PURPOSE: This study was done to develop a evidence-based guideline for pain assessment and management in Korea by adapting previously developed pain guidelines. METHODS: The guideline adaptation process was conducted using 24 steps according to the guideline adaptation manual developed by Hospital Nurses Association in 2012. RESULTS: The newly developed pain management guideline consisted of 9 domains and 234 recommendations. The number of recommendations in each domain was: 13 general instruction items, 51 pain assessments, 14 pain interventions, 66 pharmacological interventions for acute pain, 41 pharmacological interventions for chronic cancer pain, 35 pharmacological interventions for chronic noncancer pain, 21 non-pharmacological interventions, 2 documentations, 10 nursing education items, for pain. CONCLUSION: The findings suggest that the new pain management guideline can be used to address pain in hospital settings.
Acute Pain ; Documentation ; Education, Nursing ; Evidence-Based Nursing ; Korea ; Nursing ; Pain Management ; Pain Measurement

The purpose of this study is to analyze the structural pattern of nurses' pain management with patients who experience pain. As a research method, the Q methodology, which is useful for an objective view of a highly abstract concept, was applied. The data collecting activity of this study was from August, 21st, 2000 to November, 24th 2000. The Q-population, the previous thesis and a literature review were done. Questions about pain management by the nurse on the patients, caregivers, nursing students, doctors, nurses, and others were asked in documentary work and in-depth interviews. In all, 223 units of the Q-population were formed, and the last 35 units of the Q-population were extracted. The data on the P-sample was collected from 41 nurses who worked in the medical and surgical units of a hospital that belonges to C university in Seoul. The research results were constituted in 3 types. Type I was the 'pattern of judging by objectivity'. The statement on which most of the people highly agreed for those patterns was shown by 'If patients said that they are suffering from pain, we sufficiently performed an assessment about the etiology, location, duration and degree'. For type I, the same pain was found in different locations according to the patients, so the etiology of the pain should be identified first place. Since ways of coping are different according to pain etiology, it was thought that it is important to assess sufficiently the pain etiology, location, duration, and degree. Therefore, when patients complain of pain, the pain etiology should be identified and assessed; according to the result, pain management should be performed systematically. Type II was the 'pattern of accepting by subjectivity'. The statement on which most of the people highly agreed for those patterns was shown as 'If patients said that they are suffering from pain, the medical treatment should be performed rapidly and speedily.' For type II, when the patient complains of pain, treatment should be performed quickly in order to prevent the condition getting worse, and it is thought that activity is a reasonable duty. Further, by trying to show empathy after pain is admitted and by understanding and coping rapidly with the pain of patients, an attitude which matched the altruistic morals of nurses is being shown. Type III was the 'pattern of worrying about', and the statement on which most of the people highly agreed for those patterns was shown is 'When there is a pain, to help patients to tolerate the pain to the highest degree.' In type III, the pain is a subjective expression, so there is a difference according to every individual. Therefore, actually if there is no measurement of pain, it could be exaggerated so nurses should help patients to tolerate it to the utmost. Even if there is a way to remove pain without an analgesic drug, nurses were reluctant to perform pain management as they possibly could. Through these research results, pain management of nurses was classified in 3 types, and structural characteristics in each type were discovered. Based upon the characteristics according to the type, an individualized pain management intervention strategy should be established and the follow up work performed.
Caregivers ; Empathy ; Humans ; Morals ; Pain Management* ; Seoul ; Students, Nursing

PURPOSE: The purpose of this study was to determine the relationships of pain cognition, performance status, and hope with health-related quality of life. METHODS: Patients(n=149) with various cancer diagnoses completed the SF-36 standard Korean Version and the Herth Hope Index. The Perceived Meanings of Cancer Pain Inventory was used to measure the cognition dimension of pain, whereas the Brief Pain Inventory Korean version was used to represent the sensory dimension of pain. RESULTS: The patients in the pain group had significant differences in the three dimensions(loss, threat, spiritual awareness) of pain cognition. There were statistically significant negative correlations between the three dimensions(loss, threat, and spiritual awareness) of pain cognitions and SF-36 dimension, and the positive correlations between challenge dimension and SF-36 dimension. Hope had the positive correlation with SF-36 dimensions. CONCLUSION: Pain has a negative impact on health-related quality of life, especially on physical health. However, patients who ascribed more positive meaning to their pain, tended to have a higher quality of life. Therefore, nursing intervention to reinforce the positive aspects of pain cognition is to empower patients to create a sense of control and assume an active role in pain management and quality of life.
Cognition* ; Diagnosis ; Hope* ; Humans ; Nursing ; Pain Management ; Quality of Life*

