Journal of muscle and joint health (근관절건강학회지)

Korean Society of Muscle and Joint Health (대한근관절건강학회)
권호 표지
DOI QR코드

DOI QR Code

Effects of Defecation Encouragement Program in Patients Undergoing total Knee Replacement Arthroplasty

배변 격려 프로그램이 인공 슬관절 전치환술 환자의 배변에 미치는 효과

  • Received : 2022.07.25
  • Accepted : 2022.08.23
  • Published : 2022.08.31
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: The purpose of this study was to evaluate the efficacy of applying a defecation encouragement program for patients undergoing total knee replacement arthroplasty (TKRA). Methods: This program was based on the nursing best practice guideline: prevention of constipation in the older adult population by the National Guideline Clearing House (NGC) in 2011, which included fluid intake, bowel training, and abdominal and pelvic floor exercises. A team of one orthopaedic clinical nurse specialist and six orthopaedic nurses with a 10 years of clinical experience applied and assisted patients with the program. Formal counsel was provided by one orthopaedic doctor, one gastroenterologist, and one exercise therapist. Patients who defecated one day prior to or on the day of TKRA surgery were included. Data collected from 72 subjects were analyzed using SPSS/WIN 21.0. Results: Time until first defecation after surgery was 2.4±1.1 days in experimental group, which was significantly shorter than the 3.5±0.9 days in control group (t=4.28, p<.001). Constipation assessment scale showed significantly lower points (t=2.55, p=.013) in experimental group (1.3±1.2) compared to control group (2.6±2.6). The experimental group and control group were 17.3±7.67 and 23.7±14.43, respectively, and the experimental group used less laxatives (t=2.83, p=.021). Conclusion: A defecation encouragement program was proved to be an appropriate nursing intervention for patients undergoing TKRA. This study confirmed that constipation is a nursing problem that can be sufficiently prevented if nurses are interested and encourage defecation.

Keywords

Acknowledgement

본 연구는 2016년 서울아산병원 간호부에서 지원한 연구비로 수행하였음.

