Darbo tema: Pacientų, patiriančių lėtinį skausmą, skausmo valdymas. Lėtinis skausmas tampa didele medicinos, ekonomikos ir socialine problema, kuri veikia ne tik kiekvieno žmogaus gyvenimo kokybę, trikdo normalų socialinį, asmeninį gyvenimą, šeimos santykius, bet ir visuomenės ekonominį potencialą. Sergamumas ir nedarbingumas Lietuvoje atitinka pasaulines tendencijas. Tad būtina gerinti pagalbą lėtinio skausmo varginantiems ligoniams. Tokia pagalba atsispindėtų ir šalies ekonomikoje, nes didžiausia dalis kenčiančių lėtinius skausmus yra darbingo amžiaus žmonės. Darbo tikslas: įvertinti pacientų, patiriančių lėtinį skausmą, fizinius bei emocinius išgyvenimus, jų žinias apie skausmo valdymą. Darbo uždaviniai: 1. Išsiaiškinti pacientų, patiriančių lėtinį skausmą, skausmo pobūdį bei jo intensyvumą. 2. Išsiaiškinti kokiais metodais pacientai malšina skausmą. 3. Įvertinti, kaip lėtinis skausmas veikia kasdienę paciento veiklą. 4. Įvertinti, kaip lėtinis skausmas veikia emocinę paciento būklę. 5. Įvertinti pacientų žinias apie skausmo valdymą. Tyrimo objektas: pacientai, patiriantys lėtinį skausmą ir besigydantys VšĮ VUL „Santariškių klinikos“, Anesteziologijos, intensyvios terapijos ir skausmo gydymo centre. Tyrimo metodika: pateikta anketinė pacientų apklausa. Apklausta 100 respondentų. Darbo rezultatai: Apklausos duomenimis pastovus skausmas vargino 85% apklaustųjų. Daugiausia respondentų (38%) jautė aštraus pobūdžio skausmus. Tiriant skausmo intensyvumą - 47% respondentų jautė... [toliau žr. visą tekstą] / Topic of the work: Pain Management for patients experiencing chronic pain. Chronic pain becomes a big medicine, economic and social problem that influences not just every person’s quality of life, disturbs normal social and personal life, family relations, but also public economic potential. Morbidity and incapacity to work in Lithuania meet global tendencies. Aim of the work: To evaluate the chronic pain of patients, their physical and emotional experiences and their knowledge about pain control. Goals of the work: 1. To find out the nature of pain and its intensity for patients who suffer from chronic pain. 2. To find out what methods patients use to decrease pain. 3. To evaluate how chronic pain influences everyday activities of a patient. 4. To evaluate how chronic pain influences emotional state of a patient. 5. To evaluate the knowledge of patients about the management of pain. Object of the research: Patients, who suffer from chronic pain and who are cured in VSI VUL “Santariskiu klinikos” anesthesiology, intensive therapy and pain treatment center. Methodology of the research: Questionnaire poll of patients is presented. 100 respondents were questioned. Results of the work: According to the data of the results, 85% suffered of the chronic pain. The biggest part of the respondents (38%) felt acute type pains. When pain intensity was analyzed, 47% of respondents felt acute pain. Dependence relation between the intensity of pain and age was not determined (p>0.05). The... [to full text]

Pagrindinis šio darbo tikslas nustatyti fizinio aktyvumo ir skausmo intensyvumo sąryšio reabilitacijoje psichologinius veiksnius, t.y. išsiaiškinti reabilitacijos eigoje kintančio pacientų fizinio aktyvumo ir skausmo intensyvumo tarpusavio ryšį, įvertinti pacientų naudojamas skausmo įveikos strategijas ir kinezifobijos lygį bei visų šių veiksnių įtaką reabilitacijos eigai. Kadangi tyrėme pacientus, po klubo endoprotezavimo operacijos, kėlėme hipotezę, kad yra ryšys tarp pacientų skausmo intensyvumo ir fizinio aktyvumo kitimo reabilitacijoje. Taip pat tikėjomės, kad pacientų naudojamos skausmo įveikos strategijos bei kinezifobijos stiprumas irgi bus susiję su jų skausmo intensyvumu ir fiziniu aktyvumu gydymo metu reabilitacijoje. Tyrimui atlikti buvo naudojamas skausmo intensyvumo dienoraštis, fizinio aktyvumo dienoraštis, Įveikos strategijų klausimynas SCQ (Rosental, Keefe, 1983) ir Tampa kinezifobijos skalė TSK (Miller et al., 1991). Gavus reabilitacijos centrų administracijos