An acute pain is the common experience following surgery. Pain is a most miserable experience in person and most preoperative patients have fear of postoperative pain. In nursing, it is very important to understand and relieve the pain between group of Patient Controlled Analgesia and group of traditional Muscular Injection in surgical patients. This information can be utilized as data of understanding nursing care and treatment planning for pain in surgical patients. The subjects in this study were 45 post-hysterectomy patients in Gynecology ward in C.N.U.H., in Taejon. Data was collected from May 12 to June 27,1996. The instruments used for this study were subjective Visual Analog Scale, Objective nonverbal pain scale composed of Facial Appearance, Vocal Sound Change. and Sweating score, and the Melzack's Mcgill pain Questionnaire, nine Items of Developmental pain Intensity Scale by Lee Eun Ok. Analysis of data was done by using S.P.S.S. percentage, t-test, x2-test, ANOVA, and Repeated measure ANOVA. Results were obtained as follows. 1. Hypothesis 1 : There was very highly statistically significant difference in subjective self-report pain score(Visual Analog Scale) between PCA Group and IM Group(P=0.0001). 2. Hypothesis 2 : There was very highly statistically significant difference in muscle strength score(Visual Analog Scale) between PCA Group and IM group(P=0.0001). 3. Hypothesis 3 : There was very highly statistically significant difference in facial appearance score between PCA Group and IM group(P=0.0001). 4. Hypothesis 4 : There was very highly statistically significance difference in vocal sound change score between PCA Group and IM group(P=0.0001). 5. Hypothesis 5 : There was no statistically significant difference sweating scores between PCA group and IM group(F=2.50, P=.1220). But, post-operation time of 12, 24 was statistically difference between two groups(P=0.0001) So, it was partially supported. 6. Hypothesis 6 : There was very highly statistically significant difference in vocabulary pain score between PCA Group IM group. 7. Hypothesis 7 : There was very highly statistically significant difference in amounts of total analgesic between PCA Group and IM group. There was very highly statistically significant difference in Visual Analog Pain Score, Facial Appearance Score, amounts of total analgesic between PCA group and IM group. So, It is verified to asses of postoperative pain with, VAS, Checklist of facial appearance, vocal sound change, and sweating, and Vocabulary Scale.

Rheumatoid Arthritis(RA), a chronic and systemic inflammatory disorder, is characterized by joint pain, swelling and stiffness. Patients with RA suffer from joint pain and overall pain. The painful and disabling consequences of RA are accompanied by a variety of affective, cognitive, and behavioral changes. The purpose of this paper was to explore and describe the life experiences of RA patients by eliciting verbal description of their experiences. Participants were nine persons who were diagnosed with RA, and had if for more than six months. They were asked open ended and descriptive questions in order for them to talk about their experiences in their own terms. Interviews were tape recorded and transcribed verbatim. The transcripts were analyzed by Colaizzi method. From the protocols, 213 significant statements about life experience were organized into 83 formulating meanings which were then grouped into five theme clusters. The major themes that emerged from the analysis were 'Emotional Disturbances', 'Trying to Adapt to the Progress of Treatment', ' Change of Role Performances', 'Experiences related to Family'. The result of this study showed that RA patients and families need nursing care based on a deep understanding of their lived experiences in everyday life. Nurses and other health workers must develop rehabilitation programs that focus on the pain control, functional independence and psychosocial factors.

