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AIMS: To describe the prevalence of faecal incontinence in patients with inflammatory bowel disease, assess its severity, and correlation with quality of life. We adhered to relevant EQUATOR guidelines, STROBE method. DESIGN: Correlational-descriptive study. METHODS: Hebrew-speaking patients seen at an inflammatory bowel disease clinic in a large tertiary medical center in Jerusalem between February 2020 and December 2020 completed the Faecal Incontinence Severity Index and the Faecal Incontinence Quality of Life Scale. RESULTS: Ninety-six patients participated in the study, of which 70 (72.9%) had Crohn's disease, and 26 (27.1%) had ulcerative colitis. Eighty-five (88.5%) reported faecal incontinence with an overall Faecal Incontinence Severity Index mean of 27.66 (SD 15.99), yet only 14 (14.7%) reported that their physician or nurse inquired about faecal incontinence. Quality of life scores for patients with faecal incontinence was the lowest on the coping/behaviour scale (M = 2.44; SD 0.94) and the highest on the depression/self-perception scale (M = 2.86; SD 1.04). Significant correlations were found between faecal incontinence severity and quality of life in all scales except for self-embarrassment. Moderate correlations in the same scales were noted in patients with Ulcerative Colitis, while no significant correlations were found in the Crohn's Disease group. CONCLUSION: A high proportion of inflammatory bowel disease patients reported faecal incontinence associated with impaired quality of life. Only a few were questioned about faecal incontinence by their physician or nurse. IMPACT: There is limited literature regarding the prevalence and severity of faecal incontinence in inflammatory bowel disease patients. A high proportion of patients reported faecal incontinence, which negatively correlated with quality of life. Physicians and nurses must inquire about faecal incontinence to improve patient care. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.
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BACKGROUND: Low anterior resection syndrome (LARS) is a result of removing part or most of the rectum as a treatment for rectal cancer that negatively impacts quality of life. There is a lack of standardized nursing symptom-specific self-care recommendations for patients suffering from LARS. OBJECTIVE: The aim of this study was to map the existing research regarding nursing guidelines and symptom-specific recommendations for LARS self-care. METHODS: A systematic scoping review using 4 comprehensive databases (ProQuest, EMBASE, PubMed, and Web of Science) was completed using the PRISMA Extension for Scoping Reviews guidelines. Applying specified search terms, relevant articles were extracted using criteria and entered into an Excel database. RESULTS: Three publications met the study inclusion criteria: 1 randomized controlled pilot study; 1 nonrandomized, retrospective pilot study; and 1 retrospective, comparative, cross-sectional study. No professional nursing guidelines were found, but 3 nurse-led management programs were reviewed. Publications provided self-care nursing recommendations for all LARS symptoms except for repeated painful stools/tenesmus, soiling, or discrimination disorders/flatulence. Combination of nursing self-care recommendations included dietary/lifestyle modifications, fiber supplements/bulking agents, antidiarrheal and laxative over-the-counter medications, and pelvic floor muscle exercises. CONCLUSIONS: When mapping the literature, there appears to be nurse-led management programs and recommendations for self-care for patients with LARS for almost all symptoms. Yet, there are no standardized recommendations. IMPLICATIONS FOR PRACTICE: Professional nursing practice guidelines for all symptoms are lacking. Nursing recommendations for self-care of LARS exist and need to be expanded and standardized to include all symptoms. Further research regarding comprehensive nursing self-care recommendations and management is warranted.