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Plante E, Rhudy L. Bowel Management in the Acute Phase of Spinal Cord Injury. J Neurosci Nurs 2024; 56:113-117. [PMID: 38833487 DOI: 10.1097/jnn.0000000000000762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2024]
Abstract
ABSTRACT BACKGROUND: Neurogenic bowel and bladder are well-known complications of spinal cord injury. During the acute phase of recovery from spinal cord injury, spinal shock occurs, resulting in loss of reflexes and peristalsis of the gastrointestinal tract. These impairments can result in complications in the gastrointestinal tract and, secondarily, the respiratory system due to the distention of the abdomen. Current guidelines for bowel management target the chronic phase of spinal cord injury after a diagnosis of neurogenic bowel dysfunction can be made. METHODS: The purpose of this literature review was to determine evidence-based recommendations for bowel management during the acute phase of spinal cord injury. A systematic search using the databases CINAHL, PubMed, Cochrane Library, and ProQuest was used to identify relevant evidence. RESULTS: The available evidence is based on expert consensus, is dated, and tends to be based on studies conducted during the chronic phase of injury. Careful assessment of the symptoms of bowel dysfunction would indicate that during the acute phase of spinal cord injury, spinal shock causes a patient to experience an areflexive bowel pattern where bowel motility is limited and reflexes are absent. Management of areflexive bowel includes establishment of a daily bowel program including manual removal of stool. To improve emptying of stool, factors such as rectal and oral medications, fluid, fiber, and activity may be adjusted according to need. CONCLUSION: There is limited evidence focused specifically on bowel management in the acute phase of spinal cord injury. Bowel management is complex and multifaceted and needs to be individualized to the patient as well as frequently reevaluated with changes in condition. Further research is needed to evaluate outcomes for bowel management in the acute phase of spinal cord injury to promote best practices.
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Ma S, Zheng X, Gu J, Yang Y, Li C, Li Y, Fan X. Experience of rehabilitation specialist nurses in providing bowel care for stroke patients: A qualitative study. J Adv Nurs 2024; 80:1523-1530. [PMID: 37855380 DOI: 10.1111/jan.15907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 10/03/2023] [Accepted: 10/10/2023] [Indexed: 10/20/2023]
Abstract
AIMS This study aims to explore the experiences of rehabilitation specialist nurses in providing bowel care to stroke patients and to identify the factors that either facilitate or hinder their practice. DESIGN This was a descriptive qualitative design study. METHODS Between May 2022 and October 2022, we conducted in-depth and semi-structured interviews with 12 rehabilitation specialist nurses from two tertiary hospitals in Changsha, China. Thematic analysis was employed to analyse the interview transcripts. FINDINGS Three key themes were revealed from our analysis: (1) acceptance of bowel care as a process, (2) high level of recognition improves the experience and (3) challenges stemming from limited knowledge and rights. Acceptance of bowel care as a dynamic process, coupled with a high level of recognition, enabled nurses to prioritize the health and safety of patients over personal feelings and achieve professional accomplishments. However, they encountered challenges in terms of professional development and restricted prescribing rights for bowel care. CONCLUSION The experiences of rehabilitation specialist nurses in providing bowel care are dynamic. These findings have important implications for healthcare improvement, including the need for collaboration with healthcare professionals and nurturing nurses' self-identity, comprehensive training plans, innovative programs and expanding the scope of rehabilitation specialist nurses' rights. IMPACT This study enhances our understanding of the challenges faced by rehabilitation specialist nurses caring for stroke patients with neurogenic bowel dysfunction. The findings provide insights into how to enhance bowel care experience and develop further in this field. REPORTING METHOD This study adhered to the EQUATOR guideline and utilized the COREQ checklist. PATIENT OR PUBLIC CONTRIBUTIONS This study involved participants who were registered nurses, and there were no contributions from patients or public.
