Background: The purpose of this study was to investigate the effect of the combined application of manipulation and stabilization exercises on pain and spinal curvature in patients with chronic back pain. Design: Randomized controlled trial Methods: The research subjects included 24 women in their 40s and 50s who have chronic back pain. The sample was evenly divided into an experimental group, which received the combined application of manipulation and stabilization exercises, and a control group, which received stabilization exercises only. The 30-minute intervention was applied five times a week for eight weeks. A bivariate repeated measures analysis of variances was conducted to identify the differences between the two groups before the experiment, after the fourth week, and at the end of the eight-week experiment. The level of statistical significance was set at.05. This analysis examined the within-group changes and the between-group changes using a paired t-test and an independent t-test, respectively. Results: Changes in pain differed significantly depending on the time of the measurement, the interaction between the time of the measurement and each group, and between the two groups (p<.05). Changes in the curvature of the bones of the neck, the bones of the back, and the lumbar vertebrae differed significantly depending on the time of the measurement and the interaction between the time of the measurement and each group (p<.05). Conclusion: The combined application of manipulation and stabilization exercises demonstrated a positive effect on changes in pain and spinal curvature, and the method is expected to be a useful intervention for reducing pain and improving spinal curvature in patients with back pain.
The study problem was to determine the reliability of the Stewart pain circle measurement tool with Korean subjects. The purpose was to assess the tool for potential use in research in Korea. The subjects were 95 primary school students and 103 university students in Seoul. The study was conducted from May to June 1990, using Stewart's pain color circle tool. To determine the difference in the rated intensity of the order of the pain color circles, statistical mean and standard deviation were employed. Item reliability and test - retest reliability were used to test for reliability. ANOVA and t-test were used to explore for differences in the rated intensity of the order of the pain color circles according to the subjects' general characteristics. The findings were as follows ; 1. Higher level pain intensity was assigned to color circle numbers 2, 4, and 6 (These contain large amounts of color). Lower level pain intensity was assigned to numbers 1, 3, and 5(These contain small amounts of color). Higher and lower levels of pain intensity selection patterns were the same as Stewart's but the highest rating of pain was different. The highest pain intensity rating was given to the color red in this study instead of black as in Stewart's test. 2. University students and primary school students' ratings were not very difteferent. 3. Pain color circle reliability was $\alpha$=0.3468, Test - retest reliability was supported (t=0.02~0.97, p=0.337~0.988) 4. Differences in the rating of the pain intensity order were related to the subjects' age and sex, but not to religion. It was concluded that the pain color circle measurement tool is worth for further study as a research instrument with both Korean adult and child clients for validity and reliability.
Purpose: This study was done to identify pain perception (P-PER) by nurses and pain expression (P-EXP) by patients in critical care units (ICUs) and degree of agreement between nurses' P-PER and patients' P-EXP. Methods: Nurses' P-PER was measured with a self-administered questionnaire completed by 99 nurses working in ICUs during May, 2013. Patients' P-EXP was measured with the Critical Care Non-Verbal Pain Scale through observations of 31 ICU patients during nine nursing procedures (NPs) performed between May and July, 2013. Results: Nurses' P-PER was from 4.49 points for nasogastric tube (NGT) insertion to 0.83 for blood pressure (BP) measurement based on a 9-point scale, Patients' P-EXP was 4.48 points for NGT to 0.18 for BP measurement based on a 10-point scale. Eight NPs except oral care showed higher scores for nurses' P-PER than for patients' P-EXP. Position change (p=.019), subcutaneous injection (p<.001), blood sugar test (p<.001), and BP measurement (p<.001) showed significant differences between nurses' P-PER and patients' P-EXP. Conclusion: Nasogastric tube (NGT) insertion was scored highest by both nurses and patients. Eight NPs except 'oral care' showed nurses' P-PER was higher or similar to patients' P-EXP, which indicates that nurses may overestimate procedural pain experienced by patients.
