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1.
Br J Community Nurs ; 24(8): 392-396, 2019 Aug 02.
Artigo em Inglês | MEDLINE | ID: mdl-31369305

RESUMO

Individuals with intellectual disability can experience multifaceted physical, psychological, emotional health and wellbeing problems. Chronic constipation is one of the major health problems for this cohort of the population; it is linked with distress, discomfort, pain, faecal incontinence, anxiety, behavioural difficulties and severe gastrointestinal complications. A continence assessment process for constipation ensures that planning, implementation and evaluation strategies provide quality health outcomes for individuals and their families. Proactive treatment interventions range from increasing fluid intake, alterations in dietary intake, implementing toileting routine and medication management. Health promotion approaches need to be positively implemented for individuals with intellectual disability to promote a healthy lifestyle, improve nutritional intake, increase access to exercise programs and thus advance health, wellbeing and quality outcomes.


Assuntos
Enfermagem em Saúde Comunitária/normas , Constipação Intestinal/enfermagem , Incontinência Fecal/enfermagem , Vida Independente/estatística & dados numéricos , Deficiência Intelectual/complicações , Guias de Prática Clínica como Assunto , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
4.
Rev Epidemiol Sante Publique ; 66(5): 301-309, 2018 Sep.
Artigo em Francês | MEDLINE | ID: mdl-30181005

RESUMO

BACKGROUND: Constipation is a frequent issue during hospitalization. Multiple causes such as the existence of irregular habits, lack of exercise as well as medical history have been identified. Drugs such as strong painkillers, central nervous system therapies and treatments of the digestive tract are a major cause of constipation. Additionally, unbalanced diet, fluid deficiency, and anxiety may aggravate constipation. The consideration of all these risk factors being under the responsibility of nurses. The difficulty to take into account such a multifactorial aetiology in nursing practice and the fact that there is no easy to use and validated tool to assess the risk of constipation in current nurse practice has led us to consider the development of a Risk Assessment scale of Constipation in Patient Hospitalized (ERCoPH) to facilitate preventive management of this trouble. We present here the first step of the elaboration of this scale, the identification of risk factors through a consensus approach after a systematic literature review. METHODS: The key informants consensus-based approach proposed by Pineault and Daveluy is based on five steps: (1) a literature review to identify risk factors for constipation; (2) the elaboration of a questionnaire containing the factors identified in the first step; (3) pre-select a panel of experts; (4) submission the questionnaire to the panel; (5) analysis the results of the consensus survey. Only factors that received a rating>6 by at least 80 % of the experts were retained. RESULTS: The systematic literature review identified 69 risk factors submitted to the 23 experts of the panel. Fifteen risk factors were retained after analyzing the answers of the experts. The Scientific Committee added eight risk factors because of their importance in the literature and decided to group together some factors of the same domain. CONCLUSION: A total of 19 risk factors were selected and grouped by major class (age, physical activity, medication, social data, food/hydration, medical and surgical history and environmental data). These factors have been tested among 300 patients enrolled in different clinical settings as part of the construction and validation of ERCoPH.


Assuntos
Consenso , Constipação Intestinal/etiologia , Constipação Intestinal/enfermagem , Constipação Intestinal/epidemiologia , Projetos de Pesquisa Epidemiológica , Prova Pericial , Hospitalização/estatística & dados numéricos , Humanos , Padrões de Prática em Enfermagem/normas , Padrões de Prática em Enfermagem/estatística & dados numéricos , Fatores de Risco
5.
Scand J Caring Sci ; 32(2): 824-832, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28881476