sutikimą, tyrimas buvo atliekamas viso pacientų gydymo reabilitacijos įstaigoje metu. Tyrime taip pat dalyvavo pacientų kineziterapeutai, kurie stebėjo pacientų fizinį aktyvumą ir pildė jų fizinio aktyvumo dienoraščius. Iš viso tyrime dalyvavo 41 reabilitacijos pacientas po klubo endoprotezavimo operacijos iš Valakupių reabilitacijos centro, Gerontologijos ir reabilitacijos centro ir sanatorijos „Pušyno kelias“. Iš visų tiriamųjų buvo 10 vyrų (24,4%) ir 31 moteris (75,6%). Tiriamųjų amžius svyravo tarp... [toliau žr. visą tekstą] / The main goal of the study was to examine the psychological factors of the connection between pain intensity and physical performance in rehabilitation patients. With this study had we explored changes in patients’ pain intensity and physical activity over time, evaluated their kinesiophobia level and pain coping strategies they were using in rehabilitation. Moreover we were trying to find out the relations among those variables. We had hypothesized there is a connection between pain intensity and physical performance in patients after hip replacement. Also we expected that pain coping strategies and kinesiophobia would interfere with pain intensity patients were experiencing and their physical activity in rehabilitation. The survey began after given permission to execute the research. The permission was given by administration of Vilnius Valakupiai rehabilitation center, Vilnius center of gerontology and rehabilitation, and sanatorium Pusyno kelias. The study was based on 41 patients in rehabilitation after hip replacement, comprising a total of 10 (24,4%) men and 31 (75,6%) women, age between 34–78 years (average age 62,9 years). Patients were investigated during their whole treatment period. Pain intensity and physical activity diaries were used to accomplish the research. The Coping Strategies Questionaire (Rosental, Keefe, 1983) and Tampa scale for kinesiophobia (Miller et al., 1991) were also applied in this investigation. As it was needed to evaluate the physical... [to full text]

SUMMARY AIM OF THE STUDY. To evaluate the needs of medical care and the quality of care in cancer patients, experiencing pain. METHODS. One hundred cancer patients experiencing pain were interviewed in Kaunas Medical university Oncology hospital and Oncology department of Kaunas Medical university hospital (KMUH).. Age range- 27-68 years. Two questionnaires were used for the interview: “Pain anamnesis” and “McGill’s pain questionnaire”- specific questionnaire of pain-words. RESULTS. The results of questionnaires were analyzed. Men more often than women experienced chronic pain (17% and 48 %). There was statistically positive correlation between the strongest pain in 24 hours and weakest pain in 24 hours experience. While analyzing adverse reactions of various treatment methods in the respondents treated in KMUH Oncology department and KMU Oncology hospital the anorexia (p ≤ 0,05), constipation and insomnia were more common in KMUH (p ≤ 0,05). The quality of care according to 58% of Patients in KMUH and 34% in KMU OH was not sufficient (p ≤ 0,05). About 12% of KMUH patients and 46% in KMU OH declared that the quality of care is worse during the weekends. (p ≤ 0,05) CONCLUSIONS. A lot of adverse reactions appear while treating cancer patients with pain. One can decrease or even eliminate these reactions by purposeful care activities and providing information needed. Increasing the quality of care, the evaluation of received care by cancer pain patients will become better. ... [to full text]