The main purpose of this study was getting related to the pain charactristic data of elderly. It contains past and present health status, daily living activity level, pain frequency, causes, pain area, pain intensity, pain worse causes, and pain releave causes, pain management methods. The subject were 79 elderly whose age were over 65 years old. They were lived in their home environment. Half of them were resident of middle range city at province and the others were Seoul city. The data was collected from Dec. 1st. 1995 to Jan. 30th. 1996. Interviews were held with semi-structured questionaire after pilot study by researchers. Pain measurement tool were used graphic rating scale and Abstract of Korean Pain Language Scale. To analize the subject's general characteristics, past and present health status, daily living activity level, characteristics about pain, pain management methods statistical SPSS for win frequency were employed. The findings were as follows; 1. There were 33(41.8%) male and 46(58.2%) female Below 69 year old were 20(25.3%), 70-79 year old were 42 (53.2%), over 80 year old were 17(21.5%), mean age was 74(from 65 to 89). 2. Buddhist were 24(30.4%), Christian were 29(36. 7%), the other religious status or nun religians were 26(32.9%). 3. Past good health status were 63(79.7%), not so good status were 6(7.6%). Present good health status were 19 (24.1%), moderated health status were 6(7.6%), not so good status were 14(17.7%). 4. Daily living activity limitation were 39(49.4%), nonlimitation of activity were 5(6.3%). 5. Walking limitation were 3(3.8%), nonlimitation walking were 52(65.8%). 6. Insomnia was 23(29.1%), no difficult were 38(48. 1%). 7. Chronic pain complaints were 64(81%), diseases causes of pain were 25(31.6%), bad health behavior causes of pain were 27(34.2%). 8. Most pain area were back 30(29.4%), leg 17(16. 7%), knee 16(15.7%), arm 13(12.7%), teeth, chest and head were each 5(4.9%), loin, trunk were each 4(3.9%), the other areas were 3(3%). 9. Pain intensity was 3.49(mean) by Korean Language Scale, 6.59(mean) by graphic rating scale. Sensitive pain was 3.5(47.9%), affective pain was 3(20.8%) It was high pain level and sensitive pain. 10. Most pain worse causes moving was 35(44.3%), pain relieving causes rest was 29(36.7%). 11. Pain management method were medication 40 (42.1%), physiotherapy 23(24.2%), hospital 12 (12.6%), the others 7(7.4%), none 13(13.7%). The conclusion; Present health status of eldery was not so good. Almost half of them have some diseases. Most common diseases of eldery were arthristis, respitatory and heart problems. Fourty nine percent of elderly had limitation of daily living activities. Eighty one percent of eldely had chronic pain. Most of them was back pain (30%). Pain intensity was high (score over 3.5). The worsening pain causes was moving and releiving causes was rest. Pain management method were pain medication, physiotherapy. Therefore, Nursing care plan for the elderly have to focus on pain because majority of elderly have chronic high level of pain related to the arthritis.

In an attempt to investigate the effect of a muscle strengthening exercise program on muscle strength, pain, depression, self-efficacy and quality of life of patients with knee osteoarthritis, a pre-experiment, one group pre-test and post-test design, was planned. Muscle strengthening exercise was carried out from May 22 through August 14, 1995 at isokinetic exercise room in rehabilitation department of University Hospital in Taejon. The subjects were seven female clients conveniently sampled from University Hospital located in Taejon, between 39 and 61 years of age, who had a osteoarthritis in knee. Muscle strengthening exercise program was composed of three sessions per week, one isokinetic exercise at angular velocity of 60degrees and 180degrees with Cybex isokinetic dynamometer and two resistance home exercise sessions with elastic band. Data were analyzed with frequency, percentage of change, Friedman test, Duncan test using SAS program. Results were obtained as follows: 1) Flexion and extension muscle strength at angular velocity of 60degrees and 180degrees were increased after 12weeks' exercise than those of before experiment. But exept flexion muscle strength at angular velocity of 180degrees (F=3.34, P=0.0261), there was no statistically significant difference among muscle strengths, which is measured every 3 weeks. 2) Pain was decreased after 6weeks' exercise than that of before experiment, and after 12weeks' exercise than that of 6weeks' exercise. There was statistically significant difference(F=4.28, P= 0.0396). 3) Depression was increased after 6weeks' exercise than that of before experiment, and after 12weeks' execise than that of 6weeks' exercise. There was no statistically significant difference between before experiment and after 6weeks' exercise. But, there was statistically significant difference between after 6weeks' exercise and 12weeks' exercise (F=9.38, P=0.0035). 4) Self-efficacy was decreased after 6weeks' exercise than that of before exercise. But, it was increased after 12weeks' exercise than that of before exercise and after 6weeks' exercise. But there was no statistically significant difference (F=1.46, P=0.2706). 5) Quality of life was increased after Gweeks' exercise than that of before exercise, and after 6weeks' exercise than that of 12weeks' exercise. But there was no statistically significant differ-ence(F=1.06, P=0.3816). Thus, the significant of muscle strengthening exercise for the improvement of muscle strength, pain, depression, is verified. But, this study was a preexperiment with small size subjects. So, controlled experimental study is necessary to determine the effect of this muscle strengthening exercise program on muscle strength, pain, depression, self-efficacy, and quality of life of patients with knee osteoarthritis.

