화상담중재가 부인암환자의 지각된 건강상태, 심리적 안녕과 간호만족도에 미치는 효과)

  • Park, Young-Sook;Han, Kyung-Ja;Ha, Yang-Sook;Song, Mi-Soon;Kim, Sung-Jae;Chung, Chae-Weon;Park, Yeon-Hwan;Koh, Chin-Kang;Kwon, Won-Kyung;Lee, Joo-Young;Hwang, Shin-Woo
    • The Journal of Korean Academic Society of Nursing Education
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    • v.14 no.2
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    • pp.294-304
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    • 2008
  • Purpose: Cancer patients experience a range of physical and psychological sequelae. Consistent nursing support should be provided along the cancer treatment path. This study aimed to i)examine the effects of a telephone counseling program after discharge on perceived health, psychological well-being, and satisfaction with nursing services, and ii)describe symptom distress and their coping methods. Method: The study was a quasi-experimental design with a non-equivalent pre-post test. The sample included 20 women with gynecologic cancer in the experimental group and the same in the control group from a university hospital in Seoul. The telephone intervention was given once from 5 to 7 days after the chemotherapy. The General Well-Being Schedule and Symptom Distress Scale were used. Result: An effect from telephone counseling was found only in the vitality subscale of psychological well-being. Other subscores, perceived health, or satisfaction with nursing services did not differ between the two groups. Pain, skin change, decreased appetite, and constipation were the major symptoms and a relatively few coping strategies were utilized. Conclusion: Protocol of telephone counseling led by a nurse needs to be further developed in regard to best timing, amount, and target effects for follow-up care of gynecologic cancer patients.