RESUMO

BACKGROUND: The prevalence of constipation in the general population is 2-28%. Patients with constipation report symptoms of abdominal pain, bloating, nausea, straining to defecate and general discomfort. Strategies for preventing constipation include laxatives, exercise and increased fluid and fibre intake, but life style adjustments, such as exercise, eating more fibres and drinking more fluids, were not considered a solution by older patients. Previous studies have shown that actively involving patients through individualised care and support increases patients' outcome. AIM: To test the efficacy of a nursing intervention based on active patient involvement including individualised nursing care plans and daily dialogues for patients with hip fractures in preventing constipation after surgery. METHODS: A quasi-experimental design was applied. Inclusion criteria hip fracture needing surgery, understand Danish. Exclusion criteria dementia, gastrointestinal disease. A total of 186 patients were included and 155 completed. An admission interview including Constipation Risk Assessment Scale was undertaken. On that basis an individualised nursing care plan was made. At admission, discharge and 30 days after surgery constipation, intake of fibres and fluid were measured. The Bristol Stool Scale and Rasmussen's scale were used to measure constipation. Patients in the control group received standard care of the ward. RESULTS: After 30 days constipation rates for patients in the intervention group were significantly lower than for patients in the control group (p = 0.042). The fibre intakes and fluid intakes were significantly higher in the intervention group (p ≤ 0.001). The effect of liquid intake was statistically significant (OR = 1.1, 95% CI: 1.0-1.2). Likewise, the effect of fibre intake was statistically significant; the odds of constipation decreased with increasing fibre intake (OR = 0.4, 95% CI: 0.2-0.8). CONCLUSION: Patients with hip fractures that were actively involved in their own care in preventing constipation were significantly less constipated 30 days after surgery than control patients. Increases in fluid and fibre intakes had significant effects on reducing the risk of developing constipation.


Assuntos
Constipação Intestinal/tratamento farmacológico , Constipação Intestinal/enfermagem , Terapia por Exercício/métodos , Laxantes/uso terapêutico , Assistência Centrada no Paciente/métodos , Complicações Pós-Operatórias/tratamento farmacológico , Complicações Pós-Operatórias/enfermagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Dinamarca , Feminino , Fraturas do Quadril/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Relações Enfermeiro-Paciente , Participação do Paciente/psicologia
6.
Gastroenterol Nurs ; 40(6): 463-468, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29210815

RESUMO

Constipation is a common health problem in relation to hospitalization. This randomized controlled trial aimed to investigate whether advice from a home care nurse after discharge had an effect on self-reported signs of constipation. A total of 59 patients were included in the study on the basis of their self-reported signs of constipation evaluated using the Constipation Assessment Scale. Advice from the home care nurses was given on the intake of fiber and liquid and mobilization related to scorings on the Constipation Risk Assessment Scale, the administration of laxatives, and referral to a physician when needed. Results showed a tendency toward the visits being effective, but a more complex intervention might be needed.


Assuntos
Constipação Intestinal/enfermagem , Serviços de Assistência Domiciliar , Adulto , Idoso , Idoso de 80 Anos ou mais , Constipação Intestinal/diagnóstico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Alta do Paciente , Autorrelato
8.
Enferm. intensiva (Ed. impr.) ; 28(4): 160-168, oct.-dic. 2017. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-168090

RESUMO

Objetivo: Valorar la eficacia de los cuidados enfermeros frente al estreñimiento e identificar, analizar y evaluar sus causas y consecuencias. Metodología: Estudio observacional, descriptivo y prospectivo, en UCI polivalentes de un hospital de tercer nivel (2013-2015). Criterios de inclusión: >18 años, estancia >7 días, con ventilación mecánica, portadores de sonda nasogástrica y nutrición enteral o mixta. Se excluyeron pacientes con enfermedad digestiva, encefalopáticos y con yeyunostomía/ileostomía. Las variables estudiadas (edad, sexo, peso, talla, enfermedad, tratamiento médico, tipo de nutrición y volumen, características deposicionales, cantidad y frecuencia, medidas correctoras y complicaciones) se recogieron mediante parrilla ad hoc. Dispone de autorización CEIC. Resultados: Se analizaron 139 pacientes con edad media de 62 años y estancia media de 11 días; un 63% padecieron estreñimiento. Opiáceos y antiácidos fueron los fármacos más administrados (99%), aunque los relajantes musculares, suplementos de hierro y/o calcio y antihipertensivos fueron los que dieron más estreñimiento (77, 75 y 70%). La dieta sin fibra fue la más utilizada (60% estreñidos), seguida de dieta con fibra (51% estreñidos) y la combinación de ambas (85% estreñidos) Un 56% usó laxantes como medida correctora, siendo el hidróxido de magnesio el más utilizado; un 54% las iniciaron el primer día. La retención gástrica fue la complicación más relevante (49%). Conclusión: El estreñimiento es un problema real multifactorial. Recomendamos: · Intensificar la vigilancia en pacientes con fármacos que favorecen el estreñimiento. · Utilizar dietas con fibra desde el inicio. ·Aplicar de forma precoz y combinada procinéticos y laxantes. Creemos necesario crear un protocolo para la profilaxis y manejo del estreñimiento (AU)


