Forekomsten af postoperativ obstipation : en forløbsundersøgelse over 30 dage

I den akutte postoperative fase er obstipation et forsømt problem. International forskning er sparsom, selvom det er vist, at obstipation kan forringe livskvaliteten for patienterne. Symptomerne er mavesmerter, oppustethed, kvalme, anstrengelse ved defækation, alment ubehag for patienterne. Obstipat...

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Bibliographic Details
Main Author: Schütt Rasmussen, Lene
Format: Others
Language:Danish
Published: Nordic School of Public Health NHV 2008
Subjects:
Online Access:http://urn.kb.se/resolve?urn=urn:nbn:se:norden:org:diva-3191
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Summary:I den akutte postoperative fase er obstipation et forsømt problem. International forskning er sparsom, selvom det er vist, at obstipation kan forringe livskvaliteten for patienterne. Symptomerne er mavesmerter, oppustethed, kvalme, anstrengelse ved defækation, alment ubehag for patienterne. Obstipation øger risikoen for postoperative komplikationer, kan forlænge hospitalsindlæggelsen, øge de økonomiske udgifter samt antallet af plejetimer per patient.Formål: At beskrive proportionen af patienter der påvirkes af postoperativ obstipation under indlæggelsen og de første 30 dage postoperativt. At beskrive hvornår obstipation udvikles. At beskrive patientens gener ved postoperativ obstipation og om de påvirker patienternes dagligliv.Metode: En prospektiv forløbsundersøgelse blev valgt. Hvor patienter indlagt til thoraxkirurgi, indgår konsekutivt. Ved indlæggelse, udskrivelse og en måned efter operation blev defækationsmønster, afføringsform og konsistens vurderet ved hjælp af Bristol Stool Scale og et selvudviklet interviewskema. Data er indsamlet af forfatteren som led i MPH - uddannelsen.Resultater: 139 patienter med en gennemsnitsalder på 60 år (+/-14) deltog. 69 % var mænd. 18 % var obstiperede ved indlæggelsen. Efter operationen var 67,2 % obstiperede, og 31,5 % angav, tendens til obstipation en måned postoperativt. Normalt defækationsmønster blev reetableret 11 dage postoperativt med en spredning fra 2 – 30 dage. 22,5 % angav, ifølge Bristol Stool Skalaen at deres fæces ikke havde normaliseret sig en måned efter operationen. Ingen signifikant forskel i angivelse af postoperativ obstipation mellem mænd og kvinder. Patienterne rapporterede mange symptomer på grund af obstipation.Konklusion: Resultaterne af dette studie viser, at postoperativ obstipation påvirker op mod 70 % af patienterne og komplicerer den postoperative fase for patienterne. Resultaterne viser at obstipation påføres patienten under indlæggelsen og at de også har problemer efter udskrivelsen. Litteraturens beskrivelse af, at kvinder har to gange højere risiko for obstipation end mænd, er i kontrast til dette studies resultater. Mere forskning må afgøre om litteraturens resultater kan overføres til patienter, der gennemgår kirurgi. Resultaterne viser at der er behov for systematiske sygeplejeinterventioner i den første postoperative fase og efter udskrivelsen. === In the acute postoperative phase constipation is a neglected problem. International research is sparse, eventhough constipation is shown to reduce quality of life for patients. Symptoms are abdominal pain, bloating,nausea, straining to defecate and a general discomfort for the patients. Constipation increases the risk forpostoperative complications, can prolong hospital stay, increase financial cost, and staff nursing care time.Purposes: To describe the proportion of patients experiencing postoperative constipation during hospital stayand first 30 days after surgery. To describe when constipation develops. To describe the inconvenience patientsfeel with postoperative constipation and if it effects patients daily life.Method: A prospective follow up survey was chosen. Were patients consecutive admitted for cardiothoracicsurgery was included. At admission, discharge and 30 days after surgery defecation pattern, stool form andconsistency were assessed using Bristol Stool scale and a self-developed questionnaire. The data was collectedby the writer as a MPH-education.Results: 139 patients mean age 60(+/-14) participated. 69 % were men. 18 % reported to be constipated whenadmitted. The first period after surgery 67,2 % reported they were constipated and 31,5 % reported tendency toconstipation one month after surgery. Normal pattern of defecation was established at 11 days postoperative(range 2–30 days) and 22,5 % indicated that there stools, had not normalized 30 days after surgery according toBristol Stool Scale. No significant difference in report of postoperative constipation between men and women.The patients reported a number of complaints due to constipation.Conclusion: This survey shows that postoperative constipation affected up to 70% of the patients andcomplicates the postoperative phase for the patients. Results show that constipation is induced the patients atadmission and that they also have problems after discharge. The literatures description of women having 2times higher risk of constipation than men, are in contrast with this survey’s results. More resurge must decideif literatures results can be applied to patients who undergo surgery. Therefore there is a need for systematicnursing intervention in the acute postoperative phase after cardiothoracic surgery and after discharge. === <p>ISBN 978-91-85721-44-3</p>