Bowel problem management among nursing home residents: a mixed methods study

BMC Nursing

Anne Guttormsen Vinsnes¹  Christine Norton³  Siv Mørkved⁴  Arnfinn Seim²  Susan Saga² 

[1] Faculty of Nursing, Sør-Trøndelag University College, Trondheim, 7004, Norway;Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, 7491, Norway;Florence Nightingale Faculty of Nursing and Midwifery, King’s College London, 57 Waterloo Road, London SE1 8WA, UK;Clinical Service, St. Olavs Hospital, Trondheim University Hospital, Trondheim, 7006, Norway

关键词: Focus groups;    Cross-sectional survey;    Nursing homes;    Faecal incontinence;    Diarrhoea;    Constipation;   

Others  :  1090665
DOI  :  10.1186/s12912-014-0035-9

 received in 2014-05-26, accepted in 2014-11-05,  发布年份 2014

【 摘 要 】

Background

Bowel problems such as constipation, diarrhoea and faecal incontinence (FI) are prevalent conditions among nursing home residents and little is known about nursing management. This study aimed to elucidate how Norwegian registered nurses (RNs) manage bowel problems among nursing home residents.

Methods

A mixed methods approach was used combining quantitative data from a population-based cross-sectional survey and qualitative data from a focus group interview. In the cross sectional part of the study 27 of 28 nursing homes in one Norwegian municipality participated. Residents were included if they, at the time of data collection, had been a resident in a nursing home for more than three weeks or had prior stays of more than four weeks during the last six months. Residents were excluded from the study if they were younger than 65 years or had a stoma (N = 980 after exclusions). RNs filled in a questionnaire for residents regarding FI, constipation, diarrhoea, and treatments/interventions. In the focus group interview, 8 RNs participated. The focus group interview used an interview guide that included six open-ended questions.

Results

Pad use (88.9%) and fixed toilet schedules (38.6%) were the most commonly used interventions for residents with FI. In addition, the qualitative data showed that controlled emptying of the bowels with laxatives and/or enemas was common. Common interventions for residents with constipation were laxatives (66.2%) and enemas (47%), dietary interventions (7.3%) and manual emptying of feces (6.3%). In addition, the qualitative data showed that the RNs also used fixed toilet schedules for residents with constipation. Interventions for residents with diarrhoea were Loperamide (18.3%) and dietary interventions (20.1%). RNs described bowel care management as challenging due to limited time and resources. Consequently, compromises were a part of their working strategies.

Conclusions

Constipation was considered to be the main focus of bowel management. Emptying the residents’ bowels was the aim of nursing intervention. FI was mainly treated passively with pads and interventions for residents with diarrhoea were limited. The RNs prioritized routine tasks in the nursing homes due to limited resources, and thereby compromising with the resident’s need for individualized bowel care.

【 授权许可】

   
2014 Saga et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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