The purpose of this study was to identify relationships between a preoperative video program as nursing intervention and the perception of postoperative pain. The subjects consisted of an experimental group of 17 children and a control group of 13 children, for a total of 30 patients who were admitted the ENT Department for tonsilectomies. Data were collected from August 1, 1993 to September 31. The video program was made by the pediatric operating theater nursing staff. Postoperative pain was measured using the Face Pain Rating Scales devised by Beyer in 1984. The data were analyzed by a SPSS using frequencies, means, percentages, t-test and ANOVA to analyze the variables and demographic characteristics. The results of this study are as follows: The hypothesis, "Score of the experimental group which was shown the preoperative video program as a nursing intervention will be lower than the control group which did not see the video in postoperative pain perception." was rejected by t= -.42, p>.05. No significant difference was found between the experimental group and the control group according demographic characteristics. From the above findings, this study suggests the following: 1. Further studies as randomized control-group pretest-posttest design are needed to control the extraneous variables. 2. A review will be suggested to be done by the preoperative video program as nursing intervention and an exploration to improve preoperative nursing care for pediatric patients with the inclusion such activities as preoperative visiting, operation theater tour etc.

PURPOSE: This study was conducted to identify the pain characteristics, family support and physical functioning and to determine predictors of the quality of life in aged women with chronic pain. METHOD: The questionnaires were collected through direct interview by a trained research assistant from July 2 to August 24, 2001. Subjects were 108 women clients with chronic pain over 65 years of age. Data analyzed frequency, percentage, mean, Pearson's correlation, ANOVA and stepwise multiple regression by SAS. RESULT: Care providers were mostly spouses and daughters in law. Care providers who took care of elderly for a few hours a day had the highest percentile. Aged women had persistently had chronic pain of moderate intensity and was moderately satisfied with pain management. The mean score of disability due to pain was 3 on a 10 point scale. The mean scores of physical function and quality of life were moderate and there were negative correlations between pain characteristics, physical functioning, and quality of life at the range from r=-.46 to r=-.83. Satisfaction with care, duration of pain, disability due to pain, and physical functioning accounted for 56% of the variance in perceived quality of life for aged women with chronic pain. Disability due to pain was the most predictable variable of quality of life and physical function was the second . CONCLUSION: The results suggest that care by family, education in pain control, prevention of disability, and maintenance of physical function are important to improve and maintain quality of life in aged women with chronic pain. Therefore, there is a need for program development that enhance family support and nursing intervention that focuses on active pain control.

The incidence of reported acute pain is still high which indicates a lack of knowledge in clinical pain assessment and management. This study was carried out to investigate strategies of post-operative pain assessment in terms of patterns of criteria adopted and how these are influenced by prior experience. The research approach, phenomenography, was adopted in data analysis. The subjects of this study consisted of 10 nurses from post-operative care units from a University Hospital in Seoul, Korea. Findings revealed that the nurses mostly relied on "how it usually is" and "how the patient looks" as strategies of post operative pain assessment and "I have learned the typology of patients" as a frame of reference of post operative assessment.