Tyrimas buvo atliktas Kauno medicinos universiteto klinikų Onkologijos klinikoje ir Kauno medicinos universiteto onkologijos ligoninėje 2006 birželio – 2007 vasario mėnesiais. Tyrimo tikslas buvo: įvertinti onkologinėmis ligomis sergančių pacientų mokymo apie vėžinio skausmo valdymą reikšmę skausmo malšinimui. Tyrimui atlikti buvo apklaustos dvi pacientų grupės. Apklausai buvo naudotas 21 klausimo anoniminis klausimynas. Jį sudarė sociodemografiniai, pacientų žinias apie skausmą malšinančius vaistus ir elgesį skausmo metu atspindintys klausimai, bei duomenys apie susirgimo lokalizaciją, stadiją, ir laiko tarpą nuo diagnozės nustatymo. Klausimyne buvo naudojama skaitmeninė 0 – 10 balų skausmo skalė. Pacientų gyvenimo kokybei (GK) vertinti buvo naudojama EORTC QLQ – C30 (version 3) lietuviška versija. EORTC – C30, tai Europos vėžio tyrimų ir gydymo organizacijos parengtas gyvenimo kokybės klausimynas. Pacientai buvo suskirstyti į dvi grupes: pirmosios grupės pacientai pakartotinai buvo apklausti praėjus vienam mėnesiui po pirmosios apklausos. Antrosios grupės pacientai po apklausos buvo mokomi skausmo valdymo naudojant parengtą mokymo priemonę, mokymas truko 15 – 25 minutes. Pakartotinai šios grupės pacientai buvo apklausti praėjus vienam mėnesiui po pirmosios apklausos. Gauti duomenys buvo palyginti grupių viduje ir tarp abiejų grupių.. Pirmąją grupę sudarė 30 pacientų: 15 (50 proc.) vyrų ir 15 (50 proc.) moterų. Apklaustųjų amžiaus vidurkis 55,06 (40 – 64) metai. Antrąją... [toliau žr. visą tekstą] / Introduction: The aim of this study is to asses if an adequate cancer patients teaching can affect patient quality of life and self care. Material and methods: The study was performed in University hospital of Lithuania. Adult cancer patients with cancer pain score ≥ 4 were randomly assigned into to two groups: I group – patients (n=30) who had received adequate teaching about cancer pain management and educational material about cancer pain was provided. Teaching course lasted 20 – 25 minutes, II (control) group – patients who had received standard care. The anonymous questionnaires were distributed to bough patients groups a day before firs group education. Second time patients completed questionnaires a month after first group education. There were used questionnaires EORTC QLQ – 30, supplementary 21 questions questionnaire that contained questions about pain assessment, knowledge about opioids, concern about side effects, fear of addiction and tolerance, questions containing sociodemographic and disease related information. For assessing pain tolerance numerical 0 – 10 scale was used. Results: The results of the study show that following patients teaching mean score of QLQ increased from 35.3 to 58.9 points (p<0.05). Pain mean intensity in group I decreased from 7.01 to 3.1 (p< 0.05). Pain intensity correlated with QLQ (r= - 0.64). There were no significant changes in control group. Patients knowledge about cancer pain management and self care were significantly... [to full text]

The problem of low back pain is visibly increasing. About 80% of the population suffers from low back pain. Recently, the factors that affect lumbar stability have been an area of extensive research. The purpose of this study is to assess the effects of lumbar stabilization exercises program for young women (19-20 years) with low back pain. The following objectives were put forward: to assess stability of lumbar spine of young women before applying exercises program and after 10 weeks of muscular strengthening exercises around the lumbar spine; to evaluate changes in the core muscles before and after specific stabilization exercises and pain assessment. The study included a group of 37 young women (19-20 years), who felt low back pain at least once in their life. All participants were randomly allocated to either training group, which consisted of 20 young women or control group, which consisted of 17 participants. The subjects in the training group attended two supervised 1 hour exercise sessions per week for 10 weeks. A program of special physical exercises to improve core musculature was created for them. The exercise training program required training of deep muscles. In order to retrain the deep muscles, specific and testing with the STABILIZER was required. The control subjects continued their usual physical activities during the week. Both groups were assessed similarly two times: before training began and after it ended.mekis.

