Effectiveness of individualised intervention on older residents with constipation in nursing home: a randomised controlled trial

Huang, Tiao–Yuan; Yang, Shu-di; Tsai, Yu‐Hsia; Chin, Yen Fan; Wang, Bi-Hwa; Tsay, Pei-Kwei

doi:10.1111/jocn.12974

Cited by 21 publications

(26 citation statements)

References 23 publications

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“…Over 18 clinical studies have used the PAC-SYM, since its validation in 1999: 14 of these have been reported since 2010. [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] Moreover, these trials have examined a range of interventions including sacral nerve stimulation, 20 lifestyle changes 19 and pharmacological agents. 6,11 Historically, a reduction in total score of 1 point or more has been used as the cut-off to define a positive response to treatment, 2 implying that this is a meaningful improvement.…”

Section: Introductionmentioning

confidence: 99%

ThePAC‐SYMquestionnaire for chronic constipation: defining the minimal important difference

Yiannakou

Tack

Piessevaux

et al. 2017

Aliment Pharmacol Ther

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SummaryBackgroundThe Patient Assessment of Constipation‐Symptoms (PAC‐SYM) questionnaire is frequently used in clinical trials of constipation. However, the threshold for reduction in total PAC‐SYM score used to define a clinical response on this 0‐4 point scale has not undergone formal appraisal, and its relationship with clinical benefit as perceived by patients has not been defined.AimTo determine the minimal important difference in PAC‐SYM score, and the optimum cut‐off value for defining responders.MethodsThe minimal important difference was estimated using data from six international phase 3/4, double‐blind, randomised controlled trials of prucalopride in patients with chronic constipation (NCT01147926, NCT01424228, NCT01116206, NCT00485940, NCT00483886, NCT00488137), with anchor‐ and distribution‐based approaches. Five appropriate patient‐reported outcomes were selected as anchors. In addition, receiver operating characteristics (ROC) curve analyses were used to investigate responder discrimination for each anchor.ResultsData from 2884 patients were included. Minimal important difference estimates ranged from –0.52 to –0.63 across the five anchors. Estimates were not affected by study location but were consistently lower for rectal symptoms than for abdominal and stool symptoms. Distribution‐based estimates were considerably lower than anchor‐based estimates. ROC curve analyses showed optimum cut‐off scores for discriminating responders to be similar to anchor‐based minimal important difference estimates.ConclusionsAnchor‐based methods gave consistent results for the minimal important difference, at approximately –0.6, and this value was close to the ROC‐determined optimal cut‐off scores for responder discrimination. This value could be considered in clinical practice. A slightly more conservative threshold (eg –0.75) could be used in clinical trials to reduce the placebo response rate.

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Section: Introductionmentioning

confidence: 99%

ThePAC‐SYMquestionnaire for chronic constipation: defining the minimal important difference

Yiannakou

Tack

Piessevaux

et al. 2017

Aliment Pharmacol Ther

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“…In our previous study at a long‐term care facility, although 56.3% of the patients assessed for constipation actually had loose stools, all patients received suppository doses as routine care . Furthermore, individualized intervention reportedly improves symptoms related to constipation . Further studies at long‐term care facilities or hospitals where routine care is carried out to treat constipation are required to show the efficacy of individualized defecation care based on US assessment.…”

Section: Discussionmentioning

confidence: 97%

“…15 Furthermore, individualized intervention reportedly improves symptoms related to constipation. 22 Further studies at long-term care facilities or hospitals where routine care is carried out to treat constipation are required to show the efficacy of individualized defecation care based on US assessment.…”

Section: Discussionmentioning

confidence: 99%

Safety and efficacy of a defecation care algorithm based on ultrasonographic bowel observation in Japanese home‐care settings: a single‐case, multiple‐baseline study

Matsumoto

Yoshida

Yabunaka

et al. 2020

Geriatrics Gerontology Int

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Aim To verify the efficacy of defecation care based on handheld ultrasonographic observations for functional constipation by visiting nurses skilled in bowel ultrasonography. Methods Home‐care patients with suspected functional constipation receiving nursing visits were recruited in this multiple‐baseline, single‐case experiment with intervention points shifted by 1 week. A total of 15 older adults were categorized into 3‐, 4‐, 5‐ or 6‐week intervention phases. Ultrasonographic observations of fecal retention in the colorectum and defecation care based on observations during the ordinal physical assessment were reviewed. Tau‐U was used for confirming the efficacy of the intervention by measuring the number of non‐artificial and artificial defecations, as well as hard stools per week, and the amount of non‐stimulant and stimulant laxatives, enemas and suppositories per week. For evaluating safety, adverse events, such as bowel obstruction and incontinence‐associated dermatitis, were confirmed. Results No adverse events were observed. Statistical analysis showed that hard stools and artificial defecation reduced, and that their effect sizes were significant (Tau = −0.48, P < 0.01; Tau = −0.53, P < 0.01). Even the amounts of stimulant laxative and glycerin enema reduced, and their effect sizes were significant (Tau = −0.56, P < 0.01; Tau = −0.34, P = 0.04). Conclusions Thus, defecation care based on ultrasonographic assessment by nurses in home‐care settings is safe and effective for improving constipation symptoms and reducing laxative use. Geriatr Gerontol Int 2020; ••: ••–••.

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“…The results showed that the frequency of defecation and bowel sounds were higher among participants in the experimental group compared to control group. That provides evidence about the individualized intervention may be appropriate in reducing constipation [40].…”

Section: Nursing Care For Constipationmentioning

confidence: 99%

Bowel Management: Constipation among Patients with Cancer

Younes¹,

Tawalbeh²

2017

J Palliat Care Med

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Constipation has a negative effect on patients with cancer and their families. It negatively affects the quality of life terms of physical, social, psychological, and spiritual dimensions. The aim of this paper was to review the studies that addressed constipation among patients with cancer and to explore its influence on the quality of life and wellbeing for patients and their families. Completed studies were identified through systematic search using Cumulative index for Nursing and Applied Health Literature, EBSCO Host, Ovid Journal and PubMed. This search located the studies that were published between 1989 and 2015 about constipation effect, pathophysiology, assessment and management. The review identified 44 studies and indicated that constipation has negative effect on QOL among patient with cancer and their families. Various assessment and management constipation tools and strategies were used according to patient's health condition. Pharmacological and non-pharmacological methodologies were used to manage constipation. Appropriate assessment has a positive impact on effective management of constipation among patients with cancer; that may help improve the quality of life. Nurses play a significant role in performing comprehensive assessment strategies to detect the risk factor for constipation and applying the prevention precaution to reduce opportunity of its occurrence. Nurses should perform constipation management strategies that include both pharmacological and non-pharmacological approaches.

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Effectiveness of individualised intervention on older residents with constipation in nursing home: a randomised controlled trial

Abstract: Using individualised intervention to enhance the self-care ability related to constipation among older adults is recommended.

Cited by 21 publications

References 23 publications

ThePAC‐SYMquestionnaire for chronic constipation: defining the minimal important difference

ThePAC‐SYMquestionnaire for chronic constipation: defining the minimal important difference

Safety and efficacy of a defecation care algorithm based on ultrasonographic bowel observation in Japanese home‐care settings: a single‐case, multiple‐baseline study

Bowel Management: Constipation among Patients with Cancer

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