Go to the main menu
Skip to content
Go to bottom
REFERENCE LINKING PLATFORM OF KOREA S&T JOURNALS
> Journal Vol & Issue
Journal of muscle and joint health
Journal Basic Information
Journal DOI :
Korean Society of Muscle and Joint Health
Editor in Chief :
Volume & Issues
Volume 1, Issue 1 - Nov 1994
Selecting the target year
An Effect of Aquatic Exercise Program with Self-help Group Activites and Strategies for Promoting Self-efficacy on Pain, Physiological Parameters and Quality of Life in Patients having Rheumatoid Arthritis.
Kim, Jong-Im ;
Journal of muscle and joint health, volume 1, issue 1, 1994, Pages 1~30
Rheumatoid arthritis is a chronic systematic disease with unpredictable course of exacerbation and remission, characterized by pain, joint deformity and reduced activity by joint limitation. The growing public awareness of the need for health management of chronic illnesses, provides impetus for nursing to demonstrate social effectiveness by active nursing intervention in this vast area in general, and with rheumatoid condition in particular. However, nursing interventions to date have not demonstrated its active participation in the management of chronic conditions. Nursing intervention for the patients having rheumatoid arthritis is one such area that needs to be studied intensively and to demonstrate their effectiveness empirically. The purposes of this study were two fold : first, to develop a comprehensive program that was intensified with therapeutic joint exercises in water, self-help group activities and utilization of self-efficacy promoting strategies : and secondly, to determine the effect of aquatic exercise program on pain, physiological changes and quality of life in the rheumatoid arthritis patients. Thirty five female subjects participating in this study were selected from outpatients in the Rheumatism Center, Hanyang University hospital. The period of data collection was from December, 1992 to March, 1993 in seoul and Taejeon. Subjects in Taejeon were assigned to the experimental group. The comprehensive aquatic exercise program for the experimental group was carried out three times a week for 6 weeks in regular swimming pool. Subjects in Seoul did not participated in the program, and treated as the control group. Data were analyzed with repeated measure MANCOVA, t-test, ANCOVA, percentage of change, Kruskal-Wallis 1-Way ANOVA using SPSS
program. Results were obtained as follows : 1) Scores on Korean pain scale, Numeric pain score, and RAI score of the experimental group were significantly lower than those of the control group (t=2.11, p=0.022 ; F=4.40, p=0.044 : t=3.10, p=0.002). 2) There was significant improvement in the physiological parameters (higher joint movement parameters, F=15.64, p=0.024 ; higher lean body mass, percentage of change=+12.2, lower body weight, t=1.01, p=0.026 : lower ESR, t=1.69, p=0.001) in the experimental group compaired with subjects In the control group. 3) There was significant improvement in the specific self-efficacy score through the comprehensive aquatic exercise program(t=2.73, p=0.011), but not in the general self- efficacy score(t=0.62, p=0.113). 4) The quality of life failed to show significant improvement in the experimental group as compaired with the control group (F=3.69, p=0.064). 5) In the experimental group, findings from additional analysis showed no significant difference in the specific self-efficacy between those who continued to aquatic exercise after completing 6 week program and those who stopped (X2=0.086, p=0.690). Therefore, adherence to aquatic exercise program for 6 weeks seem to be affected mainly by self-help group activities. An indepth study to delve into articulation of mechanisms affecting the effect of aquatic exercise program be recommended. A further study is necessary to determine the difference in the effect of group and individual aquatic exercise program, to assess factors affecting adherence to exercise for an extended length of time.
The Effects of Muscle Relaxation to The Rheumatoid Arthritis Patients' Adaptation
Jung, Hyan-Mi ;
Journal of muscle and joint health, volume 1, issue 1, 1994, Pages 31~47
The purposes of this research are to examine the effects of muscle relaxation to the rheumatoid arthritis patients' physiological, psychological, and social adaptation, and to verify that the technique Is an effective tool for improving the patients' adaptation. This research utilized a qusi-experimental design that compares the pre-experiment measures and the post-experiment measures. The subjects of this study were 37 out-patients who were diagnosed for rheumatoid arthritis in P university hospital and K clinic between September 12, 1993 and November 30, 1993. The experimental group consisted of patients treated on Monday, Wednesday and Friday. The control group consisted of patients treated on Tuesday, Thursday and Saturday The pre-experimental survey utilized the following tools. The physiological adaptation was measured by a graphic rating scale for pain and activity of daily living. The psychological adaptation was measured by Zung's depression scale and Rosenberg's self-esteem scale : and the social adaptation was measured by Derogatis' psychosocial adjustment scale. The experimental group received muscle relaxation treatment for 15 minutes per day for the period of 2 weeks, the control group received no treatment and had quiet time. The post-experiment measurement was carried out similar to the pre-experiment survey, SPSS
is used to analyze the collected data. The reliabilities of the measurement tools were examined by Cronbach's
coefficients. The homogeneities between the experimental and control groups were tested by t-test and chi-square test, hypotheses were tested by t-test. This research found that the general characteristics between the groups were statistically homogenious. The physiological, psychological, and social adaptation between the groups in the pre-experimental survey were also statistically homogenious. The results of this research can be summarized as follows : 1. Concerning the Physiological adaptation, the experimental group showed a statistically lower pain score than the control group. Thus, muscle relaxation was effective to relieve the pain of rheumatoid arthritis patients (t=-2.95, p=.006). 2. Concerning the psychological adaptation, the experimental group showed a statistically lower depression score than the control group. Thus, muscle relaxation was effective to reduce the patient's depression(t=-4.00, p=.001). 3. Concerning social adaptation, the experimental group showed a statistically higher score for the health maintenance and disease control than the control groups. Thus, muscle relaxation was effective for the health maintenance and disease control (t=2.09, p=.004). This research showed that the muscle relaxation is a nursing intervention that can promote the physiological, psychological and social adaptation of the rheumatoid arthritis patients in terms of short-term and cognitive changes. However, more fundomental changes in behavior and long-term physiology could not be found through such a short-term relaxation treatment.
