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Park, Yun, Kim, Yu, and Ham: Constipation in Patients following Orthopedic Surgery: Incidence and Influencing Factors
Original Article

Korean Journal of Adult Nursing 2016; 28(6): 637-645.

Published online: 31 December 2016

DOI: https://doi.org/10.7475/kjan.2016.28.6.637

Constipation in Patients following Orthopedic Surgery: Incidence and Influencing Factors

Jeong Hee Park, MSN, APN1, Sun Ok Yun, MSN2, Sun Hwa Kim, MSN, APN1, Mi Gyeong Yu, RN3, Eun Jin Ham, RN3

1APN, Asan Medical Center, Seoul, Korea.

2Unit Manager, Department of Nursing, Asan Medical Center, Seoul, Korea.

3Nurse, Department of Nursing, Asan Medical Center, Seoul, Korea.

Corresponding author: Park, Jeong Hee. Clinical Nurse Specialist, Asan Medical Center, 88 Olympic-ro, 43-gil, Songpa-gu, Seoul 05505, Korea. Tel: +82-2-3010-6773, Fax: +82-2-3010-8555, antiruna@amc.seoul.kr

Received 12 September 2016       Revised 30 November 2016       Accepted 13 December 2016

© 2016 Korean Society of Adult Nursing

Korean Society of Adult Nursing

(open-access):

This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

The purpose of this study was to identify the occurrences and the factors contributing to constipation in the post surgical period following major orthopedic surgery.

Methods

The sample included 133 patients who had surgery of the hip, knee, or spine. Patients were excluded from the study if there was a history of bowel surgery or constipation from chart review. Data were collected using questionnaires such as Korean version of Modified Barthel index (K-MBI), Hospital Anxiety and Depression Scale, and Constipation Assessment Scale (CAS) before surgery and on the third postoperative day.

Results

Reports of constipation occurred in 77 instances (57.9%). The first reported defecation was within 4.0±2.2 days following surgery. Mean days of first defecation of constipation group vs. non-constipation group was 5.5±1.7 days vs. 2.1±1.0 days. There were statistically significant differences between patients who reported than those who did not in terms of age, length of NPO period, postoperative ADL, and the reported incidents of preoperative and postoperative depressive symptoms. Postoperative ADL, age, and NPO period were significant influencing factors of constipation and explained 52.4% of the variance.

Conclusion

Constipation is a very common symptom for patients undergoing orthopedic surgery. These results indicate a need for improving patient's ADL after surgery to prevent constipation.

Keywords: Constipation, Orthopedics, Postoperative period

Figures and Tables

Table 1

Incidence of Constipation and Postoperative First Defecation in Patients underwent Orthopedic Surgery (N=133)

kjan-28-637-i001
Table 2

Comparison of Characteristics between Constipation Group and Non-constipation Group (N=133)

kjan-28-637-i002

NPO=Nil per os[Latin for "nothing by mouth"], IV PCA=intravenous patient controlled analgesia.

Table 3

Comparison of ADL, Depression, and Constipation Degree between Constipation Group and Non-constipation Group (N=133)

kjan-28-637-i003

ADL=activities of daily living, Pre-op=preoperative, POD=post operative day.

Table 4

Influencing Factors on Constipation in Patients following Orthopedic Surgery (N=133)

kjan-28-637-i004

ADL=activities of daily living, NPO=Nil per os [Latin for "nothing by mouth"].

Notes

This study was supported by the research grant of Asan Medical Center Nursing department in 2013.

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