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Affiliation(s)
- Sumin Ma
- School of Nursing, University of South China, Hengyang, China
| | - Xutong Zheng
- School of Nursing, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Jiayi Gu
- Department of Rehabilitation, Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), Changsha, China
| | - Yongkang Yang
- Department of Intensive Care Medicine, Brain Hospital of Hunan, Changsha, China
| | - Chengjuan Li
- School of Nursing, University of South China, Hengyang, China
| | - Yuan Li
- Department of Neurology, Huai'an First People's Hospital, Huaian, China
| | - Xiaoyan Fan
- Nursing Department, First Hospital of Changsha, Changsha, China
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Magnuson FS, Christensen P, Krassioukov A, Rodriguez G, Emmanuel A, Kirshblum S, Krogh K. Neurogenic Bowel Dysfunction in Patients with Spinal Cord Injury and Multiple Sclerosis-An Updated and Simplified Treatment Algorithm. J Clin Med 2023; 12:6971. [PMID: 38002586 PMCID: PMC10672578 DOI: 10.3390/jcm12226971] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 10/27/2023] [Accepted: 11/02/2023] [Indexed: 11/26/2023] Open
Abstract
Neurogenic bowel dysfunction (NBD) is a common condition in individuals with spinal cord injury (SCI) or multiple sclerosis (MS). It usually entails constipation, difficult evacuation of the rectum, and fecal incontinence (FI); often in combination. It is highly burdensome for affected patients and is correlated with poor quality of life. The current treatment algorithm, or treatment pyramid, does not completely correspond to actual clinical practice, and the known and classical pyramid contains both treatments still in their experimental stage as well as several treatments which are not available at all treatment centers. Thus, an updated treatment algorithm is called upon, and the authors of this paper therefore propose a simplified version of the treatment pyramid, aiming to guide clinicians in treating NBD.
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Affiliation(s)
- Fredrika S. Magnuson
- Department of Hepatology and Gastroenterology, Aarhus University Hospital, 8200 Aarhus, Denmark
| | - Peter Christensen
- Department of Surgery, Aarhus University Hospital, 8200 Aarhus, Denmark
| | - Andrei Krassioukov
- International Collaboration of Repair Discoveries (ICORD), Department of Medicine, Division of Physical Medicine and Rehabilitation, The University of British Columbia, Vancouver, BC V5Z 1M9, Canada
| | - Gianna Rodriguez
- Physical Medicine and Rehabilitation, Spinal Cord Injury Medicine, University of Michigan Health, Ann Arbor, MI 48108, USA
| | - Anton Emmanuel
- GI Physiology Unit, University College London Hospital, London WC1E 6DB, UK
| | - Steven Kirshblum
- Kessler Institute for Rehabilitation, West Orange, NJ 07052, USA;
- Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, NJ 07103, USA
| | - Klaus Krogh
- Department of Hepatology and Gastroenterology, Aarhus University Hospital, 8200 Aarhus, Denmark
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Colasante C, Brose SW, Gustafson K, Bourbeau D. Minimally invasive electrical rectal stimulation promotes bowel emptying in an individual with spinal cord injury. J Spinal Cord Med 2023; 46:975-979. [PMID: 37195173 PMCID: PMC10653754 DOI: 10.1080/10790268.2023.2212335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/18/2023] Open
Abstract
CONTEXT Individuals with SCI typically live with neurogenic bowel dysfunction and impaired colonic motility that may significantly impact health and quality of life. Bowel management often includes digital rectal stimulation (DRS) to modulate the recto-colic reflex to promote bowel emptying. This procedure can be time-consuming, caregiver-intensive, and lead to rectal trauma. This study presents a description of using electrical rectal stimulation as an alternative to DRS to help manage bowel emptying in a person with SCI. METHODS We conducted an exploratory case study with a 65-year-old male with a T4 AIS B SCI who normally relies on DRS as the main component of his regular bowel management strategy. In randomly selected bowel emptying sessions during a 6-week period, the participant received burst-pattern electrical rectal stimulation (ERS) (50 mA, 20 pulses/s at 100 Hz), via a rectal probe electrode until bowel emptying was achieved. The primary outcome measure was number of cycles of stimulation required to complete the bowel routine. RESULTS 17 sessions were performed using ERS. In 16 sessions, a bowel movement was produced after only 1 cycle of ERS. In 13 sessions, complete bowel emptying was achieved with 2 cycles of ERS. CONCLUSIONS ERS was associated with effective bowel emptying. This work represents the first time ERS has been used to affect bowel emptying in someone with SCI. This approach could be investigated as a tool to evaluate bowel dysfunction, and it could be further refined as a tool for improving bowel emptying.
