Quality of life in gynecologic cancer survivors compared to healthy check-up women / 부인종양

OBJECTIVE: The primary objective of this study was to compare quality of life of disease-free patients after therapy for gynecologic malignancies at follow-up in comparison with healthy check-up patients. Our second objective was to assess correlation between demographic data, disease and treatment factors and quality of life scores. METHODS: Patients completed the Functional Assessment of Cancer Therapy-General (FACT-G) quality of life questionnaire at least 6 months after treatment for a gynecologic malignancy. Responses were compared to unmatched healthy women who were seen for standard gynecologic screening examinations. Statistical calculation was done using chi-squared tests, Wilcoxon rank-sum, and Kruskal-Wallis one-way analysis and Spearman rank correlations. Factors associated with FACT-G scores were evaluated using univariate and multivariate analyses. RESULTS: Eight hundred and seventy patients were recruited. The median time since therapy was 61 months (range, 6 to 173 months). The overall FACT-G scores were higher in the patient group than in the healthy group (p<0.05). The scores of each subscale measuring physical, functional, social/family and emotional well-being were also higher in the patient group (p<0.05). Multivariate analysis revealed correlation between Eastern Cooperative Oncology Group performance status, educational level, care giver, presence of economic problems and FACT-G scores. CONCLUSION: The quality of life scores were higher in gynecologic cancer patients after treatment. And the factors that associated with the higher score in the patient group are having husband as a caregiver, no financial problem, Eastern Cooperative Oncology Group score 0 or 1 and having high school or higher education.

Evaluation of Acute Pain Management at Ramathibodi Hospital

Abstract:  Keywords:  Quality indicators, Pain management, Pain assessment, Measurementoutcome, Patient satisfactionThis article presents an evaluation of quality of pain management bothprocess and outcome in post operative patients at Ramathibodi Hospital by the PainManagement Committee. The Pain Management Committee has been establishedsince B.E. 2546. They are responsible for setting the pain management systemincluding developing work instruction and pain quality indicators. The objective ofthis descriptive study was to evaluate quality of pain management using both processand outcome indicators in postoperative patients admitted to Ramathibodi Hospital.One hundred and sixty nine patients from 11 wards were recruited in the study. Theinstruments used in this study were 1) the Demographic Questionnaire, 2) the PainManagement Process Indicators, and 3) the Pain Management Outcome Indicators.Data analysis was performed using descriptive statistics. The result of this studyshowed that most nurses used the numerical rating pain scale and pain document,which met the goal of pain management process. However, they did not continueassessing pain. In addition, most of the patients received pain medication managementonly when needed rather than around-the-clock. Regarding non-pharmacologicalmanagement, positioning was most used by these patients. For outcome indicators,mean scores of worst pain, and disturbance of functional activity and sleep were inthe moderate level. Of the total sample, 13.6% did not receive information about sideeffect of analgesics, but their satisfaction levels with pain management were good andvery good. Recommendations from this study are that nurses should pay more attention on thecontinuity of pain assessment and management, as well as develop the non-pharmacologicalpain management program combined with analgesics to alleviate pain. These mayresult in decreasing pain intensity, and disturbance of functional activity and sleep.

Pain Assessmentûs Tools and Pain Management System in Ramathibodi Hospital

Abstract:\ \ Keywords:\ \ Pain assessment๛s tool, Pain management, Patient๛s knowledge, Painsatisfaction, Work instructionPain is a significant indicator of the quality of care of health care organizations.Patients suffering from pain basically expect that their pain would be alleviated whilehospitalized. However, pain is a complicated phenomenon because it involves subjectivefeeling that is difficult to quantify. When providing care for patients suffering frompain, nurses have to understand the pain in order to respond to patients๛ needsappropriately. In the past, although nurses had recognized the pain problem ofpatients, pain assessment and management were not performed systematically.Department of Nursing, Faculty of Medicine, Ramathibodi Hospital, realizes thatdevelopment of a pain management system is essential for quality of care. Thus,a committee working on development of a pain scale, an indicator for assessing painleading to set up a pain management system, has been pointed since 2003. During theyear 2003-2006, a pain management program has been developed and tested in apilot study, then disseminated to utilize in nursing practice for patients sufferingfrom pain at all wards in Ramathibodi Hospital. Therefore, the targeted goal for็Best Practice้ of pain management has been established in 2005, according to thestrategic plan of organization. It has been found that the patients๛ outcomes met theobjectives assessed by quality indicators including patients๛ knowledge about painmanagement, ability to perform activities of daily living, sleep quality, interactionwith others, and satisfaction with pain management by nurses. Also, work instruction(WI) on pain management has been developed and used as a standard guideline inDepartment of Nursing Ramathibodi Hospital.