Kaklo ir viršutinės galūnės skausmai yra plačiai paplitę tarp biuro darbuotojų. Tai šiuolaikinių biurų darbuotojų problema: kasmet daugėja ��monių, kurie didelę darbo dienos dalį praleidžia prie kompiuterio, daugėja ir tų, kurie skundžiasi kaklo bei viršutinės galūnės ir galvos skausmais. Darbo tikslas. Nustatyti kineziterapijos poveikį, mažinant galvos, kaklo ir viršutinės galūnės skausmus biuro darbuotojams. Taikyti metodai. Pirminės darbuotojų apklausos metu buvo apklausti 68 darbuotojai, didžiąją dienos dalį dirbantys kompiuteriu. Buvo atrinkti 25 darbuotojai (moterys), kurie sutiko dalyvauti antrajame tyrimo etape. Beveik visi jautė galvos, kaklo, pečių lanko skausmus. Tiriamosioms (n=25) buvo taikomi KT pratimai, laikomasi ilgų bei trumpų poilsio pertraukėlių, paaiškintos pagrindinės taisyklingos sėdėsenos taisyklės. Po 12 savaičių buvo vykdomas antrasis tyrimo etapas. Jo metu buvo pakartotinai apklausiami darbuotojai ir atliekami judesių amplitudės matavimai, vertinama raumenų jėgos dinamika bei pusiausvyra. Anketa buvo paruošta remiantis modifikuota Aberdeen skausmo skale, Borg CR10 skale, Vernono kaklo negalios indekso skale. Rezultatai. Tyrimo rezultatai parodė, jog iš (n=25) apklaustų darbuotojų prieš kineziterapiją skausmą jautė 92% tiriamųjų. Dažniausiai pasitaikantys buvo galvos, kaklo ir viršutinės žasto dalies skausmai. Po 12 savaičių KT taikymo, sėdėsenos korekcijos bei optimalaus darbo ir poilsio rėžimo laikymosi, pastebimas žymus galvos, kaklo ir rankos... [toliau žr. visą tekstą] / Neck and upper limb pain is frequently reported by computer workers. It is becoming a common problem as more people are using computers and so more and more people are complaining of pain in the neck and upper limbs, and headaches. Aims: To identify the efficacy of physiotherapy in order to relieve headache, chronic neck and shoulder pain. This research programme was concerned with people that spend the largest part of their working day using computers. Methods: The present study was designed to quantify the typical level of pain, and then to test the efficacy of physiotherapy intervention. Sixty eight workers answered the questionnaire. Only twenty five computer workers were asked to partcipate in the study, all of whom had reported headaches and had frequent or long standing neck and upper limb symptoms. Participants were asked to fill out a modified questionnaire detailing their pain before the intervention and after. The range of various neck and arm movements of the participants were then measured using goniometry and the results recorded. The group was then taught various exercises and required to take regular breaks for 12 weeks. Results: The pain was found to have been effectively relieved. Physical exercise intervention resulted in a statistically significant (p<0,05) decrease in the intensity of headaches and neck pain (from 92% to 48%). The increase in the the range of mobility and static balanse signicantly improved (p<0,05). Conclusion: Although physiotherapy is... [to full text]

Darbo tikslas – ištirti pacientų požiūrius į onkologinio skausmo kontrolės kliūtis. Darbo uždaviniai. Ištirti sergančiųjų onkologinėmis ligomis pacientų: požiūrį į skausmą ir jo kontrolę bei požiūrio poveikį patiriamo skausmo intensyvumui; bendravimą su gydytoju skausmo kontrolės klausimais ir jo poveikį patiriamo skausmo intensyvumui; analgetikų vartojimo rekomendacijų laikymąsi ir kokį poveikį tai turi patiriamo skausmo intensyvumui; patiriamo analgetikų nepageidaujamo poveikio įtaką skausmo kontrolei; emocines būsenas ir jų poveikį patiriamo skausmo intensyvumui. Metodai. Tyrimas kiekybinis analitinis atliekant anoniminę apklausą. Tyrimo klausimyną sudaro 6 anketos ir demografinis klausimynas. 