ผลของโปรแกรมกระตุ้นการขับถ่ายสามรูปแบบต่อภาวะท้องผูกในผู้สูงอายุกระดูกสะโพกหักที่ได้รับการผ่าตัด

Anucha  Inyasri; Jariya Chuensirimongkol

Authors

Anucha Inyasri Kuakarun Faculty of Nursing, Navamindradhiraj University
Jariya Chuensirimongkol Kuakarun Faculty of Nursing, Navamindradhiraj University

Keywords:

constipation, elderly, hip fracture

Abstract

This quasi-experimental study aimed to compare the effects of a three-format bowel stimulation program on constipation among elderly patients with hip fracture surgery across four groups: 1) water and dietary fiber intake, 2) physical exercise and abdominal massage, 3) a combination of water and dietary fiber intake with physical exercise and abdominal massage, and 4) usual nursing care. The sample consisted of 160 elderly patients aged 60 years or older who underwent hip fracture surgery, divided into 4 groups of 40 participants each. Participants were selected using consecutive sampling and matched pairs based on similar characteristics. The study was conducted over a period of 3 months. Research instruments included a three-format bowel stimulation program and a compliance record for bowel stimulation guidelines. Data collected in this study were demographic records and daily defecation records. The statistical analysis was performed using descriptive statistics, chi-square tests, and one-way ANOVA at a significance level of .05.

The results revealed significant differences in the average days to first defecation among the four groups (p < .05). The group receiving physical exercise and abdominal massage and the group receiving a combination of water and dietary fiber intake with physical exercise and abdominal massage had the shortest mean days to first defecation (M = 2.20, SD = .46, and M = 2.25, SD = .59, respectively), with no significant difference between these two groups (p > .05).

Therefore, registered nurses should select either the physical exercise and abdominal massage program or the combined program of water and dietary fiber intake with physical exercise and abdominal massage, depending on the individual pathology of elderly patients following hip fracture surgery.

Downloads

References

Agachan, F., Chen, T., Pfeifer, J., Reissman, P., & Wexner, S. D. (1996). A constipation scoring system to simplify evaluation and management of constipated patients. Diseases of the Colon and Rectum, 39(6), 681-685.

Berg, U., Berg, M., Rolfson, O., & Erichsen-Andersson, A. (2019). Fast-track program of elective joint replacement in hip and knee patients experiences of the clinical pathway and care process. Journal of Orthopaedic Surgery and Research, 14, 1-8.

Borson, S., Scanlan, J., Brush, M., Vitaliano, P., & Dokmak, A. (2000). The mini‐cog: A cognitive ‘vital signs’ measure for dementia screening in multi-lingual elderly. International Journal of Geriatric Psychiatry, 15(11), 1021-1027.

Celik, B., & Bilik, Ö. (2022). Postoperative constipation incidence and effects of selected risk factors on constipation development in elderly patients with hip fracture. Orthopaedic Nursing, 41(6), 397-405.

Chaloemphonphong, N. (2002). Effects of drinking water in the morning for stimulate the bowel movement in orthopedic patients with constipation (Master of nursing science program, adult nursing). Faculty of Nursing, Mahidol University, Nakhon Pathom, Phuttamonthon.

Cheskin, L. J., Kamal, N., Crowell, M. D., Schuster, M. M., & Whitehead, W. E. (1995). Mechanisms of constipation in older persons and effects of fiber compared with placebo. Journal the American Geritrics Society, 43(6), 666-669.

Chiangrai Prachanukroh Hospital. (2022). Health data center. Retrieved from https://www.crhospital.org/home/main.php

Guyton, A. C. & Hall, J. E. (2006). Textbook of medical physiology (11th ed.). Philadelphia, PA: W. B. Saunders.

Harrington, K. L., & Haskvitz, E. M. (2006). Managing a patient's constipation with physical therapy. Physical Therapy, 86(11), 1511-1519.

Kittinouvarat, S. (2009). Constipation. Thai Red Cross Nursing Journal, 2(1-3), 12-22.

Lacy, B. E., Mearin, F., Chang, L., Chey, W. D., Lembo, A. J., Simren, M., & Spiller, R. (2016). Bowel Disorders. Gastroenterology, 150(6), 1393-1407.

Lamas, K., Lindholm, L., Stenlund, H., Engstrom, B., & Jacobsson, C. (2009). Effects of abdominal massage in management of constipation a randomized controlled trial. International Journal of Nursing Studies, 46(6), 759-767.

Mamom, J. (2019). Orthopedics nursing problem. Bangkok: Thammasat University Press.

Monmai, P. (2009). The effects of a constipation prevention program on incidence and severity of constipation in hospitalized elderly undergoing hip surgery. Journal of Nursing Science, 29(4), 10-17.

Norton, C. (2006). Constipation in older patients: Effects on quality of life. British Journal of Nursing, 15(4), 188-192.

Pattamapornpong, O., Juktong, S., & Klawklar, J. (2023). The effectiveness of constipation prevention program among spine patients at Phrae hospital. (PMJCS) Phrae Medical Journal and Clinical Sciences, 31(2), 118-132.

Pattamawilai, W. (2014). The Effect of Nursing Process with Abdominal Massage on Constipation in Stroke Patients (Master of nursing science program, adult nursing). Faculty of Nursing, Chulalongkorn University, Bangkok, Pathumwan.

Putwatana, P., Sanrung, P., & Budpanya, W. (2012). Constipation, management, and clinical outcomes in critically ill surgical patients. Thai Journal of Nursing, 61(3), 60-68.

Saleesongsom, P., Wangsrikhun, S., & Sukonthasarn, A. (2022). Effect of the constipation prevention program on constipation occurrence in immobilized patients. Boromarajonani College of Nursing, Uttaradit Journal, 14(1), 16-30.

Sinclair, M. (2011). The use of abdominal massage to treat chronic constipation. Journal of Bodywork and Movement Therapies, 15(4), 436-445.

Trads, M., & Pedersen, P. U. (2015). Constipation and defecation pattern the first 30 days after hip fracture. International Journal of Nursing Practice, 21(5), 598-604.

Trongsakul, S., Lambert, R., Clark, A., Wongpakaran, N., & Cross, J. (2015). Development of the Thai version of mini‐cog, a brief cognitive screening test. Geriatrics and Gerontology International, 15(5), 594-600.

Wittbrodt, E. T., Gan, T. J., Datto, C., McLeskey, C., & Sinha, M. (2018). Resource use and costs associated with opioid-induced constipation following total hip or total knee replacement surgery. Journal of Pain Research, 11, 1017-1025.

Wongworapitak, C. (2016). 1-Year mortality in aged hip fracture patients after conservative treatment. Region 11 Medical Journal, 30(4), 345-355.