Background: Structural planning is essential for the management of constipation in stroke patients. The current study aims to determine the impact of a care plan on the frequency of new-onset constipation following stroke. Materials and Methods : This clinical trial was conducted on 132 stroke patients (two groups of 66) in three phases (pre-intervention, during discharge, 1 month after discharge). Clients were randomly assigned to blocks based on gender, type of stroke, and age. The care plan according to the nursing process was conducted. Data collection tools included a demographic–clinical information questionnaire, Rome IV criteria (diagnosis of constipation), and Bristol scale (consistency of stool). Data were analyzed using the Chi-square, McNemar, Wilcoxon, Analysis of Variance (ANOVA), and a general estimated model. Results: The prevalence of new-onset constipation following stroke in the control group decreased from 66 (100%) at admission to 39 (67.20%) at discharge and in the intervention group from 66 cases (100%) to 18 cases (34%) (p = 0.001), but it was not significant at follow-up (p = 0.16). The trend of frequency of constipation from admission to follow-up was generally significant in the intervention group (p = 0.03) vs the control group (p = 0.21). The difference in the mean number of cases of constipation was statistically significant (2.89) 2.10) control group vs 1.58 (1.65) intervention group, p < 0.001). Conclusions: A significant impact of the care plan was observed from admission to discharge, but further follow-up was required with more client-side collaboration. Therefore, the present care plan is recommended in the hospital and home care.
Introduction: The impacts of new-onset constipation outcomes in stroke clients have remained unclear. It seems helpful to update the structure planning with nursing-led intervention. Objective: The current study aimed to present a protocol and methods of Caspian Nursing Process Projects in new-onset constipation by nursing-led intervention considering the experts’ point of view. Materials and Methods: The current multi-stage evolutionary study describes the protocol and methods of Caspian Nursing Process Projects, which were conducted on stroke constipation, such as new-onset constipation. The study was conducted in several phases, including searching for scientific sources, formal-content validity, RAND and Delphi methods, and changes made at the Delphi stage and the experts’ panel. We selected 21 studies published between January 2004 and December 2019 in the Cochran database, Medline, Science Direct, PubMed, Elsevier, and Scopus. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and AGREE II (The Appraisal of Guidelines for Research & Evaluation) were used to evaluate the articles and guidelines. Results: After considering the inclusion and exclusion criteria, 14 articles and guidelines were entered. Most of the authorities were 16 men (72.7%), 11 cases had MD degrees (50%), and 4 (18.2%) were neurologists. Regarding the priority, the highest agreement was found on patient and companion education (98%) and the lowest on disability in daily activity (75.6%). In terms of benefits, patient education again achieved the highest agreement with 97.2%, and use of the Bartel index with 73.6% obtained the lowest agreement. Regarding the applicability, registration, and reporting, the water and electrolyte impairment and educational booklet obtained the highest agreement with 93.6%. Conclusion: All recommendations had reached over 70% agreement in all four areas of the initial draft, and some care should be taken only by stroke nurses or critical care nursing. The study results can be used for developing national guidelines or criteria.
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