Objective: To evaluate the effectiveness of nursing care against constipation and to identify, analyze and evaluate causes and consequences. Methodology: Observational, descriptive and prospective study in polyvalent ICU tertiary hospital (2013-2015). Inclusion criteria: >18 years, stay >7 days, connected to respiratory support, with nasogastric tube and enteral or mixed nutrition. Patients with gastrointestinal pathology, encephalopathic and jejunostomy/ileostomy were excluded. The studied variables (age, sex, weight, height, pathology, medical treatment, nutrition and volume type, depositional characteristics, quantity and frequency, corrective measures and complications) were collected by ad hoc grill. It is authorized by the CEIC. Results: 139 patients with a mean age of 62 years and average stay of 11 days were analyzed; 63% suffered from constipation. Opiates and antacid were the drugs administered most frequently (99%), even though patients who took muscle relaxants, iron supplements and/or calcium and anti-hypertensive were the ones who suffered most from constipation (77%; 75%; 70%) The fiber free diet was the most widely used (60% constipated), followed by dietary fiber (51% constipated), and the combination of both (85% constipated). 56% used laxatives as a corrective measure, Magnesium Hydroxide being the most widely used; 54% began the first day. Gastric retention was the most relevant complication (49%). Conclusion: Constipation is a real multifactorial problem. We recommend: ·Intensified surveillance in patients with drugs that promote constipation. ·Use high-fiber diets from the outset. ·Apply laxatives and prokinetics early and in combination. We need to create a protocol for prophylaxis and management of constipation (AU)


Assuntos
Humanos , Pessoa de Meia-Idade , Cuidados Críticos/métodos , Estado Terminal/enfermagem , Constipação Intestinal/complicações , Constipação Intestinal/enfermagem , Enfermagem de Cuidados Críticos/tendências , Estudos Prospectivos , Respiração Artificial/enfermagem , Constipação Intestinal/dietoterapia
10.
Br J Nurs ; 26(15): 846-856, 2017 Aug 10.
Artigo em Inglês | MEDLINE | ID: mdl-28792840

RESUMO

This article discusses transanal irrigation: what it is, the clinical conditions that might be helped by it and less invasive options that should be considered before starting irrigation. It looks at the delivery of this procedure, describes the different options available and compares and contrasts devices manufactured by five different companies. Contraindications are listed and side-effects discussed. Problems and possible solutions are considered. Transanal irrigation education for nurses and teaching patients is reviewed. Follow-up is discussed, including the reasons why some patients abandon irrigation. Quality of life can be improved for those who become successful users of transanal irrigation. When patients do continue to irrigate, even when this is not problem free, it can help them regain control over their bowel dysfunction by allowing them to evacuate their bowels at a time and a place that is convenient.


Assuntos
Constipação Intestinal/enfermagem , Incontinência Fecal/enfermagem , Irrigação Terapêutica/métodos , Irrigação Terapêutica/enfermagem , Constipação Intestinal/fisiopatologia , Incontinência Fecal/fisiopatologia , Humanos , Avaliação em Enfermagem , Qualidade de Vida , Irrigação Terapêutica/instrumentação
11.
Enferm Intensiva ; 28(4): 160-168, 2017.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-28601441

RESUMO

OBJECTIVE: To evaluate the effectiveness of nursing care against constipation and to identify, analyze and evaluate causes and consequences. METHODOLOGY: Observational, descriptive and prospective study in polyvalent ICU tertiary hospital (2013-2015). INCLUSION CRITERIA: >18 years, stay >7 days, connected to respiratory support, with nasogastric tube and enteral or mixed nutrition. Patients with gastrointestinal pathology, encephalopathic and jejunostomy/ileostomy were excluded. The studied variables (age, sex, weight, height, pathology, medical treatment, nutrition and volume type, depositional characteristics, quantity and frequency, corrective measures and complications) were collected by ad hoc grill. It is authorized by the CEIC. RESULTS: 139 patients with a mean age of 62 years and average stay of 11 days were analyzed; 63% suffered from constipation. Opiates and antacid were the drugs administered most frequently (99%), even though patients who took muscle relaxants, iron supplements and/or calcium and anti-hypertensive were the ones who suffered most from constipation (77%; 75%; 70%) The fiber free diet was the most widely used (60% constipated), followed by dietary fiber (51% constipated), and the combination of both (85% constipated). 56% used laxatives as a corrective measure, Magnesium Hydroxide being the most widely used; 54% began the first day. Gastric retention was the most relevant complication (49%). CONCLUSION: Constipation is a real multifactorial problem. We recommend: • Intensified surveillance in patients with drugs that promote constipation. • Use high-fiber diets from the outset. • Apply laxatives and prokinetics early and in combination. We need to create a protocol for prophylaxis and management of constipation.