The versions of the Oswestry disability questionnaire (ODQ) is regarded as one of the most extensively used condition-specific instruments measuring disability resulting from low back pain. It has been shown to have adequate psychometrics, reliability, validity, and responsiveness as a whole, yet the summated total score of the instrument often provide little information to rehabilitation clinicians. A keyform analysis based on Rasch measurement model is an innovative way of illustrating the specific test items that an individual may or may not perform. By applying the keyform of the Rasch measurement model to the ODQ, rehabilitation clinicians may able to select more challenging ODQ items matching an individual's ability and document them as attainable treatment goals. The results demonstrated how a keyform analysis assist to setting possible goals for the treatment of individuals with low back pain. Forty-two individuals with low back pain were recruited from rehabilitation clinics in Gainesville, Florida. A series of Rasch analyses on the 10 items of the ODQ were performed using Winsteps software. The performance of two individuals on those 10 items was illustrated on the keyform. The keyform analysis of the Rasch measurement model may be translated into a useful tool for making clinical judgements.
Purpose : The purpose of this study was to systematically review the measurement tools that are used to assess the pain of intensive care unit (ICU) patients. Method : In this systematic review, the studies published between 2009 and 2018 were selected based on the PRISMA flow chart. Data sources included MEDLINE, EMBASE, CINAHL, and Cochran. We assessed the quality of pain assessment tools reported in individual studies using Terwee et al.'s the Quality Criteria for Measurement Properties. Results : We reviewed 67 studies and 12 pain assessment tools that included two self-reported, seven observational, and three multifaced tools with observations and physiological indicators. The most frequently used tool was the Critical Care Pain Observation Tool. The Multidimensional Observational Pain Assessment Tool was rated the highest quality. Nine of the ten tools that included observations reported content validity, four reported construct validity and nine reported correlation coefficient. Conclusion : It was found that observational tools are appropriate for assessing pain in ICU patients with limited communication skills. To increase the validity and reliability of pain assessment in ICU patients, further research on the physiological indicators of pain is needed.
Purpose : This study was to identify Korean terms appropriate for a new scale using pain terms to assess the pain of the arthritis patients. Method : This study was conducted by secondary analysis of two previous studies, one from Kim's data (1994) and the other from Lee and Choi's(1988). The subjects were 482 patients with arthralgia. Data were analyzed by SPSS Win 11.0, for frequencies, percentages, and means. Results : Five pain groups were sorted out from the sensory pain category, three in the affective pain category, and two in the miscellaneous pain category by selecting groups of pain terms expressed more than 50% by all subjects. Local inflammatory repeated pain terms, simple irritative pain terms, superficial pressure pain terms, traction pain terms, and peripheral nerve terms were included in the sensory pain category, fatigue-related pain terms, digestion-related terms, and suffering-related terms in the affective category, and dull pain terms and body cavity pressure pain category. Among five sample groups terms selected by more than 3 groups with more than 30% of patients were dugumhada, sikungorinda, wooksinwooksinhada, nurudusi apuda, and dangginda in the sensory pain category; nogonhage apuda, gobukhada, and jajungsurupge apuda in the affecte pain category; and buctjockgigunhada and manjimyon apuda in the miscellaneous pain category. Conclusion : Ten pain groups were tentatively selected out of 20 pain groups; 10 pain terms composed of 1 pain term from each group were selected out of 90 pain terms from thesecondarydataofarthriticpainpatients. Implications More detailed clinical studies are needed for the refinement of the scale.
Purpose: The aim on this study was to establish the validity, reliability and efficiency of a Pain Self-Report Scale for elderly with dementia and compare these results with an observational pain rating scale. Methods: Study subjects were 136 elderly with dementia who were residents in a nursing home, geriatric hospital, or day care center. The subject's pain was measured by five self-report scales and observational scale. DS-DAT (discomfort scale-dementia of the Alzheimer's type) was used for pain behavior observational measure. Cognitive state was assessed using the MMSE (Mini-Mental State Examination). Results: Observational rating correlated moderately with self-report (r=.225~.585, p<.05) and tended to underestimate pain intensity. Test-retest reliability was high for all five self-report scales, and the correlation between these scales was very strong (r=.735~.856, p<.05). Comprehension rate of VDS (verbal descriptor scale) was 88.3%, and NRS (numeric rating scale) 69.9%, FPS (face pain scale) 66.9%, HVAS (horizontal visual analog scale) and VVAS (vertical visual analog scale) 65.4%. Conclusion: Nurses should not apply observational scales routinely in demented patients as many of these are capable of reporting their own pain. Self-report, the highest standard of pain measurement can be reliably performed in a large proportion of demented elderly.
