Caspian Nursing Process: Impactions on New‑Onset Constipations in Admission, Discharge, and Follow‑up of Acute Stroke Patients

Shayan Alijanpour, Nasrollah Alimohamadi, Soraya Khafri, Mostafa Akbarian Rokni, Fariborz Khorvash

Abstract


Background: Structural planning is essential for the management of constipation in stroke patients. The current study aims to determine the impact of a care plan on the frequency of new‑onset constipation following stroke.

Materials and Methods: This clinical trial was conducted on 132 stroke patients (two groups of 66) in three phases (pre‑intervention, during discharge, 1 month after discharge). Clients were randomly assigned to blocks based on gender, type of stroke, and age. The care plan according to the nursing process was conducted. Data collection tools included a demographic–clinical information questionnaire, Rome IV criteria (diagnosis of constipation), and Bristol scale (consistency of stool). Data were analyzed using the Chi‑square, McNemar, Wilcoxon, Analysis of Variance (ANOVA), and a general estimated model.

Results: The prevalence of new‑onset constipation following stroke in the control group decreased from 66 (100%) at admission to 39 (67.20%) at discharge and in the intervention group from 66 cases (100%) to 18 cases (34%) (p = 0.001), but it was not significant at follow‑up (p = 0.16). The trend of frequency of constipation from admission to follow‑up was generally significant in the intervention group (p = 0.03) vs the control group (p = 0.21). The difference in the mean number of cases of constipation was statistically significant (2.89) 2.10) control group vs 1.58 (1.65) intervention group, p < 0.001).

Conclusions: A significant impact of the care plan was observed from admission to discharge, but further follow‑up was required with more client‑side collaboration. Therefore, the present care plan is recommended in the hospital and home care.



Keywords


Constipation, neuroscience nursing, nursing care, patient care planning, stroke

Full Text:

PDF

References


Alijanpour S, Mostafazadeh‑Bora M, Ahmadi Ahangar A. Different stroke scales; which scale or scales should be use? Caspian J Intern Med 2021;12:1‑21.

Ahmadi Ahangar A, Saadat P, Niroomand S, Alijanpour S, Sohrabnezhad R, Firozejahi A, et al. Increased zinc serum level: New clues in babol stroke patients, Northern Iran. J Stroke research treatment. Stroke Res Treat 2018;2018:7681682.

Ahangar AA, Saadat P, Heidari B, Taheri ST, Alijanpour S. Sex difference in types and distribution of risk factors in ischemic and hemorrhagic stroke. Int J Stroke 2018;13:83‑6.

Li J, Yuan M, Liu Y, Zhao Y, Wang J, Guo W. Incidence of constipation in stroke patients: A systematic review and meta‑analysis. Medicine 2017;96:e7225.

Ahmadi Ahangar A, Saadat P, Taheri Otaghsara ST, Alijanpour S. C‑reactive protein level in admission and the outcome of stroke survivors. J Babol Univ Med Sci 2020;22:210‑4.

Aadal L, Mortensen J, Kellenberger S, Nielsen J. Lower bowel dysfunction following acquired brain injury: A challenge during rehabilitation. Gastroenterol Nurs 2019;42:12‑9.

Coggrave M, Wiesel PH, Norton C. Management of faecal incontinence and constipation in adults with central neurological diseases. Cochrane Database Syst Rev 2006;CD002115. doi: 10.1002/14651858.CD002115.pub3.

Kasaraneni J, Hayes M. Stroke and constipation—Coincidence or interrelated? Health 2014;6:2743.

Hidayati N, Sukartini T, Padoli P. Comparison of two turning regimens (1 Versus Every 2 Hours) in the prevention of constipation in patients with stroke. Belitung Nurs J 2019;5:192‑6.

Lim SF, Childs C. A systematic review of the effectiveness of bowel management strategies for constipation in adults with stroke. Int J Nurs Stud 2013;50:1004‑10.

Alijanpour S, Aslani Z, Alimohammadi N, Taleghani F. Empowerment of nurses: A key to stroke patients’ satisfactions. Iran J Nurs Midwifery Res 2020;25:237‑41.