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Affiliation(s)
- Cesar Colasante
- SCI/D Center, Syracuse VA, Syracuse, New York, USA
- Department of Physical Medicine and Rehabilitation, SUNY Upstate, Syracuse, New York, USA
| | - Steven W. Brose
- SCI/D Center, Syracuse VA, Syracuse, New York, USA
- Department of Physical Medicine and Rehabilitation, SUNY Upstate, Syracuse, New York, USA
| | - Kenneth Gustafson
- Biomedical Engineering Department, Case Western Reserve University, Cleveland, Ohio, USA
| | - Dennis Bourbeau
- Louis Stokes Cleveland VA Medical Center, Cleveland, Ohio, USA
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Ma S, Fan X, He Y, Li C, Qu D, Man Y. Effectiveness and safety of digital rectal stimulation and abdominal massage for neurogenic bowel dysfunction in stroke patients: a randomized controlled trial protocol. Trials 2023; 24:633. [PMID: 37789378 PMCID: PMC10548581 DOI: 10.1186/s13063-023-07678-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 09/27/2023] [Indexed: 10/05/2023] Open
Abstract
BACKGROUND Neurogenic bowel dysfunction (NBD) is a prevalent complication among stroke patients, significantly affecting their quality of life, duration of hospitalization, medical expenses, and even mortality. Although current guidelines suggest a conservative strategy for addressing bowel dysfunction, which includes techniques such as digital rectal stimulation (DRS) and abdominal massage, the availability of interventions remains limited in healthcare facilities. METHODS This study follows a prospective randomized controlled parallel-group clinical trial design. The control group will receive standard care, while the intervention group will undergo a program that combines DRS and abdominal massage in addition to standard care. The duration of the intervention for both groups will be 6 weeks. The primary outcome measures will be the Wexner score. Furthermore, secondary outcomes measure will be assessed, including Bristol score, Patient Assessment of Constipation-Quality of Life (PAC-QoL), and Fecal Incontinence Quality of Life (FI-QoL). DISCUSSION This study aims to evaluate the effectiveness and safety of a bowel rehabilitation program for stroke patients with NBD. The findings will provide information that can contribute to the formulation of bowel management strategies. TRIAL REGISTRATION The study has been registered in the Chinese Clinical Registry under the number ChiCTR2300071709. This registration was completed on May 23, 2023. All items from the World Health Organization Trial Registration Data set are described in this manuscript.
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Affiliation(s)
- Sumin Ma
- School of Nursing, University of South China, Hengyang, China, 421001
| | - Xiaoyan Fan
- The First Hospital of Changsha, Changsha, 410005, China
| | - Ying He
- The First Hospital of Changsha, Changsha, 410005, China.
| | - Chengjuan Li
- The First Hospital of Changsha, Changsha, 410005, China
| | - Dandan Qu
- Department of Rehabilitation, Changsha Central Hospital, Changsha, China, 410028
| | - Yanli Man
- School of Nursing, University of South China, Hengyang, China, 421001
- Operating room, Xiangya Hospital, Central South University, Changsha, 410008, China
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Guízar-Sahagún G, Grijalva I, Franco-Bourland RE, Madrazo I. Aging with spinal cord injury: A narrative review of consequences and challenges. Ageing Res Rev 2023; 90:102020. [PMID: 37487887 DOI: 10.1016/j.arr.2023.102020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 07/12/2023] [Accepted: 07/19/2023] [Indexed: 07/26/2023]
Abstract
Given the increase in life expectancy, aging with a pre-existing spinal cord injury (SCI) is becoming more common. This condition is challenging as compromised health status and functional independence can worsen. We aimed to provide an updated overview of the consequences of aging with SCI, highlighting the main challenges facing this population in a narrative review of the current literature we retrieved from the PubMed database from 2000 to 2022 on any aspect related to aging in persons with SCI. Here we address adverse circumstances that increase disability and hinder an active lifestyle, such as progressive physical deterioration, secondary health conditions, limitations in personal activity, changes in family and social support structures, aging of caregivers, and depletion of economic resources. Favorable changes are also observed, including psychosocial adjustments that improve quality of life. Additionally, various interventions are discussed to promote well-being, health, and social participation. Due to the relevance of this issue, people with SCI and all those who take care of them must have up-to-date information to carry out the necessary measures to promote healthy aging in a more inclusive social environment.