Effects of Music Therapy on Pain and Depression of Musculoskeletal Trauma Patients
Kim, Jung-Ae ;
Journal of muscle and joint health, volume 1, issue 1, 1994, Pages 48~70
The purpose of this study was to determine the effects of music therapy on acute, subacute and chronic pain and depression of musculoskeletal trauma patients. The study was designed using nonequivalent control group pretest-posttest design within the framework of an adaptation model. The subjects were composed of forty patients, and twenty of them were assigned to the experimental group and twenty to the control group within the unit of patients. Data were summarized as follows : 1. There were significant changes of pain scores in an experimental and a control group measured before and after the treatment. 2. There were significant changes of pulse rates, respiration rates and systolic blood pressure, but were no significant changes of diastolic blood pressure in an experimental and a control group measured before and after the treatment. 3. There were no significant changes of the amount of
-endorphin in an experimental and a control group measured before and after the treatment. 4. There were no significant changes of depression scores in an experimental and a control group measured before and after the treatment. As a result, music therapy was a useful nursing intervention for relief of acute, subacute and chronic pain. Two suggestions could be made on the ground of the results of this study. 1. On the basis of endogenous pain control theory, it's necessary to research the changes of the amount of
-endorphin as the effect of the music therapy on patients having severe pain. 2. It's necessary to research the changes of the amount of
-endorphin according to the lapse of time after the music therapy for pain relief.
A Study on Pain, Discomfort, Depression and Coping Patterns in Chronic Arthritis Patients
Mun, Mi-Suk ;
Journal of muscle and joint health, volume 1, issue 1, 1994, Pages 71~87
The purpose of this study was to assess pain, discomfort, depression and coping patterns and the relations between these in chronic arthritis patients. The sampling method was a purposive sampling technique. 1) Who have been diagnosed as having chronic arthritis and. 2) Who were at the out patients clinic of rheumatoid arthritis departments of one University hospital in seoul between september, 11, 1993 to september, 18, 1993. The instruments used for this study were Graphic Rating Scales of pain, discomfort level of the activities of daily living(ADL) developed by Lee, Eun Ok and The Beck Depression inventory. The research used to measure coping patterns was a tool developed by the present study researcher. Analysis of data was done frequency, Pearson correlation coefficients, ANOVA, regression and ANCOVA. The results were summerlized as follows ; 1. Female exceed male patients in number and onset of joint pain were more prevalent in the age groups of the 40s and the 50s. The average duration of suffering from the pain were seven years six mounths. 2. The mean pain score : The mean sensory score was 119mm and the affective score was 109mm. 3. The discomfort level of ADL, the mean score was 2.95 out of a possible score of 5.0 and depression syndrome subjects were 62.2%. 4. The coping responses for each pattern were as follows : 1) "Active coping" mean score was 2.28. 2) "Wishful coping" mean score was 2.89. 3) "Receptive coping" mean score was 3.31. 4) "Negative coping" mean score was 1.82. 5. Significant differences were found in age, religion, marriage status and the coping patterns of patients. 1) In the coping pattern of "receptive coping", the score of the age groups of the 50s were higher than that of 20s, and in the coping pattern of "negative coping", the score of the age groups of the 20s were higher than other age groups. 2) In the coping pattern of "wishful coping", the score of the christian were higher than other religion groups. 3) In the coping pattern of "negative coping", the score of the marrieds were lower than other groups. 6. Patients who scored low on factor 2, wishful coping, were much more likely to report having pain sensory than patioets scoring high on this factor. 7. Patients who scored high on factor 4, negative coping, were significantly more likely to report having pain sensory than patients scoring high on this factor. Consider overall, chronic arthritis patients report using a wide varity of strategies, certain strategies such as receptive, wishful and active coping are used frequently, whereas other strategies such as negative coping are rarely used. One of the most important finding of present study is that the reported use of coping strategies is related to adjustment to a chronic pain problem. The present study suggests that negative coping is related to poor emotional adjustment as assessed by depression, but not pain ratings. Considered overall, this pattern of findings suggests that counseling patients to decreased their use of negative coping may be useful. The present study has a number of limitations. First, the sample is restricted to chronic arthritis patients. Weather chronic pain patients suffering from other types of pain syndromes use similar coping strategies needs to be determined in subsequent research. Second, the tool of coping pattern must be studied further to obtain reliability.
