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养老院患者的便秘与泻药使用情况:基于长期护理机构居民评估工具(interRAI LTCF)得出的患病率及关联因素

Constipation and Laxative Use among Nursing Home Patients: Prevalence and Associations Derived from the Residents Assessment Instrument for Long-Term Care Facilities (interRAI LTCF).

作者信息

Blekken Lene Elisabeth, Nakrem Sigrid, Vinsnes Anne Guttormsen, Norton Christine, Mørkved Siv, Salvesen Øyvind, Gjeilo Kari Hanne

机构信息

Faculty of Health and Social Science, Department of Nursing Science, University College of Sør-Trøndelag, Postboks 2320, 7004 Trondheim, Norway; Faculty of Medicine, Department of Public Health and General Practice, Norwegian University of Science and Technology (NTNU), Postboks 8905, MTFS, 7491 Trondheim, Norway.

Faculty of Health and Social Science, Department of Nursing Science, University College of Sør-Trøndelag, Postboks 2320, 7004 Trondheim, Norway.

出版信息

Gastroenterol Res Pract. 2016;2016:1215746. doi: 10.1155/2016/1215746. Epub 2016 Jan 17.

Abstract

Introduction. Constipation is a common, bothersome, and potentially dangerous condition among nursing home (NH) patients. Between 50 and 74% of NH patients use laxatives. Objective. To study prevalence and associations of laxative use and constipation using the comprehensive Norwegian version of the Resident Assessment Instrument for Long-Term Care Facilities. Methods. Cross-sectional study. Patients from 20 NH units were included. Logistic regression was used to analyze the results. Data collected in NHs might be clustered. Consequently, the multivariable models were tested against a mixed effects regression model to investigate variance both on the level of patients and on the level of NH units. Results. In all, 261 patients were included. The prevalence of constipation was 23.4%, and 67.1% used laxatives regularly. Balance problems, urinary incontinence, hypothyroidism, and Parkinson's disease were associated with constipation. Reduced ability to communicate and number of drugs were associated with laxative use. Antidementia-drugs and being involved in activities 1/3 to 2/3 of daytime were protective factors for laxative use. Mixed effects analyses identified variance on the level of NH units as nonsignificant. Conclusion. Constipation and laxative use are common. Variance is mainly explained by different patient characteristics/health deficiencies. Hence, patients might benefit from individualized care to compensate for deficiencies.

摘要

引言。便秘在养老院患者中是一种常见、令人困扰且可能危险的状况。50%至74%的养老院患者使用泻药。目的。使用挪威长期护理机构居民评估工具的完整版本,研究泻药使用和便秘的患病率及相关性。方法。横断面研究。纳入了来自20个养老院单元的患者。采用逻辑回归分析结果。在养老院收集的数据可能存在聚类现象。因此,将多变量模型与混合效应回归模型进行比较,以研究患者层面和养老院单元层面的方差。结果。总共纳入了261名患者。便秘的患病率为23.4%,67.1%的患者经常使用泻药。平衡问题、尿失禁、甲状腺功能减退和帕金森病与便秘相关。沟通能力下降和药物数量与泻药使用相关。抗痴呆药物以及白天三分之一到三分之二的时间参与活动是泻药使用的保护因素。混合效应分析表明养老院单元层面的方差不显著。结论。便秘和泻药使用很常见。方差主要由不同的患者特征/健康缺陷所解释。因此,患者可能受益于个性化护理以弥补缺陷。

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