Nasr A, Alimohammadi N, Isfahani MN, Alijanpour S. Development and domestication of a clinical guideline for pharmacological pain management of trauma patients in prehospital setting. Arch Trauma Res 2019;8:111.

Datobar H, Alijanpour H, Khafri S, Jahani MA, Naderi R. Patient’s satisfaction of emergency department affiliated hospital of Babol University of Medical Sciences in 2013‑14. J Babol Univ Med Sci 2016;18:56‑62.

Alijanpour S, Alimohamadi N, Khafri S, Khorvash F. New‑onset constipation after stroke: Caspian nursing process projects. J Holist Nurs Midwifery 2022;32:29‑39.

Wang Q‑S, Liu Y, Zou X‑N, Ma Y‑L, Liu G‑L. Evaluating the efficacy of massage intervention for the treatment of poststroke constipation: A meta‑analysis. Evid Based Complement Alternat Med 2020;2020:8934751.

Alijanpour S, Alimohamadi N, Khafri S, Khorvash F. Investigation the effect of caspian nursing process in new‑onset constipation after stroke. J Vessel Circ 2021;2:28‑9.

de Miranda Engler TM, Farage L, Andrade P. Constipation in patients admitted to the neurological rehabilitation program. Acta Paul Enferm 2011;24:804‑9.

Lin C‑J, Hung J‑W, Cho C‑Y, Tseng C‑Y, Chen H‑Y, Lin F‑C, et al. Poststroke constipation in the rehabilitation ward: Incidence, clinical course and associated factors. Singapore Med J 2013;54:624‑9.

Su Y, Zhang X, Zeng J, Pei Z, Cheung RT, Zhou Q, et al. New‑onset constipation at acute stage after first stroke: Incidence, risk factors, and impact on the stroke outcome. Stroke 2009;40:1304‑9.

Engler TM, Aguiar MH, Furtado IA, Ribeiro SP, de Oliveira P, Mello PA, et al. Factors associated with intestinal constipation in chronic patients with stroke sequelae undergoing rehabilitation. Gastroenterol Nurs 2016;39:432‑42.

Liu Z, Ge Y, Xu F, Xu Y, Liu Y, Xia F, et al. Preventive effects of transcutaneous electrical acustimulation on ischemic stroke‑induced constipation mediated via the autonomic pathway. Am J Physiol Gastrointest Liver Physiol 2018;315:G293‑301.

Khorrami M, Bagheri‑nesami M, Akbari H, Mousavinasab N, Jokar A. A comparison between the effect of plums (prunes) and magnesium hydroxide on the constipation of cerebrovascular accident patients: A randomized clinical trial. Koomesh 2020;22:41‑9.

Lamas K, Lindholm L, Stenlund H, Engstrom B, Jacobsson C. Effects of abdominal massage in management of constipation—A randomized controlled trial. Int J Nurs Stud 2009;46:759‑67.

Harari D, Norton C, Lockwood L, Swift C. Treatment of constipation and fecal incontinence in stroke patients: Randomized controlled trial. Stroke 2004;35:2549‑55.

de M Engler TM, Dourado CC, Amancio TG, Farage L, de Mello PA, Padula MP. Stroke: Bowel dysfunction in patients admitted for rehabilitation. Open Nurs J 2014;8:43.

Yi JH, Chun MH, Kim BR, Han EY, Park JY. Bowel function in acute stroke patients. Ann Rehabil Med 2011;35:337.

Venn MR, Taft L, Carpentier B, Applebaugh G. The influence of timing and suppository use on efficiency and effectiveness of bowel training after a stroke. Rehabilitation Nursing. 1992;17:116-21.

Su Y, Zhang X, Zeng J, Pei Z, Cheung RTF, Zhou Q, et al. Newonset constipation atacute stage after first stroke: incidence, risk factors, and impact on the stroke outcome. Stroke 2009;40:1304-9.


Refbacks

  • There are currently no refbacks.