Effectiveness of individualised intervention on older residents with constipation in nursing home: a randomised controlled trial

AIMS AND OBJECTIVES: To develop and examine the effectiveness of individualised intervention to reduce constipation among older adults in nursing homes.

BACKGROUND: In long-term care facilities, approximately 60-80% of the residents have symptoms of constipation. Constipation may lead to haemorrhoids, faecal impaction, ulcers, intestinal bleeding and can also lead to a decrease in quality of life. Although a high prevalence of constipation in older adults can be seen, there is a lack of empirical evidence for delivering interventions based on individual risk factors of constipation. Many factors cause constipation but the risk factors are different for each individual.

DESIGN: A prospective, randomised control trial conducted in northern Taiwan.

METHODS: Nursing home residents (n = 43) were randomly assigned to either the control group or the experimental group. The control group received no extra care from the researcher while the experimental group received an individualised intervention and an eight-week follow-up. Participants were assessed using the Bristol Stool Form Scale, the Patient Assessment of Constipation Symptoms, types and dosages of laxative, and bowel sound observations. Data were taken at baseline, four weeks as well as eight weeks after the intervention.

RESULTS: The participants in the experimental group had a significantly higher increase in the frequency of defecation (group effect, p = 0·029) and in bowel sounds (interaction effect, p = 0·010) compared to those in the control group. However, the two groups did not differ significantly in symptoms and the severity of the constipation symptoms, Bristol Stool Form and use of laxatives.

CONCLUSIONS: The results of this trial suggest that the individualised intervention may be appropriate for decreasing constipation among nursing home residents and encourage further study and confirmation.

RELEVANCE TO CLINICAL PRACTICE: Using individualised intervention to enhance the self-care ability related to constipation among older adults is recommended.