5 anketos kol kas nebuvo naudotos Lietuvoje: Trumpa Skausmo Intensyvumo skalė (angl. Brief Pain Inventory (BPI), Short form); Modifikuotas Barjerų klausimynas (angl. The Barriers Questionnaire-II); Modifikuota Paciento Dalyvavimo Gydyme klausimyno versija (angl. Modified Version of the Patients’ Perceived Involvement in Care Scale); Vaistų vartojimo rekomendacijų laikymosi vertinimo skalės variantas (angl. Medication Adherence Report (MAR)). Sensoriniams trukdžiams įvertinti sudarytas klausimas, kuriuo paciento prašoma atsakyti ar jis dėl šalutinio analgetikų poveikio kada nors buvo nustojęs vartoti analgetikus. Jei dėl šalutinio vaistų poveikio pacientas nustojo vartoti analgetikus, prašoma juos nurodyti. Anketos buvo adaptuojamos ir verčiamos iš anglų į lietuvių kalbą. HAD skalė... [toliau žr. visą tekstą] / Aim of the study – to evaluate patients attitudes towards barriers for control of oncologic pain. Objectives: to evaluate characteristics of oncologic patients: attitudes towards pain and its control, perception of pain intensity; communication with physician about pain control and pain intensity; adherence of analgesics use related with pain intensity; analgesics side effects impact on pain control; emotional conditions and influence on pain intensity. Methods. The study was quantitative analytical, including anonymous survey. The questionnaire comprised 6 subscales (all of them except HAD not used in Lithuania this far) and demographic set. Subscales included Brief Pain Inventory (BPI; short form), the Barriers Questionnaire-II, Modified Version of the Patients’ Perceived Involvement in Care Scale, Medication Adherence Report (MAR), and Hospital Anxiety and Depression Scale (HAD). For evaluation of sensoric disorders the questionnaire was constructed that consisted of questions concerning patient's refusal to get analgesic due to its side effects. The questionnaires were adapted and translated from English to Lithuanian. The survey was conducted during April 31, 2007 and February 1, 2008 at Pain Treatment division and Department of Family Medicine, Kaunas University Hospital. The permission for study was obtained from University Bioethics Center and head of Kaunas University Hospital. Inclusion criteria: patient with oncologic disease, treated on out-patient basis, having... [to full text]

SUMMARY The problem of low back pain has been visibly increasing nowadays. About 60 - 80% of population at least once has experienced the backache. Back pain is one of the most important reason of working days loosing though there isn’t any lack of different directories and other newest literature offering the support how to prevent low back pains. Consequently the aim of the study was to test how to handle and prevent effectively back pain applying kinesitherapy and the spine stability exercise programs. The tasks were: 1. To test trunk muscle (back extensors, flexors: right-side bridge and left-side bridge) endurance before different exercises programs; 2. To test trunk muscle after different exercises programs to the subjects of the study; 3. To evaluate the intensity of the back pain before the research and after it; 4. To asses and compare the effectiveness of traditional kinesitherapy and the spine stability exercises programs. These research methods were used: trunk muscle endurance test, back pain intensity estimation and statistics, questioning to determine back problems. The subjects of the study were 30 28-60 years old women who had experienced back pain. They accidentally were divided into 2 groups. The study lasted 13 weeks. During that period 3 times a week traditional kinesitherapy program was applied to the Ist group of the subjects and the spine stability exercise program-to the IInd group. After the analysis of the study material conclusions were made:... [to full text]

