EVALUATION OF PHYSICAL, PSYCHOLOGICAL AND CONSTIPATION STATUS OF PATIENTS HOSPITALIZED IN PHYSICAL THERAPY CLINIC

Abstract

Aim: The demographic characteristics and physical conditions of the patients hospitalized in the physical therapy clinic with constipation problems, determining the traditional and intra-clinical medical methods applied by the patient or their caregivers were made descriptive for the purpose of evaluating the psychological effect of constipation on the patient.
Methods: This research was conducted as descriptive. Sample selection was not made and 110 patients who had constipation problems and volunteered were the sample of the study. 'Personal Questionnaire Form', 'Rome III Diagnostic Criteria', ‘Bristol Stool Scale’ and 'Beck Depression Scale' were used by the researchers in the collection of research data.
Results: In our study, 53.6% of the patients were women, 34.5% were 65 years and older, according to the diagnosis group, individuals with hemiplegia constituted 40.9% of the group, and individuals with paraplegia constituted 30% of the group. It was determined that 50.9% of the patients were dependent on mobilization and 41.8% were semi-dependent. It was determined that they mostly used wheelchairs as a walking aid. It was determined that 70% of the patients were dependent on defecation. It was determined that 3/4 of the patients could not defecate for at least three days and this situation was continuous (93.6%), more than half of them used enemas as laxatives and 1/3 of them had moderate depressive symptoms.
Conclusion: According to our research results, immobile and semi-mobile groups mostly consist of patients with constipation problems. It is concluded that the majority of the patients (95.5%) who have constipation problems are below 2500cc daily fluid consumption. Inactivity, low fluid consumption, high number of nutritional meals, and high day of hospitalization affect the constipation.

Keywords

• depression
• nursing
• constipation
• rehabilitation
• stroke

FİZİK TEDAVİ KLİNİĞİNDE YATAN HASTALARIN FİZİKSEL, PSİKOLOJİK VE KONSTİPASYON DURUMLARININ DEĞERLENDİRİLMESİ

Abstract

Amaç: Fizik tedavi kliniğinde yatan ve konstipasyon sorunu yaşayan hastaların demografik özelliklerinin, fiziksel durumlarının belirlenmesi, hasta veya bakıcılarının uyguladıkları geleneksel ve klinik tıbbi yöntemlerin belirlenmesi, konstipasyonun hasta üzerindeki psikolojik etkisinin değerlendirilmesi amacı ile yapılmıştır.
Yöntem: Bu araştırma tanımlayıcı olarak yürütülmüştür. Örneklem seçimine gidilmemiş olup konstipasyon sorunu yaşayan ve gönüllü olan 110 hasta çalışmanın örneklemini oluşturmuştur. Araştırma verilerinin toplanmasında araştırmacılar tarafından oluşturulan ‘Kişisel Anket Formu’, ‘Roma III Tanı Kriterleri’, ‘Bristol Gaita Skalası’ ve ‘Beck Depresyon Ölçeği’ kullanılmıştır.
Bulgular: Çalışmada hastaların %53.6’sı kadın, %34.5’i 65 yaş ve üstü, tanı grubuna göre hemiplejik olan bireyler grubun %40.9’unu, paraplejik olan bireyler grubun %30’unu oluşturdu. Hastaların %50.9’unun mobilizasyonda bağımlı, %41.8’inin yarı bağımlı olduğu belirlendi. Yürümeye yardımcı araç olarak en fazla tekerlekli sandalye kullandıkları belirlendi. Hastaların %70’inin defekasyonda bağımlı olduğu belirlendi. Hastaların 3/4’ünün en az üç gün defekasyona çıkamadığı ve bu durumun süreklilik arz ettiği (%93.6), yarısından fazlasının laksatif olarak lavman kullandığı ve 1/3’ünün orta düzey depresif belirtilere sahip olduğu saptanmıştır.
Sonuç: Araştırma sonuçlarımıza göre konstipasyon sorunu yaşayan hastaları çoğunlukla bağımlı ve yarı bağımlı gruplar oluşturmaktadır. Konstipasyon sorunu yaşayan hastaların çoğunluğunun (%95.5) günlük sıvı tüketiminin 2500 cc altında olduğu sonucuna ulaşılmıştır. Hareketsizlik, sıvı tüketiminin az olması, beslenme öğün sayısı, yatış süresi konstipasyonu etkilemektedir.