The purpose of this study was to investigate the impact of depression, discomfort, spirituality, physical care, and opioid use on pain with terminally ill cancer patients residing in hospice units. The convenient sample of this study consisted of 41 terminally ill cancer patients at three hospice units in university affiliated hospitals. Patients were interviewed with structured questionnaires three times at predetermined intervals: admission to the hospice unit (Time 1), one week later (Time 2), and two weeks later (Time 3). The data was collected from January 1998 to January 1999 and was analyzed using ANOVA, Pearson correlation coefficient, and multivariate multiple regression. The results of this study were as follows: 1. The mean age of the participants was approximately 55 years old. In terms of diagnosis, lung cancer showed the highest frequency (19.5%), followed by stomach cancer and rectal cancer (17.1%). The motive of seeking hospice unit admission was control (72. 2%), followed by spiritual care (50%), and symptom relief (38.9%). 2. Regarding the type of pain felt, the highest pain frequency the participants experienced was deep pain (55%), followed by multiple pain (25%), intestinal pain (10%), then superficial (5%) and neurogenic pain (5%). For the level of pain measured by VAS, there was no significant difference among the three time points; Time 1 (5.04 +/-2.21), Time 2 (4.82+/-2.58) and Time 3(4.73+/-2.51). 3. There was significant change seen in spirituality and physical care in each time interval. Namely, the longer the length of admission at the hospice unit, the higher the importance of spirituality (p=0.0001) and the more the physical care the participants received (p=0.01). The opioid use at the three time points showed the following frequencies : Time 1 (75.6%), Time 2 (85.4%) and Time 3 (75.6%). 4. Regarding factors influencing pain, the pain level was significantly affected by the depression level (p <0.01) and the opioid use (p <0.1). These results were the most significant at the two time points (Time 1 and Time 2). At Time 3 (two weeks later), the pain level was significantly affected by the depression level (p <0.05) and the amount of physical care the participants received (p <0.1). In conclusion, the terminally ill cancer patients had moderate pain, were generally depressed, and were treated with opioid analgesics. As approaching death, the patients received more physical care due to increased physical symptoms experienced and they had a higher perception of the importance of spirituality. Thus, health care professionals need to provide continuous care for each of them to die comfortably physically, psycho- logically, and spiritually.

The purpose of this study was to determine the meaning of the pain and experiences of elderly women with osteoarthritis, by adopting Colaizzi's phenomenological method. The participants were 7 elderly women over the age of 65. They were selected using a theoretical sampling technique. The Data was collected by in-depth and open-ended interviews from Dec. 1. 1999. to Feb, 28. 2000. The length of the interviews varied from 120 minutes to 180 minutes. Data was recorded and analyzed by a constant comparative
method
. From the data, significant statements were extracted and then organized into 48 themes, which resulted in 15 clusters of themes and 6 categories. The final descriptions turned out to be valid through the interviewee' validation process. Essential themes of the pain experiences emerged : "physical discomfortness(disturbances)", "negative state of mind", "influence of the death", "positive change in life", "Cause of pain perceived", and "change of their personal relationships". From these results, it was found that elderly women need nursing care based on a deep understanding of pain, and a reflection on their past is imperative to overcome their given situations. In conclusion, it is suggested that the care givers provide more support to solve the problems experienced by the elderly. Thus the researchers expect to provide understanding of older people and give basic data of holistic care for them.

Parents are primary care taker for the children and have an important role for the assessment and managent of children's pain following surgery. The purpose of the present study was to examine the validity and clinical utilization of the Postoperative Pain Measure for Parents (PPMP) developed by Chambers et al. Subjects were 52 children aged 4-12 years admitted for tonsillectomy and other minor surgery and their mothers. Faces Pain Scale, State Anxiety, and Postoperative Pain Measure for Parents were used. The data were collected by two research assistant on the operation day and 1st day after surgery at hospital during the period of July 20 to August 28, 1998. The results are as follows: 1. Eta correlation coefficient between 15 items of PPMP and child rated pain were calculated. Correlation coefficients were more than .2 for both day. 2. Internal consistency for PPMP were .82 and .83. 3. The scores of the PPMP were 10.73 (SD=3.71) and 9.27(SD=4.07) on the operation day and 1st day after surgery and there was no significant difference between two days(p=.056) On the other hand, there was a significant difference on the child rated pain by Faces Pain Scale between operation day and 1st day after surgery(p=.001). 4. The correlation(Spearman Rho) between PPMP and child rated pain were .40(p=.003) and .56(p=.000). The score of the PPMP and the children's state anxiety were highly correlated on the operation day and 1st day after surgery (.60, .52, p=.000). 5. Partial correlation between PPMP and child rated pain except state anxiety were .18(p=.23) and .48(p=.001) on the opration day and 1st day after surgery. 6. Using a cut-off score 10 out of 15, the measure showed excellent sensitivity (>80%) and moderate specificity (46.15%, 60% ). This study provides preliminary evidence for the use of the PPMP as a valid pain assessment tool with children between the ages of 4-12 years following surgery. It is suggested to explore the validity with a different subjects with other surgery and to examine the validity for infant and younger children.

