• Title, Summary, Keyword: Chronic pain

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A Study on Chronic Pain, Pain Beliefs, Pain Coping, and Fatigue in the Elderly (노인의 만성통증과 통증신념, 통증대처 및 피로에 관한 연구)

  • Chang, Hae Kyung
    • Korean Journal of Adult Nursing
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    • v.18 no.3
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    • pp.377-385
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    • 2006
  • Purpose: This study were to examine the relationship among chronic pain, pain beliefs, pain coping, and fatigue and to define the main factors influencing chronic pain in the elderly. Method: Data were collected by self-reported questionnaires from 276 Korean elderly. Data analysis was done with SPSS 10.1 for descriptive statistics, t-test, ANOVA, Pearson Correlation Coefficient, and Stepwise multiple regression. Results: Chronic pain score was 5.45, which was slightly higher than the average. There were significant differences in chronic pain according to age, marital state, economic state, and duration of pain. There was a significant positive correlation between chronic pain and pain beliefs, passive pain coping, physical fatigue and mental fatigue. In addition, there was a significant negative correlation between chronic pain and active pain coping. Stepwise multiple regression analysis showed that 44% of the variance in chronic pain was significantly accounted for by passive pain coping(31%), pain beliefs(8%), physical fatigue(4%), and active pain coping(1%). Conclusion: These results suggested that pain beliefs, pain coping, and fatigue can be influencing factors on chronic pain for the elderly. Also, the findings can provide a basis for nursing intervention development to effectively manage chronic pain for the elderly.

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A Study of Pain, Depression and Self-Efficacy According to the Classifications of Pain among Chronic Pain Patients (만성통증환자의 통증분류에 따른 통증, 우울 및 자기효능감 정도)

  • Yang, Jin-Hyang
    • Korean Journal of Adult Nursing
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    • v.16 no.2
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    • pp.202-210
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    • 2004
  • Purpose: this study was to examine the differences of the level of pain, depression and self-efficacy according to the classifications of pain among chronic pain patients. Method: The data were collected by means of self-reported questionnaire from 164 patients with chronic pain visited in one university hospital and one local pain clinic in Busan, from October 7 to November 16, 2002. Analysis was done by ANOVA, and Scheffe test using SPSS program. Result: The subjects were divided into five classifications of chronic pain : 26.2% low back and extremity pain, 23.2% neck, shoulder and upper extremity pain, 19.5% postherpetic neuralgia, 15.9% complex regional pain syndrome and 15.2% peripheral neuralgia. There were significant differences in pain (p=.000), depression (p=.000) and self-efficacy (p=.003) according to the 5 kinds of chronic pain. With the results of the Scheffe test, the patients with peripheral neuralgia experienced pain and depression higher than those with the other kinds of chronic pain. The patients with neck, shoulder and upper extremity pain experienced self-efficacy higher than those with peripheral neuralgia. Conclusion: Chronic pain patients should be provided effective individualized intervention depending on the classifications of chronic pain. Therefore the development of interventions for pain management according to the classifications of pain in chronic pain patients is needed.

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Chronic Pain Control of SCI Patients after Cervical Epidural Block -Case report on 2 cases- (경부 경막외 차단에 의한 척수손상 환자의 만성 통증 조절 -2예 보고-)

  • Lee, Ji-Young;Sung, Choon-Ho
    • The Korean Journal of Pain
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    • v.5 no.2
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    • pp.273-278
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    • 1992
  • With the medical progress that has given spinal cord injured(SCI) individuals greater longevity and better overall health, chronic pain is emerged as major challenge in treating this population. According to past reports, estimates of prevalance of severe/disabling chronic pain in SCI patients have ranged from 18% to 63%. In etiologies of chronic pain in SCI patients, psychic or psychogenic pain categories should be included and more recent data have demonstrated that the persistant pain is directly related to higher levels of psychosocial distress and impairment. Recently, neurophysiological classification of the SCI pain syndrome into three etiologic groups(a; mechanical pain, b; radicular pain, c; deafferentation pain) is more frequently adopted for the classification of chronic SCI pain syndrome. The deafferentation pain is most common of the pain syndromes associated with SCI. After cervical epidural anesthesia for the surgical intervention of decubitus ulcer on the hip of two SCI patients, there were much reduction of existing chronic deafferentation character pain.

