Annells Merilyn, Koch Tina
MP Annells Research, Adelaide, Australia.
J Clin Nurs. 2002 Sep;11(5):603-12. doi: 10.1046/j.1365-2702.2002.00626.x.
This article reports an extensive descriptive survey of 90 older people (65+ years) living in the community who sought through in-depth, semistructured interviews to explore their experiences and responses to constipation. The composite story of these older people is that seeking a solution to constipation may be fraught with great difficulty. Most commonly tried are laxatives, yet laxative use can be like a mire. The older people tend to be uncertain of which way to turn to avoid getting stuck in a murky conglomeration of laxative options. The imperative for self-management of constipation is strong amongst most of the older people and the process in which they engage when seeking for a solution is discussed. There is an evident frustrating lack of readily identifiable and accessible services and information that could help them navigate successfully through or around this mire. "Through the mire" would be the appropriate use of suitable laxatives with minimal side-effects. "Around the mire" would be the gaining of useful solutions other than laxative use. Solutions may be strategies to prevent constipation or to treat constipation. The needs of these older people seeking solutions to constipation are grouped into two main categories: provision of accessible, empathetic and useful advice about affordable solution choices, and accessibility to solutions, including laxatives, where evidence-based knowledge informs selection or prescription of the solution. Eight major recommendations, including research suggestions, are offered for consideration.
本文报告了一项针对90位居住在社区的老年人(65岁及以上)的广泛描述性调查。这些老年人通过深入的半结构化访谈,探讨了他们便秘的经历和应对方式。这些老年人的综合情况是,寻求便秘解决方案可能充满巨大困难。最常尝试的是泻药,但使用泻药可能就像陷入泥沼。老年人往往不确定该转向何方,以避免陷入泻药选择的混乱局面。大多数老年人自我管理便秘的紧迫性很强,文中讨论了他们在寻求解决方案时所采取的过程。明显令人沮丧的是,缺乏易于识别和获取的服务及信息,无法帮助他们成功穿越或避开这片泥沼。“穿越泥沼”意味着适当使用副作用最小的合适泻药。“避开泥沼”意味着获得除使用泻药之外的有用解决方案。这些解决方案可以是预防便秘或治疗便秘的策略。这些寻求便秘解决方案的老年人的需求主要分为两大类:提供关于可负担得起的解决方案选择的易于获取、富有同情心且有用的建议,以及获取包括泻药在内的解决方案,这些解决方案的选择或处方要有循证知识作为依据。文中提出了八项主要建议,包括研究建议,以供参考。