The author investigated pain experiences of 90 cancer patients and 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.

This study was designed to investigate the effects of exercise therapy on joint mobility, daily activity, pain and depression of patients with ankylosing spondylitis. 25 persons with the experimental group and 25 persons with the control group were conveniently sampled among out-patients diagnosed with ankylosing spondylitis at the rheumatism center of H University Medical Center. The control patients were matched to the experimental group and they were selected considering sex and age. The exercise therapy was developed by the author with the assistance of exercise specialists. The program includes muscle relaxation, flexibility, muscle strengths, breathing strengths and straight posture exercises. The 20-minute exercise therapy was carried out to the experimental group once a day for eight weeks from October, 1997 to February, 1998. Before and after the experiments, joint mobility, daily activity, pain and depression were measured respectively. Data were analyzed by x2-test, t-test, paired t-test and unpaired t-test. The results were as follows : Joint mobility(cervical flexion, extension, shoulder flexion, abduction, hip abduction, knee flexion and fingertip to floor distance) and daily activity in the experimental group after the exercise were significantly increased than that in the control group. The pain and depression score in the experimental group after the exercise were significantly decreased than that in the control group. These findings may indicate that the exercise therapy is effective in increasing the joint mobility and daily activity, and also effective in decreasing pain and depression in patients with ankylosing spondylitis. Accordingly, the exercise therapy can be adopted as an effective nursing intervention for ankylosing spondylitis.

Despite acknowledgment that pain is likely to be a major problem for many older adults, it is difficult to estimate the frequency of pain problems for this population. The main purpose of this study was to identify the various characteristics of chronic pain in the elderly by gender. It examines by gender, pain frequency, pain intensity, number of chronic pain sites, localization of pain, impact on activities, methods of pain management, and effects of chronic pain management. The subjects were 189 elderly people(65 years and older) living in an urban area. They were surveyed at their homes. They were surveyed by interview using a closed-ended questionnaire. The survey was done from Nov. 6th. to Dec. 6th. 1997. Descriptive statistics were used to determine all of the reported pain variables. Chi-square tests were used to determine crude differences between pain intensity and gender. T-test was used to determine differences in number of pain sites between men and women. The findings are as follows ; Of the 189 subjects, 83.6% reported experiencing pain, and men reported a lower prevalence(69.5%) than women(89.2%). Women had significantly more severe pain than did men(p=.001). Lower back pain(20.2%) and leg pain(20.2%) were the most prevalent, followed by knee pain(17.4%), arm pain(13.3%), neck and shoulder pain(11.6%), and headache(9.9%). Women experienced more multiple localizations of pain(p=.0001). The greatest impact was on movement(83.5%), followed by usual activities(60.8%), sleep(49.4%), visiting(29.1%), and hobbies and recreations(50.0%). No differences were observed between men and women in the proportion of subjects reporting a negative impact on each of these activities. The methods of pain management were hospital visit(70.9%), drug store medication(46.7%), oriental medicine clinic(32.9%), endurance(13.3%), self-management(6.3%). Drug therapy was the most effective pain management strategy(94%), followed by physical therapy(63%) and accupuncture byssocausis(55%). The conclusion: Pain is a symptom of great clinical importance that is often associated with disability, loss of independence, and reduced quality of life. In this study chronic pain symptoms were common but unevenly distributed in men and women. The results further advance understanding of the experience and impact of pain by gender. Future studies should incorporate questions that gather systemic and more detailed information on the characteristics of pain, expecially by gender and by age.