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The Cause and Mechanism of Chronic Pain (만성 동통의 원인과 기전)

  • Na, Chul
    • Korean Journal of Psychosomatic Medicine
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    • v.3 no.1
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    • pp.81-90
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    • 1995
  • It is essential in evaluating the chronic pain patients that the physician obtain a multiple causative factors including organic, psychological, and socioenvironmental factors. Though these multiple factors are involved in the development of chronic pain syndrome, chronic pain syndrome is not only the sum of the interaction of all of these factors, but is also influenced by the sequelae of chronic pain, which again are organic, psychological, and socioenvironmental in nature. Therefore a systemic approach is probably the best way to asses the role of all of these factors. Furthermore, this approach can provide a framework for understanding chronic pain syndrome, for assessing chronic pain syndrome, for the rational management of chronic pain syndrome, and for the development and testing of hypotheses.

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The Biological Approach of Chronic Pain (만성동통에 대한 정신시체의학적 접근 -생물학적 접근-)

  • Oh, Byoung-Hoon
    • Korean Journal of Psychosomatic Medicine
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    • v.3 no.1
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    • pp.91-97
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    • 1995
  • Pain is a complex symptom consisting of a sensation underlying potenial disease and associated emotional state. Acute pain is a reflex biological response to injury, in contrast, chronic pain consists of pain of a mininum of 6 months duration and associates with physical, emotional past experience, economic resources of the patient, family and society. Moreover, chronic pain is characterized by physiological affective and behavioral responses that are quite different than those of acute pain. The different type of stimuli exciting pain receptor are mechanical, thermal and chemical stimli and chronic pain are concerned with three of all stimli. The major three components of pain central(Analgesia) system in the brain and spinal cord are 'periaqueductal gray area of the mesencephalon', 'the raphe magnus nucleus' and 'pain inhibitory complex located in the dorsal horns of the spinal cord'. But unfortunately, the central biochemical mechanisms of chronic pain are not clearly defined. To proper management of chronic pain, comprehensive urderstanding as a psychosomatic aspect and multidisciplinary therapeuti-team approach must be emphasized.

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Opioid Pharmacotherapy for Chronic Noncancer Pain: The American Experience

  • Chapman, C. Richard
    • The Korean Journal of Pain
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    • v.26 no.1
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    • pp.3-13
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    • 2013
  • Chronic noncancer pain is a significant and growing public health challenge in the United States. Lacking effective alternative interventions for effective chronic noncancer pain management, many physicians have turned to opioid pharmacotherapy. Increased opioid prescribing brings not only gains in therapeutic benefit but also a higher incidence of adverse drug events including increased medication misuse and opioid related mortality. Currently the United States must confront the dual problems of widespread undertreated chronic noncancer pain and a prescription opioid abuse crisis. Withholding pain relieving drugs from patients in need is unjustifiable, yet drug diversion, abuse and adverse drug events have become major social as well as medical problems. At the heart of this crisis is the lack of definitive evidence about the risk to benefit ratio of opioid pharmacotherapy for chronic noncancer pain both on an individual case and on a population basis. This article describes the extent and severity of the American chronic noncancer pain problem and the history of opioid pharmacotherapy for chronic noncancer pain in the United States. It then discusses the concept of evidence based practice and reviews current evidence supporting opioid pharmacotherapy for chronic noncancer pain as well as adverse drug events related to opioid pharmacotherapy including misuse and abuse. Finally, it considers the conflict of providing pain relief versus protecting society and reviews steps that governmental agencies, industry and others are taking to contain and ultimately resolve the problems of excessive prescribing and conflicting priorities.

Repetitive Transcranial Magnetic Stimulation to Treat Depression and Insomnia with Chronic Low Back Pain

  • Park, Eun Jung;Lee, Se Jin;Koh, Do Yle;Han, Yoo Mi
    • The Korean Journal of Pain
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    • v.27 no.3
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    • pp.285-289
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    • 2014
  • Transcranial magnetic stimulation (TMS) is a noninvasive and safe technique for motor cortex stimulation. TMS is used to treat neurological and psychiatric disorders, including mood and movement disorders. TMS can also treat several types of chronic neuropathic pain. The pain relief mechanism of cortical stimulation is caused by modifications in neuronal excitability. Depression is a common co-morbidity with chronic pain. Pain and depression should be treated concurrently to achieve a positive outcome. Insomnia also frequently occurs with chronic lower back pain. Several studies have proposed hypotheses for TMS pain management. Herein, we report two cases with positive results for the treatment of depression and insomnia with chronic low back pain by TMS.

