The effect of lifestyle modification on severity of constipation and quality of life of elders in nursing homes at Ismailia city, Egypt

Abstract

Background:Constipation has a significant impact on the quality of life (QOL). Lifestyle modification is widely accepted and recommended by experts as first-line therapy.Aim:This study aimed at using education on lifestyle modification to improve the QOL of the elderly in nursing homes suffering from functional constipation (FC).Materials and Methods:This study was conducted in nursing homes in Ismailia city, Egypt. It involved 23 elderly patients suffering from FC, who were randomly selected according to the sample equation. They fulfilled the inclusion criteria of being ≥60 years age and according to Rome II criteria. Participants completed personal characteristics and lifestyle questionnaire, the Patient Assessment of Constipation Symptom questionnaire (PAC-SYM) to assess the severity of symptoms, and the Patient Assessment of Constipation Quality of Life Questionnaire (PAC-QOL) to assess pre- and post-intervention. The intervention was conducted in three sessions, of 30 min each, 2 weeks apart using group discussions to educate the sample about dietary pattern, fluid intake, regular physical activity, and the use of laxatives. Statistical analysis: Data were analyzed using a statistical package for social sciences (SPSS version 20).Results:The lifestyle modification education on constipation significantly reduced the severity of symptoms as measured by PAC-SYM, including its total score and subscores (P < 0.001). It also improved the QOL of elderly suffering from constipation as measured by PAC-QOL and reduced total scores of dissatisfaction (P = 0.001) with the exception of the psychosocial subscale. It also significantly increased the satisfaction subscale of PAC-SYM (P < 0.001).Conclusion:Education on lifestyle modification leads to an improvement in the severity of the symptoms of constipation and the QOL of the elderly in nursing homes.

Constipation is casting a shadow over everyday life – a systematic review on older people's experience of living with constipation

“…Improvement in the satisfaction subscale was also identified in a recent pre‐ to postintervention study intervening with three sessions of group‐based health education ( n = 23); the mean score changed from 5·3 (SD 1·7)–10·6 (SD 2·5) ( p < 0·001) (Nour‐Eldein et al . ). Marteau et al .…”

“…Only one pre‐ to postintervention study found significant improvement in the subscale of worries in PAC‐QOL after the intervention of group‐based intervention programme focusing on lifestyle modification in relation to constipation (14·4 (SD 11·8) vs. 6·7 (SD 6·1) ( p = 0·004)) (Nour‐Eldein et al . ). The subscale of worries included 11 questions about being worried or irritable about the condition, being afraid it might get worse and feeling less confident or not in control (Marquis et al .…”

Psychometric evaluation of a newly developed Elderly-Constipation Impact Scale

“…'Treatment satisfaction', as factor or an item, is a common inclusion in many constipation-related scales (Li, Lee & Suen, 2014;Müller-lissner et al, 2010;Müller-Lissner et al, 2013;Nour-Eldein et al, 2014). Earlier QoL scales had a 'satisfaction' subscale, but items were heterogeneous and based on frequency and regularity in bowel movements, activities, expectations, values, effectiveness and treatment satisfaction (Marquis et al, 2005;Szeinbach et al, 2009).…”

Responses to the Letter to the Editor by Brusciano et al.

“…[1][2][3] For that reason, we have a low recommendation for isolated changes in fiber intake, but a strong recommendation for a general intervention in the conjunction of lifestyle modifications, including dietary advice, physical exercise, and defecation habits. 4,5 In patients with constipation associated with irritable bowel syndrome, the increment in bowel contents, both water and gases, induced by fibers may be poorly tolerated by these patients, probably related to the visceral hypersensitivity that characterizes this disorder. 6 For that reason, the guideline recommends to use soluble fiber in these patients, and in patients with functional constipation who we strongly recommend this treatment modality.…”