Assuntos
Constipação Intestinal/diagnóstico , Constipação Intestinal/enfermagem , Constipação Intestinal/etiologia , Estado Terminal , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Resultado do Tratamento
12.
Nurse Pract ; 42(7): 30-34, 2017 07 15.
Artigo em Inglês | MEDLINE | ID: mdl-28622255

RESUMO

Deviation from normal bowel function in the pediatric population is often a cause for concern for parents and caregivers, prompting numerous visits to a primary care provider. Constipation is a common and challenging issue in children that can have an adverse impact on their psychosocial and emotional well-being as well as quality of life. This article provides practical strategies for diagnosing, treating, and preventing constipation in children.


Assuntos
Constipação Intestinal/enfermagem , Diagnóstico de Enfermagem , Criança , Constipação Intestinal/psicologia , Humanos , Pais/psicologia
13.
Int J Orthop Trauma Nurs ; 27: 7-15, 2017 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-28456422

RESUMO

INTRODUCTION: The Constipation Assessment Scale (CRAS) was developed in order to enable the prediction of the risk of developing constipation. The scale needs validation in acute and elective patients with common disorders. MATERIALS AND METHOD: Two hundred and six acute patients with hip fracture and 200 elective patients with total knee or hip replacement were included. They were assessed with CRAS before surgery and their defecation pattern, stool consistency and degree of straining were measured at admission and 30 days after surgery. RESULTS: The prevalence of constipation was 0.49 for the acute patients and 0.34 for the elective patients. Sensitivity was 0.67 and 0.57. Specificity was 0.54 and 0.52. Positive predictive value was 0.59 and 0.38, whereas the negative predictive value was 0.63 and 0.7. CONCLUSION: When used in an orthopaedic ward, the prognostic accuracy of CRAS is poor and it cannot be recommended as a screening tool.


Assuntos
Constipação Intestinal/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Constipação Intestinal/diagnóstico , Constipação Intestinal/etiologia , Constipação Intestinal/enfermagem , Dinamarca/epidemiologia , Feminino , Hospitalização , Humanos , Masculino , Pessoa de Meia-Idade , Enfermagem Ortopédica , Valor Preditivo dos Testes , Estudos Prospectivos , Medição de Risco , Sensibilidade e Especificidade
15.
Br J Nurs ; 26(6): 312-318, 2017 03 23.
Artigo em Inglês | MEDLINE | ID: mdl-28345979

RESUMO

Constipation is a common complaint for people of all ages, with prevalence increasing with age and during pregnancy. Women are more likely to be affected than men. Severity of constipation varies from person to person; most people experience short periods of constipation during their lives, including possibly after surgery, while others have constipation as a chronic long-term condition that can significantly affect their quality of life. There are a number of factors that can contribute to developing constipation including diets low in fibre, changes in lifestyle, side effects of certain medications and low fluid intake. People can successfully treat constipation by making changes to their diet and lifestyle. However, medication may be required to manage constipation for some.


Assuntos
Constipação Intestinal/enfermagem , Dietoterapia , Laxantes/uso terapêutico , Avaliação em Enfermagem , Catárticos/uso terapêutico , Constipação Intestinal/diagnóstico , Constipação Intestinal/terapia , Gerenciamento Clínico , Humanos , Lactulose/uso terapêutico , Metilcelulose/uso terapêutico , Peptídeos/uso terapêutico , Polietilenoglicóis/uso terapêutico , Qualidade de Vida , Extrato de Senna/uso terapêutico
16.
J Wound Ostomy Continence Nurs ; 44(2): 160-164, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28267123