Keywords

• depresyon
• hemşirelik
• konstipasyon
• rehabilitasyon
• strok

References

1. 1. Korkmaz YÖ. Yaşlılarda Konstipasyon Yönetimi. Hemşirelikte Eğitim ve Araştırma Dergisi 2009; 6(2): 10-5.
2. 2. Kasap E, Bor S. Fonksiyonel barsak hastalığı prevalansı. Güncel Gastroenteroloji 2006; 10(2): 165-8.
3. 3. Uysal N, Khorshid L, Eser I. The identification of constipation problem in healthy young individuals. TAF Preventive Medicine Bulletin 2010; 9(2): 127-32.
4. 4. Tufan A, Akın S. Yaşlıda Konstipasyon ve Fonksiyonel Dispepsi. Turkiye Klinikleri Geriatrics-Special Topics 2015; 1(1): 95-9.
5. 5. Chu H, Hou X. Understanding of constipation symptoms and the diagnosis and management of constipation in Chinese physicians. PloS one 2016; 11(3):1-13, e0152801.
6. 6. Morad M, Nelson NP, Merrick J, Davidson PW, Carmeli E. Prevalence and risk factors of constipation in adults with intellectual disability in residential care centers in Israel. Research in developmental disabilities 2007; 28(6): 580-6.
7. 7. Bengi G, Yalçın M, Akpınar H. Kronik konstipasyona güncel yaklaşım. Güncel Gastroenteroloji 2014; 18(2): 181-97.
8. 8. Frank L, Flynn J, Rothman M. Use of a self-report constipation questionnaire with older adults in long-term care. The Gerontologist 2001; 41(6): 778-86.

