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Behavioral risk factors of constipation in palliative care patients.

Dzierżanowski T, Ciałkowska-Rysz A - Support Care Cancer (2014)

Bottom Line: The exclusion criterion was Karnofsky performance status score ≤20.Spearman's rank correlation coefficient was used to measure the statistical dependence between two variables and frequency analysis was performed using the chi-squared test and Fisher's exact test.We found the correlation between FoBM and insufficient food and fluid intake (p < 0.0001), as well as for inadequate conditions of privacy (p = 0.0008), dependency on a caregiver (p = 0.0059), and the patient's overall performance status (p = 0.013).

View Article: PubMed Central - PubMed

Affiliation: Palliative Care Unit, Medical University in Lodz, Lodz, Poland, tomasz.dzierzanowski@umed.lodz.pl.

ABSTRACT

Background: Constipation is frequently encountered in palliative care patients and remains a significant therapeutic problem. The etiology of constipation is multifactorial. Nutritional and behavioral factors are considered common causes of constipation; however, their impact has not yet been assessed precisely.

Objective: The aim of this study was to assess the correlation between the frequency of bowel movements (FoBM) and risk factors of constipation in palliative care patients.

Design and subjects: A cohort retrospective study was performed in three palliative care centers, including outpatient, home, and inpatient care cancer patients using questionnaires on bowel dysfunction symptoms, behavioral risk factors, and opioid use. The inclusion criterion was adult patients examined on the day of admission. The exclusion criterion was Karnofsky performance status score ≤20.

Measurements: Spearman's rank correlation coefficient was used to measure the statistical dependence between two variables and frequency analysis was performed using the chi-squared test and Fisher's exact test.

Results: Two hundred thirty-seven valid questionnaires were collected. We found the correlation between FoBM and insufficient food and fluid intake (p < 0.0001), as well as for inadequate conditions of privacy (p = 0.0008), dependency on a caregiver (p = 0.0059), and the patient's overall performance status (p = 0.013). We did not manage to prove bed rest as the independent risk factor of constipation.

Conclusions: The main risk factors of constipation in palliative care patients appeared to be insufficient fluid and food intake, inadequate conditions of privacy, dependency on a caregiver, as well as poor general performance status.

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Related in: MedlinePlus

The correlation between the frequency of bowel movements and behavioral factors and Karnofsky performance status score
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Fig1: The correlation between the frequency of bowel movements and behavioral factors and Karnofsky performance status score

Mentions: The degree of immobilization was measured as the percentage of daily activity spent in bed and its mean was 62 %, with the full range of the values possible (0–100 %); however, there were significant differences between inpatient, outpatient, and home care patients (Fig. 1a; p < 0.001). Home care patients appeared much more immobilized than inpatient and ambulatory care patients (mean 44.7 vs. 19.5 and 8.5 %, respectively). Spearman’s rank coefficient of correlation between frequency of bowel movements and the degree of bed rest was −0.13 (p = 0.046); however, with the Bonferroni correction, it appeared insignificant.Fig. 1


Behavioral risk factors of constipation in palliative care patients.

Dzierżanowski T, Ciałkowska-Rysz A - Support Care Cancer (2014)

The correlation between the frequency of bowel movements and behavioral factors and Karnofsky performance status score
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4555193&req=5

Fig1: The correlation between the frequency of bowel movements and behavioral factors and Karnofsky performance status score
Mentions: The degree of immobilization was measured as the percentage of daily activity spent in bed and its mean was 62 %, with the full range of the values possible (0–100 %); however, there were significant differences between inpatient, outpatient, and home care patients (Fig. 1a; p < 0.001). Home care patients appeared much more immobilized than inpatient and ambulatory care patients (mean 44.7 vs. 19.5 and 8.5 %, respectively). Spearman’s rank coefficient of correlation between frequency of bowel movements and the degree of bed rest was −0.13 (p = 0.046); however, with the Bonferroni correction, it appeared insignificant.Fig. 1

Bottom Line: The exclusion criterion was Karnofsky performance status score ≤20.Spearman's rank correlation coefficient was used to measure the statistical dependence between two variables and frequency analysis was performed using the chi-squared test and Fisher's exact test.We found the correlation between FoBM and insufficient food and fluid intake (p < 0.0001), as well as for inadequate conditions of privacy (p = 0.0008), dependency on a caregiver (p = 0.0059), and the patient's overall performance status (p = 0.013).

View Article: PubMed Central - PubMed

Affiliation: Palliative Care Unit, Medical University in Lodz, Lodz, Poland, tomasz.dzierzanowski@umed.lodz.pl.

ABSTRACT

Background: Constipation is frequently encountered in palliative care patients and remains a significant therapeutic problem. The etiology of constipation is multifactorial. Nutritional and behavioral factors are considered common causes of constipation; however, their impact has not yet been assessed precisely.

Objective: The aim of this study was to assess the correlation between the frequency of bowel movements (FoBM) and risk factors of constipation in palliative care patients.

Design and subjects: A cohort retrospective study was performed in three palliative care centers, including outpatient, home, and inpatient care cancer patients using questionnaires on bowel dysfunction symptoms, behavioral risk factors, and opioid use. The inclusion criterion was adult patients examined on the day of admission. The exclusion criterion was Karnofsky performance status score ≤20.

Measurements: Spearman's rank correlation coefficient was used to measure the statistical dependence between two variables and frequency analysis was performed using the chi-squared test and Fisher's exact test.

Results: Two hundred thirty-seven valid questionnaires were collected. We found the correlation between FoBM and insufficient food and fluid intake (p < 0.0001), as well as for inadequate conditions of privacy (p = 0.0008), dependency on a caregiver (p = 0.0059), and the patient's overall performance status (p = 0.013). We did not manage to prove bed rest as the independent risk factor of constipation.

Conclusions: The main risk factors of constipation in palliative care patients appeared to be insufficient fluid and food intake, inadequate conditions of privacy, dependency on a caregiver, as well as poor general performance status.

Show MeSH
Related in: MedlinePlus