This review explores the essential methodologies for effective postoperative pain management, focusing on the need for thorough pain assessment tools, as underscored in various existing guidelines. Herein, the strengths and weaknesses of commonly used pain scales for postoperative pain-the Visual Analog Scale, Numeric Rating Scale, Verbal Rating Scale, and Faces Pain Scale-are evaluated, highlighting the importance of selecting appropriate assessment tools based on factors influencing their effectiveness in surgical contexts. By emphasizing the need to comprehend the minimal clinically important difference (MCID) for these scales in evaluating new analgesic interventions and monitoring pain trajectories over time, this review advocates recognizing the limitations of common pain scales to improve pain assessment strategies, ultimately enhancing postoperative pain management. Finally, five recommendations for pain assessment in research on postoperative pain are provided: first, selecting an appropriate pain scale tailored to the patient group, considering the strengths and weaknesses of each scale; second, simultaneously assessing the intensity of postoperative pain at rest and during movement; third, conducting evaluations at specific time points and monitoring trends over time; fourth, extending the focus beyond the intensity of postoperative pain to include its impact on postoperative functional recovery; and lastly, interpreting the findings while considering the MCID, ensuring that it is clinically significant for the chosen pain scale. These recommendations broaden our understanding of postoperative pain and provide insights that contribute to more effective pain management strategies, thereby enhancing patient care outcomes.
Purpose: This study was performed to determine the effects of foot reflexology on pain and quality of sleep in patients with terminal cancer. Method: Quai-experimental research design was used. The subjects of this study were consisted of 19 for experimental group and 18 for control group. Visualue Scale(VAS) was used as the measurement tool of pain in this study, Verra & Snyder-Halpern Sleep Scale(VSH) and Visual Analogue Scale(VAS) were used as the measurement tool of perceived quality of sleep. Data were analyzed using statistical methods such as frequency, percent, $x^2$-test, t-test using SPSS WIN 12.0 program. Results: The hypothesis 1 that the experimental group with reflexology has less degree of pain than the control group without reflexology was supported (t=5.41, p<.001). The hypothesis 2 that the experimental group with reflexology has higher degree of VSH Scale than the control group without reflexology was supported(t=2.37, p=.02). The hypothesis 3 that the experimental group with reflexology has the difference among the mean of sleep VAS Scale during the 12 measurement periods was not supported(F=1.63, p=.08), and no significant interactions between group and time. Conclusion: It is considered that reflexology is effective for reducing cancer pain and improving quality of sleep in patients with terminal cancer.
The main purpose of th study was to evaluate he validity of Korean Pain Measurement Tool composed of pain terms. The specific purposes of this study were 1. to examine whether pain intensities of pain terms are congruent with those classified in three previous studies. 2. to evaluate the relative intensity of each term by panel of judges. 3. to explore the difference of ranks of pain terms according to the sex, education, and ages. One hundred and sixty normal individuals were selected by 2$\times$2$\times$4 sampling design. Sex (male, female), education (high school, college), and age (20s, 30s, 40s, 50s) were matched. Each individual was asked to rate the ranks of 3~8 pain terms in each subclass. The data measured by ordinal scale were transformed to the interval scale to compare with the pain intensities gained from the previous study. The pain ranks different from previous results were finally rearranged or cancelled through the consultation of 4 panel of judges and sunmed up to 91 pain terms in the scale. As a result, the ranks of pain terms within each of eleven subclasses among the twenty subclasses completely were congruent with the Previous pain ranks, while the ranks of nine subclasses were different from the previous pain ranks. In addition, there was significant relation between sex and pain ranks in skin punctuate pressure pain and cavity pressure. (sp : $\chi$$^2$=5.18 ø=0.26; cp : $\chi$$^2$=5.83 ø=0.24) In conclusion, seven terms from subclasses of inflammatory repeated pain, traction pressure pain, fatigue-related pain, fear-related pain, dull pain, and pulsation. related pain were cancelled. The ranks of four terms in subclasses of incisive Pressure pain and constrictive pressure pain were tentatively rearranged. Ranks of two terms in the tract pain were left as shown in the third study. As a result, six terms must be studied repeatedly for obtaining exact scores from ratio scale.
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