RESUMO

PURPOSE: The purpose of this study was to determine the effect of a conservative regimen for the treatment of constipation in persons living with a colostomy. DESIGN: Prospective, noncontrolled, single-center study. SUBJECTS AND SETTING: The study sample comprised 35 patients with a colostomy who were diagnosed with constipation. Subjects with morphologic changes causing constipation such as stomal stenosis and neoplastic and inflammatory changes were excluded. The study was conducted in the Proctology and Stoma Outpatient Clinic at Poznan University of Medical Sciences. METHODS: Patients at our Stoma Outpatient Clinic underwent baseline evaluation, and those with symptoms of constipation (prolonged periods between bowel movements, passage of pasty or hardened fecal effluent, and associated symptoms such as abdominal discomfort or bloating, flatulence, and pain with passage of effluent into the stoma) received individualized dietary recommendations that typically included an increase in dietary fiber and fluid intake, along with increased fluid intake. The outcomes of dietary changes were evaluated during a follow-up visit 3 months later. If dietary changes alone did not improve constipation symptoms, we prescribed a psyllium-based bulk-forming agent, an osmotic stool softener, and a probiotic, with or without a prokinetic agent such as metoclopramide taken 3 times daily. RESULTS: Dietary interventions alone were deemed successful in 60% of study subjects (n = 21); the remaining 14 patients required additional treatment. CONCLUSIONS: Dietary modifications alone relieved constipation in more than half of a group of 35 patients with constipation. We therefore recommend a trial of dietary modifications prior to the initiation of pharmacotherapy in patients with a colostomy.


Assuntos
Colostomia/efeitos adversos , Constipação Intestinal/etiologia , Resultado do Tratamento , Idoso , Constipação Intestinal/dietoterapia , Constipação Intestinal/enfermagem , Fibras na Dieta/farmacologia , Fibras na Dieta/uso terapêutico , Feminino , Humanos , Laxantes/farmacologia , Laxantes/uso terapêutico , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos
17.
Br J Nurs ; 26(2): 76-80, 2017 Jan 26.
Artigo em Inglês | MEDLINE | ID: mdl-28132549

RESUMO

Progress has been made in the past year in the guidance available for health professionals caring for patients with irritable bowel syndrome (IBS). In April 2016, the first National Institute for Health and Care Excellence (NICE) quality standard on IBS in adults was published and new dietary guidelines were developed. Nurses are at the forefront of caring for people with IBS across all healthcare sectors and may have more time to understand the patient's perspective and advise on lifestyle changes than a general practitioner in the average 10-minute consultation. Rapid diagnosis and evidence-based treatments using treatment pathways significantly reduces healthcare costs in primary care and improves quality of life. First-line treatment modalities remain a combination of lifestyle factors, diet and medications, but for persistent refractory symptoms, referral to specialist practitioners should be considered. This article aims to update nurses on new practice guidance and provide information on when it is appropriate to refer patients for specialist care.


Assuntos
Constipação Intestinal/enfermagem , Síndrome do Intestino Irritável/enfermagem , Cuidados de Enfermagem/normas , Guias de Prática Clínica como Assunto , Atenção Primária à Saúde/normas , Melhoria de Qualidade/normas , Medicina Estatal/normas , Adulto , Idoso , Idoso de 80 Anos ou mais , Constipação Intestinal/diagnóstico , Feminino , Humanos , Síndrome do Intestino Irritável/diagnóstico , Masculino , Pessoa de Meia-Idade , Qualidade de Vida , Reino Unido
18.
J Clin Nurs ; 26(3-4): 495-501, 2017 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-27404560

RESUMO

AIMS AND OBJECTIVES: To analyse the impact of preoperative defecation pattern on postoperative defecation pattern for patients undergoing cardiac surgery. BACKGROUND: Constipation is a neglected problem that occurs frequently after cardiac surgery. DESIGN: Descriptive study. METHOD: The study sample comprised 102 patients who underwent cardiac surgery. A Descriptive Information Form, Rome III Diagnostic Criteria, Constipation Severity Instrument, Postoperative Defecation Pattern Evaluation Form and Bristol Stool Form Scale were used for data collection and analysis. RESULTS: The Constipation Severity Instrument scores of just over one-third (37·2%) of the patients who were constipated prior to surgery were higher compared to those who were not constipated. Following cardiac surgery, 39·2% of patients developed constipation and 80% of these patients were constipated prior to cardiac surgery. The findings indicate a significantly high relationship between preoperative and postoperative defecation pattern (r = 0·71, p < 0·001). CONCLUSION: Preoperative defecation pattern is a determining factor for the development of postoperative constipation for patients undergoing cardiac surgery. RELEVANCE TO CLINICAL PRACTICE: During the preoperative period, clinical nurses may evaluate the patients' defecation patterns using valid and reliable scales and follow the defecation of the patients, especially patients with defecation problems, during the postoperative period.


