요양병원에 입원한 암환자의 통증경험 및 통증관리실태

Abstract

Purpose : This study is a descriptive research to investigate pain experience, pain management, barriers to, and satisfaction on pain management in cancer patient at long-term care hospitals in order to develop effective interventions for pain management.

Method : Data were collected from 170 hospitalized patients with cancer pain at 3 long-term hospitals in G and J. regions using a survey method between July 2014 and Setember 2014. The data were analyzed using SPSS/WIN 21.0 to conduct descriptive statistics, independent t-test, one-way ANOVA , Scheffé test and Pearson correlation.

Findings : The findings of this study are as follows; (1) Forty percent of the participants were in their 70’s and 18.0% of the participants had genital cancer, which constituted the largest proportion.

(2) Degree of pain was 3.90 out of 10 points, which means that they had mild to moderate degrees of pains. Region of pain was abdomen (35.3%), arms and legs (29.4%), chest (17.1%). Degree of impediment in daily life caused by pains was 1.96 out of 4 points.

(3) Method of pain control were used oral medications (87.6%), physical therapy (81.2%), chinese medicine use (81.2%), injection (80.6%), hot pack apply (53.5%), massage (42.9%). Injection (60.6%) was the most effective pain relief method. The most frequently used painkillers was tamadol (54.7%), followed by durogesic (22.9%), IR-codone (22.4%), morpine (10.6%), targin (7.6%), and tylenol (7.6%) .The pain medications were properly used in 75.9 % of the cases according to pain management index (PMI).

(4) The mean score of barriers regarding pain management was 3.14±0.80 (range 1-5), and concerns about the progress of cancer was the most highly evaluated barrier among the patients.

(5) The mean score of satisfaction on pain control was 3.26±0.61 (range 1-5).

(6) Degree of pain had a significant effect on age (F=5.46, p=.000), marital status (F=4.35, p=.002), family (F=6.45 p=.000), education (F=4.53, p=.002), and income (F=4.55,p=.001). Barriers of pain control had a significant effect on age (F=3.48, p=.009), education (F=3.11, p=.017), activity state (F=4.24, p=.016). Satisfaction of pain control had a significant effect on insight(t=2.83, p=.005), metastasis (F=7.14, p=.001), and experience of surgery (t=3.94, p=.000).

(7) There was a negative relationship between degree of pain and satisfaction to pain management (r=-.26, p<.01). No significant relationship between barriers and satisfaction on pain management (r=-.08, p>.05).

Conclusion : The findings show that cancer patients at long-term care hospitals are suffering from mild to moderated degrees of pains. Satisfaction on pain control was moderate degree. The study results also indicate that precise evaluation on pains is very important to manage pains properly. Therefore, education on proper pain management may help to patients who suffer from cancer pains overcome barriers to pain management.