Transcription of khna.or.kr
1 3 I..126II. 1..1262..1273..127 III. 1..1292..1303..1304..1385..1386..150IV. 1..1542..156V..157I. 5 , , , , (Brekken&Sheets,2008). 2,500 ,5,000 , (Pain&PolicyStudiesGroup,2007). , 30-50%, 60-70%, 80 90% , ( ,2003) (intolerance) (addiction) , , , (Brekken&Sheets,2008).
2 II. 1. (InternationalAssociationforthestudyofPa in,1980) , (McCaffery,1979).2. 1) 1 . 1. (6 ) (6 ) , , ( , , , , , ) 2) : ( ), ( , ), , : (cramping) : (burning), (tingling), , 3. 1) (Specificitytheory).
3 , (Phantompain), .2) (Gatecontroltheory)1965 Melzack Wall , .. (T-cell) (SubstantiaGelatinosa,SG) . , . , . T-cell (actionsystem) . , .3) (Endogenouspaincontroltheory) , enkephalin .enkephalin .. , .III.
4 , , , . , , , (Miller,1984). , .1. 1 . , , , . WHO 5 . 1. 2. , .3. , , , , . , (Anderson,1982).1) PQRST( , , / , , )( 2) (painhistory).
5 2. PQRSTP (Position) ? ?Q (Quality) ? ?R (Relievingoraggravatingfactor) ? ?S (Severity) ? , ?T (Timing) ? , ? , ? (Position) . X . , , ( 2). 2. :TheUniversityofIowaCollegeofNursing(200 2).Evidence- (Quality) , , , , , , . (Relievingoraggravatingfactor).
6 : , , : , , , (Severity) ( , , , , ) . 3 .. (NumericRatingScale) 12 ( 3). 1-10 (1-4 ), (5-6 ), (7-10 ) , (WHO)3 .. 0 10 ? . 3. (NumericRatingScale) :AHCPR(AgencyforHealthCarePollicyandRese arch).(1992).Acutepainmanagement:Operati veormedicalproceduresandtrauma.( ).Rockville,MD:AgencyforHealthCarePolicy andResearch,PublicHealthService, .Wong-Baker (FacesPainRatingScale)3 , ( 4).. 4. (FacesPainRatingScale) ,Hockenberry-EatonM.
7 ,WilsonD., ,SchwartzP.(2001).Wong'sEssentialsofPedi atricNursing, , ,p1301 .FLACC (Face-Legs-Activity-Cry-ConsolabilitySca le)3 ( 3). (Face-Legs-Activity-Cry-ConsolabilitySca le)0 1 2 (Face) , , , , (Legs) , , (Activity) , , , , (Cry) , , , (Consolability) . :MerkelS.(1997). (3) (Timing) . ? ? ? ? (painhistory) . (opioid), , 1.
8 A,b,c,d .2. (sharp) (burning) (cutting) (tingling) (comesandgoes) (dull) (pressing) (numbing) (cramping) (radiating) . ( , , , ) , , , 2) ( 4). , , , , / , , . 4. ( ) a,b,c,d .3. * : 0 , 10 ? ____ , ____ , ___ , ___ 0 1 2 (Face) , , , , (Legs) , , (Activity) , , , , (Cry) , , , , (Consolability).
9 *3 4. 5. / :_____ :_____6. ( , )_____ _____ _____ _____ _____ ( , , )_____ ( , , , )_____ _____7. , , 8. ( : , ) 9. 3) , , 5 . :5 (WHO3 , ) : 1 , 15 ( ,2008) : 5 8 , , , 8 , . / / / ( a,b,c,d ) ( a,b,c,d ) ( a,b,c,d ) :() :() :() FLACCF 0 1 2 FLACCF 0 1 2 FLACCF 0 1 2L 0 1 2L 0 1 2L 0 1 2A 0 1 2A 0 1 2A 0 1 2C 0 1 2C 0 1 2C 0 1 2C 0 1 2C 0 1 2C 0 1 2 5.
10 4. ( , , , ) . : ) 5. 1) 6 . 6. Acetaminophen,Ibuprofen,Naproxen,Ketorol ac,Ketoprofen Morphine,Fentanyl,Codeine,Tramadol,Oxyco done,Hydromorphone Amitriptyline,Nortriptyline,Imipramine Phenytoin,Carbamazepine,Gabapentine Dexamethasone,Prednisolone Midazolam,Diazepam,Lorazepam Ketamine,Buscopan(1) . ( 5).. WHO 3 , , . (aspirin paracetamol ), (codeine ), (morphine ) .. , , ( , ).