A Study of the Relationship of Chronic Pain, Pain Coping, Fatigue, Self-esteem, and Depression in Elders (노인의 만성통증과 통증대처, 피로, 자아존중감 및 우울의 관계연구)

  • Chang Hae-Kyung;Sohn Jung-Nam;Cha Bo-Kyoung
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.13 no.1
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    • pp.86-95
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    • 2006
  • Purpose: This study was done to investigate the relationship among the variables, chronic pain, pain coping, fatigue, self-esteem, and depression in elders. Method: Data were collected by self-reported questionnaires from 270 older adults. Data analysis was done with SPSS 10.1 for descriptive statistics and a PC LISREL program for covariance structural analysis. Results: According to modified model, chronic pain was found to have a significant direct and total effect on pain coping. Chronic pain and pain coping were found to have a significant direct and total effect on fatigue. Chronic pain, pain coping and fatigue were found to have a significant direct and total effect on self-esteem. Chronic pain, pain coping, and self-esteem were found to have a significant direct effect on depression. Conclusion: This modified model is considered appropriate for explaining the relationship among chronic pain, pain coping, fatigue, self-esteem, and depression in elders. Also, the findings support the development of an intervention strategy to relieve chronic pain in elders.

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"I'm healthy, I don't have pain"- health screening participation and its association with chronic pain in a low socioeconomic status Singaporean population

  • Wee, Liang En;Sin, David;Cher, Wen Qi;Li, Zong Chen;Tsang, Tammy;Shibli, Sabina;Koh, Gerald
    • The Korean Journal of Pain
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    • v.30 no.1
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    • pp.34-43
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    • 2017
  • Background: We sought to determine the association between chronic pain and participating in routine health screening in a low socioeconomic-status (SES) rental-flat community in Singapore. In Singapore, ${\geq}85%$ own homes; public rental flats are reserved for those with low-income. Methods: Chronic pain was defined as pain ${\geq}3$ months. From 2009-2014, residents aged 40-60 years in five public rental-flat enclaves were surveyed for chronic pain; participation in health screening was also measured. We compared them to residents staying in adjacent owner-occupied public housing. We also conducted a qualitative study to better understand the relationship between chronic pain and health screening participation amongst residents in these low-SES enclaves. Results: In the rental-flat population, chronic pain was associated with higher participation in screening for diabetes (aOR = 2.11, CI = 1.36-3.27, P < 0.001), dyslipidemia (aOR = 2.06, CI = 1.25-3.39, P = 0.005), colorectal cancer (aOR = 2.28, CI = 1.18-4.40, P = 0.014), cervical cancer (aOR = 2.65, CI = 1.34-5.23, P = 0.005) and breast cancer (aOR = 3.52, CI = 1.94-6.41, P < 0.001); this association was not present in the owner-occupied population. Three main themes emerged from our qualitative analysis of the link between chronic pain and screening participation: pain as an association of "major illness"; screening as a search for answers to pain; and labelling pain as an end in itself. Conclusions: Chronic pain was associated with higher cardiovascular and cancer screening participation in the low-SES population. In low-SES populations with limited access to pain management services, chronic pain issues may surface during routine health screening.

Analysis of Autonomic Nerve System by Analyzing the Herat Rate Variability(HRV) in Chronic Musculoskeletal Pain (만성통증환자의 심박변이도(Heart Rate Variability) 분석을 통한 자율신경계 특징에 관한 연구)

  • Ha, Seon-Yun;Kim, Dong-Min;Cho, Seong-Yeun;Im, In-Hwan;Kim, Yong-Suk;Nam, Sang-Soo
    • Journal of Acupuncture Research
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    • v.25 no.6
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    • pp.35-46
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    • 2008
  • Objectives : Chronic pain affects and is affected by physical and psychosocial factors. It also has a complicated and indefinite mechanism. This research is for clarifying relations with chronic pain, stress, and autonomic nerve system by comparing HRV and Stress Reaction Index(SRI) of chronic pain patients with those of acute pain patients. Methods : The subjects were 32 patients who visited Kangnam Kyunghee Hospital for nuchal pain or low back pain treatment from March 2008 to September 2008. Among them, 16 patients who suffered over 6 months are classified chronic pain group and 16 patients who suffered under 6 months as acute pain group. All subjects had their HRV(SA-2000E: Medicore Co..Ltd. Korea) and SRI measured at first visit. We studied the difference of HRV between two groups.(Statistics by Student t-test, p<0.05) Results : R-MSSD, TP, VLF, LF, HF and LF/HF ratio of the chronic pain group were significantly lower than those of the acute pain group. Compared with those of the acute pain group, total SRI of the chronic pain group were low but it's not significant except frustration. Conclusion : The results of HRV of the chronic pain group patients show that chronic pain is related to psychosocial factor and autonomic disturbance.

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