Many people all over the world suffer from back pain. It is unavoidable for pregnant women too. According to various authors, about 50 % of women suffer from this symptom. During pregnancy, high loads that are influenced by mechanical as well as hormonal factors affect the spine. The aim of the work was to evaluate effectiveness of the muscle flexion and strengthening program in the reduction of back pain in pregnancy. In the research, the state of muscles producing waste and pelvis movements was evaluated before and after kinesiotherapy application in pregnant women suffering from back pain, and an influence of flexion and strengthening for muscle condition was evaluated in pregnant women suffering from back pain. The research lasted 10 weeks and it was performed in the Kaunas Clinical Hospital II in 2004. In total, 56 pregnant women were surveyed. 12 women participated in the kinesiotherapy program (experimental group), 11 women who did not participate in the kinesiotherapy program due to various reasons were attributed to the control group. Remaining 33 women did not participate in the research due to earlier problems with spine, syndrome of pelvic ligament relaxation or other individual reasons. Results of these two groups were compared and analyzed. Tests that were performed before and after the research show that results of the experimental group have improved significantly, while women in the control group have reported pain and disturbed physical activity. Pain... [to full text]

Šiame darbe tiriamas skausmo, patiriamo sergant reumatoidiniu artritu, fenomenas. Įvadinėje dalyje buvo apžvelgtas skausmo fenomenas, bandyta atskleisti jo daugiabriauniškumą ir sudėtingumą. Aptartas biopsichosocialinis skausmo modelis bei skausmo vertinimo problemos. Skausmo fenomenas apžvelgtas ir kaip savarankiškas potyris, ir sąveikoje su reumatoidiniu artritu. Darbe siekiama išsiaiškinti, kaip mūsų tiriamas fenomenas patiriamas konkrečių žmonių kasdieniame gyvenime. Didelis dėmesys buvo skiriamas tiek bendriems visiems tyrimo dalyviams, tiek unikaliems patyrimo aspektams. Tyrime dalyvavo dešimt vyrų. Gauti duomenys buvo analizuojami pagal A.Giorgi pasiūlytą fenomenologinės analizės metodą. Sudaryti dešimt unikalių situacinių skausmo išgyvenimo apibrėžimų, kuriais remiantis suformuluotas bendras galutinis fenomeno apibrėžimas. Tyrimo rezultatai rodo, kad skausmo išgyvenimas sergant reumatoidiniu artritu yra gyvenimą keičianti patirtis. Jis daro labai didelę įtaka mobilumui, darbingumui, kontaktų su išoriniu pasauliu susiaurėjimui. Skausmo pasekoje patiriami įvairūs, skirtingo intensyvumo jausmai: nežinomybė, pyktis, baimė, vienišumas, nepasitikėjimas, pavydas, neviltis, nerimas, gėda, apleistumas, nereikalingumas, liūdesys, gailestis, kaltė, nepasitenkinimas. Gauti rezultatai taip pat rodo, kad skausmas tiesiogiai veikia santykius. Buvo pastebėta, kad skausmo išgyvenimas atneša ne tik neigiamus potyrius: žmonės susimąsto ir pradeda giliau suvokti pasaulį bei žmogų... [toliau žr. visą tekstą] / Research of pain phenomena for patients with rheumatoid arthritis (RA) was done in this study. The introductory part of the study is dedicated to the review of pain phenomena. The attempt was made to reveal it‘s complexity. Biopsychosocial model of pain and problems of pain evaluation were discussed. Pain was reviewed both as independent experience and in relation with rheumatoid arthritis. Attempt was made to clearify how pain is experienced by concrete persons in their everyday life. Attention was paid to aspects of pain experience both common for all participants and unique. Group of ten male chronic pain patients participated in the research. Collected data was analysed using method suggested by A. Giorgi for phenomenological analysis of interview data. Preparation of ten unique situational definitions and final common combined definition of phenomena were done. Results of the study show that pain is life changing experience for patients with rheumatoid arthritis. It greatly affects mobility, efficiency and substantially reduces contacts with outer world. It was found that pain provokes different feelings and emotions of various intensity: uncertainty, anger, fear, loneliness, lack of self-confidence, envy, despair, anxiety, shame, sorrow, regret, blame, desolation, discontent. Results of the study also show how pain directly affects relations with other people. It was revealed that pain provokes not only negative experiences: people began to reconsider and to realize... [to full text]