References

  1. Bouras, E. P., & Tangalos, E. G. (2009). Chronic constipation in the elderly. Gastroenterology clinics of North America, 38(3), 463-480. https://doi.org/10.1016/j.gtc.2009.06.001
  2. Bouvier, M., Meance, S., Bouley, C., Berta, J. L., & Grimaud, J. C. (2001). Effects of consumption of a milk fermented by the probioticstrain Bifidobacterium animalis DN-173010 on colonic transittimes in healthy humans. Bioscience and Microflora, 20(2), 43-48. https://doi.org/10.12938/bifidus1996.20.43
  3. Choi, J. Y. (2004). Effects of a constipation intervention program on inpatients defecation. Journal of Korean Academy Nursing, 34(1), 72-80. https://doi.org/10.4040/jkan.2004.34.1.72
  4. Davies, E. C., Green, C. F., Mottram, D. R., & Pirmohamed, M. (2008). The use of opioids and laxatives, and incidence of constipation, in patients requiring neck-of-femur(NOF) surgery: a pilot study. Journal of Clinical Pharmacy and Therapeutics, 33(5), 561-566. https://doi.org/10.1111/j.1365-2710.2008.00949.x
  5. De Lillo, A. R., & Rose, S. (2000). Functional bowel disorders in the geriatric patient: constipation, fecal impaction, and fecal incontinence. The American Journal of Gastroenterology, 95(4), 901-905. https://doi.org/10.1111/j.1572-0241.2000.01926.x
  6. DeSouza. (2002). Effectiveness of nursing interventions in alleviating perceived problems among orthopaedic patients. Journal of Orthopaedic Nursing, 6(4), 211-219. https://doi.org/10.1016/S1361-3111(02)00093-6
  7. Kennedy, J. W., Johnston, L., Cochrane, L., & Boscainos, P. J. (2013). Total knee arthroplasty in the elderly: does age affect pain, function or complications?. Clinical Orthopaedics and Related Research, 471(6), 1964-1969. https://doi.org/10.1007/s11999-013-2803-3
  8. Kim, Y. A. & Choi, S. Y. (2013). The effects of abdominal meridian massage on constipation to CVA patients. Journal of the Korean Data Analysis Society, 15(2), 859-872.
  9. Koloski, N. A., Jones, M., Wai, R., Gill, R. S., Byles, J., & Talley, N. J. (2013). Impact of persistent constipation on health-related quality of life and mortality in older community-dwelling women. The American Journal of Gastroenterology, 108(7), 1152-1158. https://doi.org/10.1038/ajg.2013.137
  10. Koppen, I. J., Lammers, L. A., Benninga, M. A., & Tabbers, M. M. (2015). Management of functional constipation in children: therapy in practice. Paediatric Drugs, 17(5), 349-360. https://doi.org/10.1007/s40272-015-0142-4
  11. Kyle, G. (2013). The older person: Management of constipation. British Journal of Community Nursing, 15(2), 58-64. https://doi.org/10.12968/bjcn.2010.15.2.46391
  12. Laila, S. M., Brigitte, S., & Lorenz, L. (2016). Constipation prophylaxis in children undergoing orthopedic surgery: A quasiexperimental study. Journal for Specialists in Pediatric Nursing, 21(3), 109-118. https://doi.org/10.1111/jspn.12145
  13. McMillan, S. C., & Williams, F. A. (1989). Validity and reliability of the Constipation Assessment Scale. Cancer Nursing, 12(3), 183-188. https://doi.org/10.1097/00002820-198906000-00012
  14. Myatt, R. (2012). Constipation: a common postoperative complication of cardiac surgery. British Journal of Cardiac Nursing, 7(4), 172-177. https://doi.org/10.12968/bjca.2012.7.4.172
  15. Park, J. H., Yun, S. O., Kim, S. H., Yu, M. G., & Ham, E. J. (2016). Constipation in patients following orthopedic surgery: incidence and influencing factors. Korean Journal of Adult Nursing, 28(6), 637-645. https://doi.org/10.7475/kjan.2016.28.6.637
  16. Park, S. H., Kang, C. B., Jang, S. Y., & Kim, B. Y. (2013). Effect of Kegel exercise to prevent urinary and fecal incontinence in antenatal and postnatal women: systematic review. Journal of Korean Academy of Nursing, 43(3), 420-430. https://doi.org/10.4040/jkan.2013.43.3.420
  17. Rao, S. S., & Go, J. T. (2010). Update on the management of constipation in the elderly: new treatment options. Clinical Interventions in Aging, 5, 163-171. https://doi.org/10.2147/cia.s8100
  18. Registered Nurses'Association of Ontario. (2005, March) Prevention of constipation in the older adult population. Retrieved December 30, 2015, from https://rnao.ca/sites/rnao-ca/files/Prevention_of_Constipation_in_the_Older_Adult_Population.pdf
  19. Ross-Adjie, G. M., Monterosso, L., & Bulsara, M. (2015). Bowel management post major joint arthroplasty: results from a randomised controlled trial. International Journal of Orthopaedic and Trauma Nursing, 19(2), 92-101. https://doi.org/10.1016/j.ijotn.2014.04.002
  20. Sendir, M., Buyukyilmaz, F., Asti, T., & Gurpinar, S. (2012). Postoperative constipation risk assessment in Turkish orthopedic patients. Gastroenterology Nursing, 35(2), 106-113. https://doi.org/10.1097/SGA.0b013e31824d2945
  21. Shin, J. E., Hong, K. S., Chung, K. W., Lee, T. H., Lee, B. Y., Park, S. Y., et al. (2015). Guidelines for the use of laxatives-which laxatives, when? Korean Journal Medicine, 88(1), 22-26. https://doi.org/10.3904/kjm.2015.88.1.22
  22. Silva, C. A., & Motta, M. E. (2013). The use of abdominal muscle training, breathing exercises and abdominal massage to treat paediatric chronic functional constipation. Colorectal disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland, 15(5), e250-e255. https://doi.org/10.1111/codi.12160
  23. Swegle, J. M., & Logemann, C. D. (2006). Management of common opioid-induced adverse effects. American Family Physician, 74(8), 1347-1354.
  24. Toner, F., & Claros, E. (2012). Preventing, assessing, and managing constipation in older adults. Nursing, 42(12), 32-40. https://doi.org/10.1097/01.NURSE.0000422642.83383.17
  25. Yoo, E. H. (2006). Pelvic floor muscle rehabilitation. Korean Journal of Obsterics and Gynecology, 49(9), 1838-1843.