This study was designed to identify the relationship between perceived pain, family support and quality of life in patients with ankylosing spondylitis. The purpose of this study was to contribute to the theoretical understanding of the relationship of these three variables and eventually to more effective adaptation of patients to their situation. The subjects for this study were the 68 patients who had been diagnosed with ankylsing spondylitis and registered as out-patients in the Rheumatism Center of one university hospital in Seoul. The data were collected during the period from October 10, 1997 to December 20, 1997. Pain was measured using the perceived pain scale(VAS: Visual Analog Scale)developed by Calin(1993), family support using the scale developed by Kang Hyun Suk(1985) and Quality of Life using the scale developed by Ro Yoo Ja(1988). The data were analyzed by descriptive statistics, Frequencies, Pearson correlation, using the SPSS program. The results of this can be summarized as followings. 1. The mean perceived pain score was 5.13 with a range of 2 to 10. 2. The mean perceived family support score was 41.08+/-5.34 with a range of 20 to 50. 3. The mean perceived quality of life score was 134.07+/-19.82 with a range of 83 to 176. 4. Significant statistical difference was found between family support and quality of life(r=.331, p<0.001). A significant negative statistical difference was found between the family support and quality of life and pain(r=-.250, p<0.05, r=-.460, p<0.001). 5. General characteristics related to pain were exercise(t=4.72, p<0.0006). 6. General characteristics related to family support were age(F=2.65, p<0.0246), educational level(F=2.84, p<0.0282) and exercise(t=3.24, p<0.0452). 7. General characteristics related to quality of life were educational level(F=3.03, p<0.0392) and exercise(t=3.12, p<0.0465). It was found that the higher the level perceived pain, the lower the degree of perceived family support and the quality of life. It was also fund that the higher the degree of perceived family support the higher the degree of perceived quality of life. Accordingly, the conclusions from this study are that reduction of pain is achieved through the family support. Therefore, it is proposed that family support is an appropriate nursing intervention to improve the quality of life of patients with anklosing spondylitis.

Cutaneous stimulation and distraction are independent nursing interventions used in various painful conditions, which I explained by gate control theory. This study was aimed at identifying the effect of cutaneous stimulation, distraction and combination of cutaneous stimulation and distraction on the reduction of intravenous injection pain levels of chemotherapy patients. Repeated measurement post test research design was used for one group. Fifty-three cancer patients who received intravenous chemotherapy regular in outpatient injection rooms of D medical center and Y medical center in Taegu were studied from June 23, 1997 to July 12, 1997. First the intravenous injection pain level of the control period was measured. Second, the intravenous injection pain level of the experimental period using cutaneous stimulation was measured. Third, the intravenous injection pain level of the experimental period using distraction was measured. Fourth, the intravenous injection pain level of the experimental period using a combination of cutaneous stimulation and distraction was measured. The instruments used for this study were a visual analogue pain scale as subjective pain measurement and an objective pain behavior checklist. Analysis of data was done by use of repeated measure ANOVA, bonferni, t-test, and F-test. The results of this study were summarized as follows : 1) The first hypothesis that the subjective pain score of intraveneous injection pain in the experimental period with cutaneous stimulation will be lower than in the control period. 2) The second hypothesis that the objective pain behavior score of intravenous injection pain in the experimental period with cutaneous stimulation will be lower than in the control period was accepted(F=24.23, p=0.0001, Bornferni p<0.5). 3) The third hypothesis that the subjective pain score of intravenous injection pain in the experimental period with distraction will be lower than in the control period was rejected. 4) The fourth hypothesis that the objective pain score of intravenous injection pain in the experimental period with distraction will be lower than in the control period was accepted(F=24.23, p=0.0001, Bornferni p<.05). 5) The fifth hypothesis that the subjective pain score of intravenous injection pain in the experimental period with combination of cutaneous stimulation and distraction will be lower than in the control period was accepted(F=3.04, p=0.031), Bonferni p<.05). 6) The sixth hypothesis that the objective pain score of intravenous injection pain in the experimental period with combination of cutaneous stimulation and distraction will be lower than in the control period was accepted(F=24.23, p=0.0001, Bonferni p<.05).