Needs of Home Care Services for the Arthritic Patients of One Hospital
Lee, Eun-Ok ; Yoo, Kyung-Hee ;
Journal of muscle and joint health, volume 1, issue 1, 1994, Pages 88~96
Treatment for the arthritic is mostly on the out-patient basis. The present rheumatologists practicing in Korea do not cover the total number of the patients. Also patients with arthritis need medical treatment for long period of time. Therefore, the number of patients waiting for the treatment is huge in number. This vicious cycle need to be broken in some way. Purpose of this study is to identify the need for home care of the arthritic patients. Nineteen hundred and sixty two subjects were interviewed in one hospital for one month. The following findings were observed : 1. The rates for demanding home care were from 60% to 100% depending on the areas. 2. Reasons for no need of home care were mainly credibility and short distance from the hospital. 3. Time spent for one way transportation was more than 3.3 hours except from Seoul and Kyungki area. The longer they spend time for transportation, the more they want home care services. 4. The number of patients who asked other persons to travel for prescription was 446(22.73%) and average number was 3.26 per year in those 446 cases. 5. Average expenses for transportation and other cost for each time of hospital visit were 21,073won ranged from 8,373 won to 132,571 won. The more spend money for visiting the hospital, the more they want home care services. In order to reduce the physical and economical burden of the arthritic patients living in remote areas, hospital-based home care services are justified on the bases of patients' demand and legislative support.
Reliability and Validity of the Behavioral Observation Method for Assessing Low Back Pain in Patients with Spinal Diseases
Yoon, Ho-Soon ; Lee, Eun-Ok ;
Journal of muscle and joint health, volume 1, issue 1, 1994, Pages 97~115
The purpose of this study was to examine the reliability and validity of the observed behaviors of subjects who suffered from low back pain with spinal diseases, Thirty two low back pain patients admitted on the neurosurgical unit in an army hospital were compared with 30 normal controls belonged to an army unit, by means of matching the age, hight and weight. Observed pain behaviors were developed by the researcher on the bases of literature and patient observation. This tool consists of 18 behaviors seperated into two major groups : mutually exclusive and concomittent behaviors. The mutually exclusive behaviors included coding cathegories for 6. body motions assumed by the subjects during the observation session. These 6 standardized motions consisted of sitting from standing first, and serially tying down, reclining, sitting again, and then standing, 6 steps walking. Concomittent behaviors consisted of 12 observable patterns that can be observed systematically from the face, grimacing, bracing, rubbing, walking with arms fixed, support with hands on sitting or standing, guarded movement, limping, unbalaced weightbearing, stopped movement from tying position to sitting, sighing and graoning. Subjects were videotrecorded as they performed a 6-standardized sequence of motions, simultanously researcher measured the time spent performing each motion and step length. Patients were asked torate their subjective pain score on the 10 mm graphic rating scale ranging from 'no pain' to 'sever pain'. For scoring of the pain behaviors, two trained nursing officiers independently and simutanously viewwd each videorecording and checked subject 'pain behaviors at the observational item checklist. The result of the study are summarized as follows : 1. Reability of the observational tool was a=.845. 2. Spearman's rho and percentage agreement were p=.97 and 81.7 persent respectively, that indicate adequate interrater reability of this tool. 3. The sensitivity rate of the tool was .875 while specificity rate .866 for differentiating patient from the normal. 4. When difference in the objective pain indices between patient group and control were compared, there was significant difference of all indices, such as pain behavior(t=7.71, p=.0001). spent time performing motion(t=14.2, p=.0001), step length (t=-10.72, p=.0001). 5. There were differences in the objective indices the subjective pain subgroups (low, medium, high). Differences in the mean score of objective pain behavior (F=6.376. p=.005) and spent time for moyion(F=4.631, p=.018). But there were no significant differences in the step length among the subgroups(F=.667, p=.521). 6. Highly correlated pain behavior items wiyh subjective pain score were 'stopped movement from lying position to sitting', 'limping', 'support with hands on sitting or standing', 'bracing', 'guarding' and 'walking with arms fixed'. In summary, although some of rho behavior items such as sighing and groaning in this study could not be observed because of videotaped datd, the reliability and validity of the over all observation method were satifactory. Thus, the results of the present study demonstrate rye potetional utility of the tool in assessing objective pain complementing self-reported pain in low back pain patients.