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Affiliation(s)
- Gabriel Guízar-Sahagún
- Research Unit for Neurological Diseases, Instituto Mexicano del Seguro Social, 4430 Calzada de Tlalpan, Mexico City, Mexico.
| | - Israel Grijalva
- Research Unit for Neurological Diseases, Instituto Mexicano del Seguro Social, 4430 Calzada de Tlalpan, Mexico City, Mexico
| | - Rebecca E Franco-Bourland
- Department of Biochemistry, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, 289 Calzada México-Xochimilco, Mexico City, Mexico
| | - Ignacio Madrazo
- Research Unit for Neurological Diseases, Instituto Mexicano del Seguro Social, 4430 Calzada de Tlalpan, Mexico City, Mexico
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Autonomic dysreflexia in patients with spinal cord injury. Nursing 2023; 53:21-26. [PMID: 36573864 DOI: 10.1097/01.nurse.0000902944.16062.1f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
ABSTRACT Patients with traumatic spinal cord injury have a vast array of secondary pathophysiologic effects, one of which is autonomic dysreflexia (AD). It can be triggered by noxious stimuli and cause severe and fatal consequences that require rapid intervention. This article examines AD and its implications for nursing care.
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Zhang D, Tang H, Li T, Li P, Pan X, Jia Q, Wang L, Zhao Y. Application of rectal balloon ice water stimulation for the rehabilitation of stroke patients with neurogenic bowel dysfunction. NeuroRehabilitation 2023; 53:83-90. [PMID: 37424483 DOI: 10.3233/nre-230026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Abstract
BACKGROUND Neurogenic bowel dysfunction (NBD) is a common complication in stroke patients. OBJECTIVE To investigate the effect of rectal balloon ice water stimulation on the rehabilitation of patients with NBD after a cerebral stroke. METHODS Forty stroke patients with NBD were selected between March and August 2022 and randomly divided into a study group (n = 20) and a control group (n = 20). Based on routine rehabilitation training, rectal balloon ice water stimulation or finger rectal stimulation were performed on the study or control group, respectively. After two weeks, the changes in the NBD, self-rating depression scale (SDS) and self-rating anxiety scale (SAS) scores were compared between the two groups. RESULTS Before the intervention, there were no significant differences in age, sex ratio, and NBD, SDS and SAS scores between the two groups (p > 0.05). The NBD, SDS and SAS scores of both groups were significantly decreased following intervention (p < 0.05). After 2 weeks of intervention, the NBD score of the study group was significantly lower than that of the control group (5.50±1.28 vs 6.45±1.05; p = 0.014). The SDS score of the study group was lower than that of the control group, and the difference was statistically significant (32.30±2.81 vs 44.05±2.19; p = 0.014). The study group also had significantly lower SAS scores than the control group (p = 0.024). In addition, the incidence of dizziness, headaches, nausea, vomiting and abdominal pain and distension in the study group was significantly lower than in the control group (p < 0.05). CONCLUSION Rectal balloon ice water stimulation can significantly improve stroke patients with NBD's intestinal function and psychological status.