Assuntos
Procedimentos Cirúrgicos Cardíacos/efeitos adversos , Constipação Intestinal/etiologia , Constipação Intestinal/enfermagem , Defecação , Cuidados Pré-Operatórios/enfermagem , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Período Pós-Operatório
19.
J Palliat Med ; 20(5): 528-532, 2017 05.
Artigo em Inglês | MEDLINE | ID: mdl-27754744

RESUMO

OBJECTIVE: The aim of this work was to investigate whether variables identified as likely to impact the experience of constipation in other clinical settings similarly affected the experiences of constipated palliative care patients. BACKGROUND: The majority of palliative care patients with cancer are likely to be bothered by constipation symptoms at some point in their disease trajectory. Despite this, it remains unclear as to which factors predict more severe problems. METHODS: This study was conducted in a sample of 94 constipated palliative care patients who were asked to voluntarily complete a series of questions regarding their demographic and other characteristics, including whether they had chronic constipation symptoms, that is, constipation symptoms for 12 months. Other variables included age, body mass index, sex, performance status, and regular opioids and their doses. At the same time, they were asked to complete the Patient Assessment of Constipation Symptoms (PAC-SYM) and Patient Assessment of Constipation Quality of Life (PAC-QOL) questionnaires. RESULTS: Descriptive statistics summarized baseline data. Unadjusted associations between the selected variables on PAC-SYM were examined by using bi-variate analyses. Significant variables identified on bi-variate analyses were included in a multivariate analysis. The final results identified that only the chronicity of constipation symptoms predicted more severe symptoms. This relationship persisted when this single variable was retained in the final model, illustrating that PAC-SYM scores are 0.41 higher in patients with chronic constipation compared with those without it (p = 0.02). In contrast, regular opioid use was not identified as a significant factor (p = 0.56). DISCUSSION: This study suggests that the factor most likely to predict worse constipation symptoms was the duration that people had experienced problems. Further, those who perceived their constipation symptoms to be more severe had a poorer quality of life. More work is required to better define constipation risk factors and ways to best modify a patient's experiences.


Assuntos
Analgésicos Opioides/efeitos adversos , Constipação Intestinal/induzido quimicamente , Constipação Intestinal/enfermagem , Transtornos Relacionados ao Uso de Opioides/etiologia , Cuidados Paliativos/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários
20.
Br J Nurs ; 25(22): 1231-1242, 2016 12 08.
Artigo em Inglês | MEDLINE | ID: mdl-27935351

RESUMO

Constipation is a common childhood condition that health professionals will encounter in many different settings. The majority of these cases of childhood constipation are idiopathic in nature. It is considered to exhibit the 'tip of the iceberg' phenomenon as a large number of cases remain undetected due to under-recognition by families, embarrassment regarding the condition, fear of receiving a negative response from health professionals, or parental belief there is actually something more seriously wrong and failure to accept the diagnosis. Prompt evaluation and management is likely to be associated with better outcomes. To ensure this, fast recognition of symptoms, with care taken to exclude any 'red flag' symptoms that could indicate an organic cause and subsequently a different treatment pathway, is essential. Nurses, given their regular contact with families in different settings, are suitably placed to detect these symptoms early and can play a vital role in successful management of the condition. Laxatives are the first line in management of constipation. Polyethylene glycol 3350 is the laxative that evidence-based guidelines from the National Institute for Health and Care Excellence (2010) recommend as the initial pharmacological management. Advice should also be given about supportive measures, including diet and lifestyle changes.


Assuntos
Constipação Intestinal/enfermagem , Papel do Profissional de Enfermagem , Criança , Constipação Intestinal/diagnóstico , Constipação Intestinal/terapia , Dieta , Gerenciamento Clínico , Enema , Humanos , Laxantes/uso terapêutico , Polietilenoglicóis/uso terapêutico , Padrões de Prática em Enfermagem
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