Centre for Population Health and Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, 50603 Malaysia.
Nutr Clin Pract. 2012 Apr;27(2):252-60. doi: 10.1177/0884533611431986. Epub 2012 Jan 5.
Diarrhea is a common complication in patients receiving enteral nutrition (EN), and understanding this problem among patients and healthcare professionals is required. The aim of the study was to investigate patients', nurses', and dietitians' definitions of diarrhea during EN, the attitudes of nurses and patients toward it, and the management practices of nurses and dietitians in response to diarrhea during EN.
Twenty-two patients receiving EN, 57 nurses, and 33 dietitians were recruited and interviewed in a cross-sectional study, using a questionnaire that had been developed following an extensive literature review and pretested for clarity.
The ratings assigned by the 3 groups differed significantly for all the characteristics used to define diarrhea: frequency (P = .006), quantity (P < .001), consistency (P = .003), color (P < .001), odor (P < .001), and incontinence (P < .001). Patients gave incontinence the highest rank when defining diarrhea, whereas the healthcare professionals gave fecal consistency and frequency the highest ranks. Patients and nurses rated the unpleasantness of each characteristic of diarrhea during EN differently, with patients rating incontinence and fecal frequency and nurses rating odor and changing the patients' underwear as the most unpleasant characteristics. Nurses and dietitians differed in the frequency with which they adopted various strategies to manage patients who developed diarrhea during EN.
Patients have different definitions and attitudes toward diarrhea during EN from those of nurses and dietitians. Patients' perceptions need to be understood and respected by healthcare professionals to improve patient-centered care.
腹泻是接受肠内营养（EN）的患者常见的并发症，需要了解患者和医护人员对此问题的认知。本研究旨在调查患者、护士和营养师对 EN 期间腹泻的定义、护士和患者对腹泻的态度，以及护士和营养师针对 EN 期间腹泻的管理实践。
采用横断面研究，共招募了 22 名接受 EN 的患者、57 名护士和 33 名营养师，使用在广泛文献回顾和预测试基础上开发的问卷进行访谈。
3 组对所有用于定义腹泻的特征的评分存在显著差异：频率（P =.006）、量（P <.001）、稠度（P =.003）、颜色（P <.001）、气味（P <.001）和失禁（P <.001）。患者在定义腹泻时将失禁评为最高，而医护人员则将粪便稠度和频率评为最高。患者和护士对 EN 期间腹泻的每个特征的不愉快程度评价不同，患者认为失禁和粪便频率，以及护士认为气味和更换患者的内衣裤是最不愉快的特征。护士和营养师在处理 EN 期间发生腹泻的患者时采用各种策略的频率存在差异。
患者对 EN 期间腹泻的定义和态度与护士和营养师不同。医护人员需要理解和尊重患者的看法，以改善以患者为中心的护理。