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Affiliation(s)
- Di Zhang
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou, China
- Department of Geriatric Rehabilitation, Wuxi Central Rehabilitation Hospital, Wuxi, China
| | - Hong Tang
- Department of Geriatric Rehabilitation, Wuxi Central Rehabilitation Hospital, Wuxi, China
| | - Ting Li
- Department of Geriatric Rehabilitation, Wuxi Central Rehabilitation Hospital, Wuxi, China
| | - Ping Li
- Department of Geriatric Rehabilitation, Wuxi Central Rehabilitation Hospital, Wuxi, China
| | - Xiangying Pan
- Department of Geriatric Rehabilitation, Wuxi Central Rehabilitation Hospital, Wuxi, China
| | - Qin Jia
- Department of Nursing, Zhejiang Provincial People's Hospital (People's Hospital of Hangzhou Medical College), Hangzhou, China
| | - Lu Wang
- Department of Geriatric Rehabilitation, Wuxi Central Rehabilitation Hospital, Wuxi, China
| | - Yanjun Zhao
- Jiangnan University Medical Center, Wuxi, China
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Preventive strategies for feeding intolerance among patients with severe traumatic brain injury: A cross-sectional survey. Int J Nurs Sci 2022; 9:278-285. [PMID: 35891911 PMCID: PMC9304998 DOI: 10.1016/j.ijnss.2022.06.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 05/26/2022] [Accepted: 06/13/2022] [Indexed: 11/25/2022] Open
Abstract
Objectives This study aimed to investigate the application status of preventive measures for feeding intolerance in patients with severe traumatic brain injury (STBI) in China and analysis the differences and their causes. Methods A cross-sectional survey was conducted. From December 2019 to January 2020, ICU nurses and physicians of 89 hospitals in China were surveyed by using a questionnaire on preventive strategies for feeding intolerance in patients with STBI. The questionnaire included two parts: the general information of participants (10 items) and application of preventive measures for feeding intolerance in STBI patients (18 items). Results Totally 996 nurses and physicians completed the questionnaire. Among various methods, gastrointestinal symptoms(85.0%) and injury severity (71.4%) were mostly used to assess gastrointestinal functions and risk of feeding intolerance among STBI patients, respectively. Initiating enteral nutrition (EN) within 24–48 h (61.5%), nasogastric tubes (91.2%), 30°–45° of head-of-bed elevation (89.5%), continuous feeding by pump (72.9%), EN solution temperature of 38–40 °C (65.5%), <500 ml initial volume of EN solution (50.0%), monitoring gastric residual volume with a syringe (93.7%), and assessing gastric residual volume every 4 h (51.5%) were mostly applied for EN delivery among STBI patients. Prokinetic agents (73.3%), enema (73.6%), probiotics (79.0%), antacid agents (84.1%), and non-nutritional preparations as initial EN formula (65.6%) were commonly used for preventing feeding intolerance among STBI patients. Conclusions The survey showed that nurses and clinicians in China have a positive attitude towards preventive strategies for feeding intolerance. However, some effective new technologies and methods have not been timely applied in clinical practice. We suggest that managers, researchers, clinicians, nurses, and other health professionals should collaborate to explore effective and standard preventive strategies for feeding intolerance among patients with STBI.
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Thomson KH, O'Connor N, Dangova KT, Gill S, Jackson S, Bliss DZ, Wallace SA, Pearson F. Rapid priority setting exercise on faecal incontinence for Cochrane Incontinence. BMJ Open Gastroenterol 2022; 9:bmjgast-2021-000847. [PMID: 35500941 PMCID: PMC9062784 DOI: 10.1136/bmjgast-2021-000847] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 03/24/2022] [Indexed: 12/15/2022] Open
Abstract
Objective This rapid priority setting exercise aimed to identify, expand, prioritise and explore stakeholder (patients, carers and healthcare practitioners) topic uncertainties on faecal incontinence (FI). Design An evidence gap map (EGM) was produced to give a visual overview of emerging trial evidence; existing systematic review-level evidence and FI stakeholder topic uncertainties derived from a survey. This EGM was used in a knowledge exchange workshop that promoted group discussions leading to the prioritisation and exploration of FI stakeholder identified topic uncertainties. Results Overall, a mismatch between the existing and emerging evidence and key FI stakeholder topic uncertainties was found. The prioritised topic uncertainties identified in the workshop were as follows: psychological support; lifestyle interventions; long-term effects of living with FI; education; constipation and the cultural impact of FI. When these six prioritised topic uncertainties were explored in more depth, the following themes were identified: education; impact and burden of living with FI; psychological support; healthcare service improvements and inconsistencies; the stigma of FI; treatments and management; culturally appropriate management and technology and its accessibility. Conclusions Topic uncertainties identified were broad and wide ranging even after prioritisation. More research is required to unpick the themes emerging from the in-depth discussion and explore these further to achieve a consensus on deliverable research questions.