PURPOSE: The purpose of this study was to develop a computer decision making support system that enables nurses to utilize the computer in selecting the best decision for pain management for patients with dementia institutionalized in nursing homes. METHODS: To formulate the protocol for the management of patients' pain, the researcher analyzed content of interviews with 30 nurses in three nursing homes and an expert group. A decision support computer program was formalized based on existing protocols. To evaluate the effectiveness and applicability of the system, analysis of data on patient pain management and nurse satisfaction with the system were done after the formalized decision support computer program was complete. RESULTS: The decision support computer program for pain management for institutionalized patients with dementia was finalized after adjustments following the evaluation. Nurse satisfaction with the program was moderate. It also provided opportunity to reassess thinking about pain and pain management. CONCLUSIONS: The results indicate that this program provides nurses with useful knowledge for pain management in institutionalized patients with dementia and aids in decision making in nursing practice in nursing home.
Decision Making ; Dementia ; Humans ; Nursing Homes ; Pain Management ; Software ; Thinking

PURPOSE: This study was conducted to develop a nurse-learning program for the pain management of cancer patients. METHODS: In this methodological study, a learning program was developed between January and June 2011, following the methodological procedure based on the ADDIE Instructional System Design. RESULTS: The learning program consists of 4 parts: learning goal, learning outcomes, learning method, and evaluation method. Learner-centered learning goal and learning outcomes were established, and lecture-based group learning and self-directed study were combined as the learning method. For the evaluation, we developed a written test, a nursing skill checklist, and a case report evaluation tool. After a pilot test, the learning program was assessed by an expert group for its construct validity and content-related conformance. Moreover, the effectiveness of the program was validated by the results of the learning outcomes evaluation and the achievement levels of 40 trainees who participated in the program. CONCLUSION: On the basis of the results of this study, we suggest that this unit-based core nursing practice learning program, comprising 202 nursing units developed by a research institute nursing department since 2010, be shared by all nurses in clinical nursing care settings to improve their practical performance and ensure necessary specialization.
Academies and Institutes ; Checklist ; Humans ; Learning* ; Methods ; Nursing Care ; Nursing* ; Oncologic Nursing ; Pain Management* ; Programmed Instruction as Topic

PURPOSE: This study was done to develop a pain management protocol for nursing home patients with dementia and to examine effects of the protocol on pain assessments and interventions by the nurses and on pain relief signs in the patients. METHOD: The six steps in the protocol development and the examination of effect are outlined. Three rounds using the Delphi technique and one group pretest-posttest design experiment were developed. Design issues, such as sample selection and sample size, are addressed in relation to the study protocol. RESULTS: After implementation of the pain management protocol, there were significant changes nursing actions including frequency of number of physical examinations, utilization of pain assessment tools, and request to doctors for discomfort management and there were significant changes in frequency in the number of verbal and physical expressions of pain, and emotional patterns. CONCLUSION: This is the first pain management protocol for patients with dementia in Korea. However, more study will be needed to determine the methodological strength and necessary revisions for the protocol.
Delphi Technique ; Dementia* ; Humans ; Korea ; Nursing Homes* ; Nursing* ; Pain Management* ; Pain Measurement ; Physical Examination ; Sample Size

PURPOSE: This study was performed to validate the linkage between nursing diagnoses and nursing interventions by identifying performance and importance of nursing interventions linked to five NANDA nursing diagnoses. METHOD: Data was collected from 153 staff and head nurses working in 4 hospitals in K city. The results were analyzed using mean, SD and spearman correlation for ranking correlation. RESULT: The most importantly considered interventions were Medication Administration (IV) for pain, Pain Management for Constipation, Intravenous (IV) Insertion for Diarrhea, treatment, Vital Sign Monitoring for Hyperthermia, and Vital Sign Monitoring for Infection risk. The most frequently performed interventions was Medication Administration (IV) for Pain, Fluid Management for Constipation, Intravenous (IV) Insertion for Diarrhea, Vital Sign Monitoring for Hyperthermia, and Vital Sign Monitoring for Infection: Risk for. The rank correlations between importance and performance were highest in Diarrhea and lowest in Constipation. CONCLUSION: The above findings can be used to develop a nursing information system which can be used to facilitate documenting the nursing process, and a nursing information system developed by this research process will ultimately contribute to identifying nurses contribution to patient health.
Constipation ; Diarrhea ; Fever ; Humans ; Information Systems ; Nursing Diagnosis* ; Nursing Process ; Nursing* ; Nursing, Supervisory ; Pain Management ; Vital Signs

