Faculty of Nursing, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan.
Department of Community Health and Preventive Medicine, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan.
Am J Gastroenterol. 2023 Mar 1;118(3):531-538. doi: 10.14309/ajg.0000000000001986. Epub 2022 Sep 1.
Chronic constipation (CC), which can cause behavioral and psychiatric symptoms of dementia and related caregiver distress, is common in older adults admitted to care facilities with dementia. This study aimed to examine the effect of defecation care on CC and related problems.
This study compared bowel training and defecation posture intervention (intervention group) with general care (control group) as the treatment of CC among older adults with dementia in 6 long-term care facilities. The primary outcomes were the number of spontaneous bowel movements (SBMs) and complete SBMs. The secondary outcomes were Patient Assessment of Constipation Quality of Life Questionnaire, Constipation Scoring System, constipation symptoms, and Neuropsychiatric Inventory Nursing Home Version scores. The differences were analyzed using 2-way ANOVA with repeated measures.
The data of 30 patients (14 in the intervention group, 16 in the control group) were analyzed. Weekly mean complete SBMs increased from 0.53 times at baseline to 1.58 times at 8 weeks in the intervention group compared with a change from 0.56 to 0.43 times in the control group (interaction P < 0.001). The Patient Assessment of Constipation Quality of Life Questionnaire, Constipation Scoring System, behavioral and psychiatric symptoms of dementia, and caregiver distress scores showed significant improvement after 8 weeks of defecation care intervention.
Defecation care, including bowel training and appropriate defecation posture, is effective for CC among older adults with dementia, improving patient mental health and reducing burden on caregivers.
慢性便秘（CC）可导致痴呆患者出现行为和精神症状以及相关照料者的困扰，在入住痴呆照料机构的老年人中较为常见。本研究旨在探讨排便护理对 CC 及相关问题的影响。
本研究将排便训练和排便姿势干预（干预组）与常规护理（对照组）比较，作为 6 家长期护理机构中痴呆老年人 CC 的治疗方法。主要结局为自发性排便次数（SBMs）和完全 SBMs 的数量。次要结局为患者便秘生活质量问卷评分、便秘评分系统、便秘症状和神经精神科住院患者护理观察量表评分。采用重复测量的 2 因素方差分析比较差异。
分析了 30 名患者（干预组 14 名，对照组 16 名）的数据。每周平均完全 SBMs 从基线时的 0.53 次增加到干预组的 8 周时的 1.58 次，而对照组则从 0.56 次增加到 0.43 次（交互 P<0.001）。患者便秘生活质量问卷评分、便秘评分系统、痴呆的行为和精神症状以及照料者困扰评分在 8 周排便护理干预后均显著改善。
排便护理，包括肠道训练和适当的排便姿势，对痴呆老年人的 CC 有效，改善了患者的心理健康，减轻了照料者的负担。
