Ph.D. Defence by Mette Trads
Mette Trads will defend her Ph.D. thesis: "Preventing post-operative constipation in elderly orthopedic patients – a challenge in fundamental nursing care"
29.05.2017 kl. 13.00 - 17.00
The prevalence of postoperative constipation is sparsely described. Constipation might have an impact on quality of life. Screening for risk of developing constipation has yet to be validated in a Danish population of orthopedic patients and it is necessary to enable the patients in preventing health problems like constipation.
A prevalence and incidence study: patients with hip fractures were interviewed at admission, discharge and by telephone 30 days after surgery to assess constipation rates. A validation study: patients with hip fractures or with knee or hip replacements were assessed with Constipation Risk Assessment Scale upon admittance or in the outpatient clinic and 30 days after surgery by phone. An intervention study: Quasi-experimental design where patients in a control group received conventional care. A nursing intervention including admission interview with usual defecation pattern and usual intake of fluid and fibers, an individual care plan, principles of primary nursing and continued dialogues with the patient was tested on patients with hip fractures. A systematic review: The methodology of "Joanna Briggs Institute" was used.
Constipation rates were 51.9 % upon admission, 69.1 % at discharge and 62.7 % 30 days after surgery. Usual defecation pattern was re-established after 9.5 days. For the acute and the elective patients sensitivity for the screening tool was 0.67 and 0.57, specificity 0.54 and 0.52, positive predictive value 0.59 and 0.38, negative predictive value 0.63 and 0.7, respectively. Constipation rate 30 days after surgery in the intervention group vs. the control group was significantly lower than in patients and the fiber and fluid intake was significantly higher. In the systematic review all the 13 included studies reported statistically significantly lower health status in the constipated than in the non-constipated subjects with few exceptions.