This study was done in order to identify symptoms of grief and patterns of coping in mothers of chronically ill children. Nurses, as health professionals, must understand helpful coping methods for mothers who have chronically ill children. Based on this knowledge, nurses can develop appropriate nursing intervention strategies, and so help the mothers to develop effective ways of coping and give support to mothers with chronically ill children in process of coping with this grief. The research questions guiding this research were: 1. what type of grief does the mother have at the time of child's diagnosis and at present? 2. what are the problems confronting the mother? 3. what are the coping patterns of the mother? 4. is there a difference according to child's diagnosis in the mother's grief and coping pattern? Ths subject for this study were obtained by taking a convenience sample of 120 mothers with a chronically ill child. Interviews took place in four medical school hospitals and one medical center in Seoul from March 19th to May 16th 1990. The tools used in this study were Mcfarlan's (1983), Grief contents, Folkman & Lazarus (1983), Ways of Coping and Hymovich's (1983) the Chronicity Impact and Coping Instrument. The findings were as follows; 1. Grief items had a maximum score of three points. The highest item scores at the time of diagnosis, were in order, heart broken, talkative, and could not do anything, at the present, 'talkative', 'heart broken' and 'busy myself with other things'. 2. The problems confronting the mothers were 'worry about ill child's future', 'her responsibilities in taking care of the ill child.' 3. Most of the mothers used similar ways of coping, that is 'problem focused coping', 'detachment', 'wishful thinking', 'seeking social support' and 'focusing on the positive and hardly any of them used 'tension reduction'. 4. There was a significant difference in coping methods according to the child's diagnosis, leukemia, cancer hemophillia and nephrotic syndrome. The most frequently used coping method was detachment, especially for the mother of the child with. 5. At the time of diagnosis there was a positive correlation between the level of grief and the coping method of detachment and seeking social support.
We used the method of reverse transcription-polymerase chain reaction (RT-PCR) to observe the effects of long-term administration of peptide delta opioid receptor agonist DPDPE and non-peptide delta agonist BW373U86 on the mRNA expression of delta receptor and the possible difference between the two agonists. The results showed: (1) the level of delta receptor mRNA decreased significantly 24-48 h after administration of DPDPE; the effect of BW373U86 lasted only 24 h; and (2) DPDPE produced a significant decrease of delta-receptor mRNA at 10(-6) mol/L, whereas BW373U86 was effective only at 10(-5) mol/L. These results suggest that long-term administration of both peptide delta opioid receptor agonist (24, 48 h) and non-peptide delta opioid agonist (24 h) significantly decreased mRNA expression of delta opioid receptor and the effect of peptide agonist DPDPE seems to be stronger and last longer than that of non-peptide agonist BW373U86.
The purpose of this study was to determine whether serotonin(5-HT)and en-dogenous opioid substances(OLS)contained and released in amygdala play a rolein mediating the analgesic effect elicited by morphine or electroacupuncture(EA)stimulation.Rabbits were equipped with bilateral stainless steel guide cannulae(o.d.0.7 mm)with the cannula tip placed dorsal to the amygdala.Microinjectionwas performed through an injection tube(o.d.0.3 mm)protruding 2 mm beyondthe cannula tip to reach the nucleus,at a speed of 2μl/8 min.Pain threshold wasassessed by the latency of radiant heat head jerk response.(1)Pain threshold wassignificantly increased by bilateral intra-amygdaloid injection of morphine(10 μg/site),but not by normal saline,naloxone(2μg/site),cinanserin(4μg/site),D-phenylalanine(DPA,10μg/site)or 5-hydroxytryptophan(5-HTP,2.5μg/site).(2)The analgesic effect induced by EA stimulation was significantly attenuated bythe intra-amygdaloid injection of opiate receptor blocker naloxone or 5-HT receptorblocker cinanserin.Maximal blocking effect was obtained by bilateral intra-amyg-daloid injection,especially to the central nucleus of amygdala.Unilateral injec-tion elicited a weaker action.Injection to the vicinity of amygdala was not effective.(3)EA analgesia was significantly augmented by intra-amygdaloid injection of 5-HTP(a precursor of 5-HT)or of DPA(a putative blocking agent for enkephalin degra-dating enzymes).(4)Chemical agents exerting a potentiating or antagonizing ef-fect on EA analgesia showed a similar effect on morphine analgesia in the same sitesof injection.The results suggest that morphine and EA may stimulate the release of 5-HTand OLS(most probably enkephalins)in the amygdala thereby producing an anal-gesic effect.
This review deals with the recent functional brain imaging studies of pain. In summary, the sensory-discriminative component of pain is related with the lateral thalamus, primary and secondary somatosensory area and insular cortices, while the posterior parietal and prefrontal cortices seem to play a role in the cognitive-attentional process of nociceptive information. Different parts of anterior cingulate gyrus are correlated with cognitive and emotional aspects of pain. Brain imaging data obtained from clinical patients suffering from various kinds of pain especially neuropathic pain, were discussed at the end of this article.
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