9. 9. Talley NJ, Jones M, Nuyts G, Dubois D. Risk factors for chronic constipation based on a general practice sample. The American Journal of Gastroenterology 2003; 98(5): 1107-11.
10. 10. Kaya N, Turan N. Konstipasyon Ciddiyet Ölçeğinin Güvenilirlik ve Geçerliliği. Turkiye Klinikleri Journal of Medical Sciences 2011; 31(6): 1491-501.
11. 11. Caspersen CJ, Powell KE, Christenson GM. Physical activity, exercise, and physical fitness: definitions and distinctions for health-related research. Public Health Reports 1985;100:126-31.
12. 12. Orhan C, Akbayrak T, Kaya S, Kav T, Günel MK. Fiziksel aktivite seviyesi ile konstipasyon şiddeti arasındaki ilişkinin incelenmesi. Journal of Exercise Therapy and Rehabilitation 2015;2(2):66-73.
13. 13. Kim HS, Park DH, Kim JW, Jee MG, Baik SK, Kwon SO, et al. Effectiveness of walking exercise as a bowel preparation for colonoscopy: a randomized controlled trial. American Journal of Gastroenterology 2005;100(9):1964-9.
14. 14. Dukas L, Willett WC, Giovannucci EL. Association between physical activity, fiber intake, and other lifestyle variables and constipation in a study of women. American Journal of Gastroenterology 2003;98(8):1790-6.
15. 15. Mugie SM, Benninga MA, Di Lorenzo C. Epidemiology of constipation in children and adults: a systematic review. Best Practice and Research Clinical Gastroenterology 2011;25:3-18.
16. 16. Noiesen E, Trosborg I, Bager L, Herning M, Lyngby C, Konradsen H. Constipation–prevalence and incidence among medical patients acutely admitted to hospital with a medical condition. Journal of Clinical Nursing 2014; 23(15-16): 2295-302.
17. 17. Brown E, Henderson A, McDonagh A. Exploring the causes, assessment and management of constipation in palliative care. International Journal of Palliative Nursing 2009; 15(2): 58-64.
18. 18. Kimberly BS. Constipation in the elderly: implication in skilled nursing facilities. Director (Cincinnati, Ohio) 2007; 15(3): 20-23.
19. 19. Uz B, Türkay C, Bavbek N, Işık A, Erbayrak M, Uyar ME. Konstipasyon saptanan olgularımızın değerlendirilmesi. Akademik Gastroenteroloji Dergisi 2006; 5(1): 56-9.
20. 20. Lewis SJ, Heaton KW. Stool form scale as a useful guide to intestinal transit time. Scandinavian Journal of Gastroenterology 1997; 32: 920-4.
21. 21. Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J. An inventory for measuring depression. Arch Gen Psychiatry 1961; 4: 561-71.
22. 22. Hisli ŞN. Beck Depresyon Envanterinin geçerliği üzerine bir çalışma. Psikoloji Dergisi 1988; 6:118-26.
23. 23. Chu H, Zhong L, Li H, Zhang X, Zhang J, Hou X. Epidemiology characteristics of constipation for general population, pediatric population, and elderly population in China. Hindawi Publishing Corporation, Gastroenterology Research and Practice, 16.10.2014; 2014: 1-11.
24. 24. Kılıç Z, Yılmaz U, Karakaya MG. Relation of constipation problem and physical activity level in university students. TAF Preventive Medicine Bulletin 2015; 14(4): 329-32.
25. 25. Bilgiç Ş, Dilek F, Arslan HSA, Ünal A. Bir Huzurevinde Yaşayan Yaşlıların Konstipasyon Durumları ve Etkileyen Faktörler. International Journal of Basic and Clinical Medicine 2016; 4(1): 9-16.
26. 26. Karakaya Çİ, Kılıç Z, Yılmaz U, Karakaya MG. Relation of constipation problem and physical activity level in university students. TAF Preventive Medicine Bulletin 2015; 14(4): 329-32.
27. 27. Ayaş S, Leblebici B, Sözay S, Bayramoğlu M, Niron EA. The effect of abdominal massage on bowel function in patients with spinal cord injury. American Journal of Physical Medicine & Rehabilitation 2006; 85(12): 951-5.
28. 28. Cheng C, Chan AOO, Hui WM, Lam SK. Coping strategies, illness perception, anxiety and depression of patients with idiopathic constipation: a population based study. Alimentary Pharmacology & Therapeutics 2003; 18(3): 319-26.
29. 29. Bouchoucha M, Hejnar M, Devroede G, Boubaya M, Bon C, Benamouzig R. Patients with irritable bowel syndrome and constipation are more depressed than patients with functional constipation. Digestive and Liver Disease 2014; 46(3): 213-8.
30. 30. Zhou L, Lin Z, Lin L, Wang M, Zhang H. Functional constipation: implications for nursing interventions. Journal of Clinical Nursing 2010; 19(13‐14): 1838-43.
31. 31. Hosseinzadeh ST, Poorsaadati S, Radkani B, Forootan M. Psychological disorders in patients with chronic constipation. Gastroenterology and Hepatology from bed to bench 2011; 4(3): 159-63.
32. 32. Mason HJ, Serrano-Ikkos E, Kamm MA. Psychological morbidity in women with idiopathic constipation. The American Journal of Gastroenterology 2000; 95(10): 2852-7.
33. 33. Nellesen D, Chawla A, Oh DL, Weissman T, Lavins BJ, Murray CW. Comorbidities in patients with irritable bowel syndrome with constipation or chronic idiopathic constipation: a review of the literature from the past decade. Postgraduate Medicine 2013; 125(2): 40-50.
34. 34. Nehra V, Bruce BK, Rath-Harvey DM, Pemberton JH, Camilleri M. Psychological disorders in patients with evacuation disorders and constipation in a tertiary practice. The American Journal of Gastroenterology 2000; 95(7): 1755-8.