The purpose of this study was to identify pain management done by nurses and to develop an educational program for pain management, and also to evaluate the effects of education on the knowledge, attitudes, nurses and on the pain control practice of nurses. The first stage of this study was to identify the process of pain management in cancer units. A focus group interview using 15 nurses who were working in cancer units was conducted for the purpose of convenience sampling. The focus group interview results indicated that pain assessment wasn`t completed systematically, and was mainly dependent on the verbal complaints of patients or caregivers. The educational contents of the nurses were identified. The 2nd stage of this study was to develop a pain education program and to test its effect on nurses. A One Group pre-test/post-test design was utilized. The educational program(6 hours) consisted of: 1) Myths about pain, 2) Pain assessment, 3) Pain management with medications, pharmacological mechanism, 4) Pain management with noninvasive methods, and 5) Questions and discussion. The testing instrument was modified from the nurses' Knowledge and Attitudes Survey Regarding Pain(Ferrell and McCaffery, 1996) and face validity was completed by the nursing faculty and a pain clinic physician, and reliability testing was done for 80 RN-BSN students. The purposive convenience sample of 40 nurses participated in the study. Attitudes and Knowledge changes were measured 2 weeks prior to education and 4 weeks after the education. Ad hoc testing was done 8 weeks after the education with the review of 89 patients' charts. 1. The result were statistically significant on knowledge and changes in attitudes in pain management (t=-4.079, p<0.001). 2. The contents of 89 nursing records were analyzed and it was found that there were great changes in the pain description The assessment of pain severity was measured using VAS. Recommendations for further study are as follows: 1. Continuous pain education for nurses, physicians and students of the health professions is recommended. 2. There is a great need to develop a program for resolving decisional conflicts experienced by nurses in the pain management process.
Caregivers ; Education* ; Faculty, Nursing ; Focus Groups ; Health Occupations ; Humans ; Nursing Records ; Pain Clinics ; Pain Management ; Pain Measurement

PURPOSE: The purpose of this study was to identify pain intensity according to activities over postoperative days and to identify factors of patient satisfaction with pain management after abdominal surgery. METHODS: The subjects were 123 patients who were admitted at a general surgical ward and had abdominal surgery from Mar. 2005 to June 2005. The collected data were analyzed using the SPSS 12.0 program. RESULTS: The average postoperative pain scores were 6.13 at POD 1, 5.46 at POD 2, and 4.22 at POD 3. In stepwise multiple regression analysis a total of 40% of variance in satisfaction with pain management was accounted for by pain intensity on POD 3 at rest (29.4%) and attitude toward using pain medicine (6.6%), and side effects of pain medicine (4.0%). CONCLUSION: According to the findings of this study, patients had inadequate pain management after abdominal surgery. Therefore, nurses need to provide educational programs focused on changing attitudes toward using pain medicine, to reduce side effects of pain medicine, and to develop nursing intervention for relieving pain.
Analgesia, Patient-Controlled ; Humans ; Nursing ; Pain Management ; Pain, Postoperative* ; Patient Satisfaction

PURPOSE: This study aimed to explore and compare the knowledge structure of pain management nursing research, between Korea and other countries, applying a text network analysis. METHODS: 321 Korean and 6,685 international study abstracts of pain management, published from 2004 to 2017, were collected. Keywords and meaningful morphemes from the abstracts were analyzed and refined, and their co-occurrence matrix was generated. Two networks of 140 and 424 keywords, respectively, of domestic and international studies were analyzed using NetMiner 4.3 software for degree centrality, closeness centrality, betweenness centrality, and eigenvector community analysis. RESULTS: In both Korean and international studies, the most important, core-keywords were “pain,” “patient,” “pain management,” “registered nurses,” “care,” “cancer,” “need,” “analgesia,” “assessment,” and “surgery.” While some keywords like “education,” “knowledge,” and “patient-controlled analgesia” found to be important in Korean studies; “treatment,” “hospice palliative care,” and “children” were critical keywords in international studies. Three common sub-topic groups found in Korean and international studies were “pain and accompanying symptoms,” “target groups of pain management,” and “RNs' performance of pain management.” It is only in recent years (2016~17), that keywords such as “performance,” “attitude,” “depression,” and “sleep” have become more important in Korean studies than, while keywords such as “assessment,” “intervention,” “analgesia,” and “chronic pain” have become important in international studies. CONCLUSION: It is suggested that Korean pain-management researchers should expand their concerns to children and adolescents, the elderly, patients with chronic pain, patients in diverse healthcare settings, and patients' use of opioid analgesia. Moreover, researchers need to approach pain-management with a quality of life perspective rather than a mere focus on individual symptoms.
Adolescent ; Aged ; Analgesia ; Child ; Chronic Pain ; Delivery of Health Care ; Humans ; Korea ; Nursing Care ; Nursing Research ; Nursing ; Pain Management ; Pain Measurement ; Quality of Life ; Semantics