School of Nursing, Deakin University, Burwood, Melbourne, Australia.
J Wound Ostomy Continence Nurs. 2010 Mar-Apr;37(2):193-8. doi: 10.1097/WON.0b013e3181cf7206.
Constipation is a common symptom in the general community that incurs considerable cost and negative effects on quality of life. This article reports the effects of an individualized, multimodal, conservative intervention on symptom severity and quality of life in community-dwelling adults who presented with constipation and specific lower urinary tract symptoms to a community-based continence service.
The study was a within-subject, pretest-posttest design that utilized purposeful recruitment. The sample was drawn from a clinical population of patients attending a community-based continence service.
Twenty-seven community-dwelling adults aged 35 to 83 years (mean age 63.85 years) who presented with lower urinary tract symptoms and constipation received individualized conservative treatment of constipation that comprised advice on dietary supplementation, fluid intake, exercise, position to defecate, the gastrocolic reflex, and over-the-counter laxatives. Participants completed the Patient Assessment of Constipation Symptom Questionnaire (PAC-SYM) and the Patient Assessment of Constipation Quality of Life Questionnaire (PAC-QOL) prior to the intervention and 8 to 12 weeks later.
Wilcoxon signed ranks test results indicated that the intervention significantly reduced the severity of overall constipation symptoms measured by the PAC-SYM (T = 75.5, P < .01). In particular, there were significant improvements in abdominal and stool symptoms subscales. Participants also reported statistically significant improvements in their overall quality of life as measured by the PAC-QOL (T = 48.5, P < .01). There were significant improvements in relation to psychosocial discomfort, worries and concerns, and satisfaction as measured by the PAC-QOL. While no participants felt in control of their situation "all of the time" prior to treatment, 26.9% of participants reported feeling in control of their situation "all of the time" following treatment.
The severity of constipation symptoms are reduced following a multimodal, individually tailored conservative intervention. This improvement in symptoms corresponds with quality-of-life improvements.
便秘是普通人群中常见的症状，会给生活质量带来相当大的成本和负面影响。本文报告了对出现便秘和特定下尿路症状的社区居民进行个体化、多模式、保守干预对症状严重程度和生活质量的影响，这些患者向社区为基础的控尿服务机构就诊。
本研究为自身前后对照试验设计，采用了有针对性的招募方法。样本取自参加社区为基础的控尿服务机构的临床人群。
27 名年龄 35 至 83 岁（平均年龄 63.85 岁）的社区居民，他们出现下尿路症状和便秘，接受了个体化的便秘保守治疗，包括饮食补充、液体摄入、运动、排便姿势、胃结肠反射和非处方泻药的建议。参与者在干预前和 8 至 12 周后完成了便秘症状问卷（PAC-SYM）和便秘生活质量问卷（PAC-QOL）。
Wilcoxon 符号秩检验结果表明，干预显著降低了 PAC-SYM 测量的整体便秘症状严重程度（T=75.5，P<0.01）。特别是腹部和粪便症状亚量表有显著改善。参与者还报告了 PAC-QOL 测量的整体生活质量有统计学意义的改善（T=48.5，P<0.01）。在 PAC-QOL 测量的心理社会不适、担忧和满意度方面也有显著改善。虽然没有参与者在治疗前“一直”感到能够控制自己的情况，但 26.9%的参与者在治疗后“一直”感到能够控制自己的情况。
经过多模式、个体化的保守干预，便秘症状的严重程度减轻。症状的改善与生活质量的提高相对应。