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Affiliation(s)
- Katie H Thomson
- NIHR Innovation Observatory, Newcastle University, Newcastle upon Tyne, UK
- Evidence Synthesis Group, Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Nicole O'Connor
- Evidence Synthesis Group, Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
- Cochrane Incontinence, Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Kim Tuyen Dangova
- NIHR Innovation Observatory, Newcastle University, Newcastle upon Tyne, UK
| | - Sean Gill
- NIHR Innovation Observatory, Newcastle University, Newcastle upon Tyne, UK
| | - Sara Jackson
- NIHR Innovation Observatory, Newcastle University, Newcastle upon Tyne, UK
| | - Donna Z Bliss
- School of Nursing, University of Minnesota, Minneapolis, Minnesota, USA
| | - Sheila A Wallace
- Evidence Synthesis Group, Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
- Cochrane Incontinence, Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Fiona Pearson
- NIHR Innovation Observatory, Newcastle University, Newcastle upon Tyne, UK
- Evidence Synthesis Group, Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
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Bowel and Bladder Care in Patients With Spinal Cord Injury. J Am Acad Orthop Surg 2022; 30:263-272. [PMID: 34932503 DOI: 10.5435/jaaos-d-21-00873] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 11/21/2021] [Indexed: 02/01/2023] Open
Abstract
Complete and incomplete spinal cord injuries affect between 250,000 and 500,000 people on an annual basis worldwide. In addition to sensory and motor dysfunction, spinal cord injury patients also suffer from associated conditions such as neurogenic bowel and bladder dysfunction. The degree of dysfunction varies on the level, degree, and type of spinal cord injury that occurs. In addition to the acute surgical treatment of these patients, spine surgeons should understand how to manage neurogenic bowel and bladder care on both a short- and long-term basis to minimize the risk for complications and optimize potential for rehabilitation.
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Retrospective trends in length of stay and bowel management at discharge from inpatient rehabilitation among individuals with spinal cord injury. Spinal Cord 2022; 60:674-678. [DOI: 10.1038/s41393-022-00753-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 01/07/2022] [Accepted: 01/11/2022] [Indexed: 11/08/2022]
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Li Q, Shen YL, Jiang YL, Li DS, Jin S. The effect of the therapy of "combination 3 methods progression" in patients with neurogenic bowel dysfunction (constipated type): Study protocol for a randomized controlled trial. Medicine (Baltimore) 2021; 100:e24662. [PMID: 33607803 PMCID: PMC7899824 DOI: 10.1097/md.0000000000024662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 01/19/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND As one of the important manifestations of neurogenic bowel dysfunction, constipation is characterized by high incidence and harmful effects. It has a negative impact on both physical and psychological health of patients. And there are no effective treatment options for this type of disease clinically. Therefore, this study is designed to examine the effect of the therapy of "combination 3 methods progression" in patients with neurogenic bowel dysfunction (constipated type). METHODS This is a randomized, controlled, parallel-design clinical trial. A total of 60 patients with neurogenic bowel dysfunction (constipated type) will be randomly assigned to intervention group and control group. The control group will receive 4 weeks of usual rehabilitation care, the intervention group will receive 4 weeks of the therapy of "combination 3 methods progression" in addition to usual rehabilitation care. The primary outcome is the number of spontaneous bowel movement per week. Secondary outcomes are stool characteristics, degree of difficulty in defecation, level of anxiety, level of depression, and level of self-efficacy. DISCUSSION The interventions of this protocol have been programmed to alleviate constipation in patients with neurogenic bowel dysfunction. Findings may provide preliminary evidence for clinical efficacy of the therapy of "combination 3 methods progression." TRIAL REGISTRATION Chinese Clinical Trial Registry, IDF: ChiCTR2000041463. Registered on December 26, 2020.
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Affiliation(s)
- Qing Li
- Nursing School, Chengdu University of Traditional Chinese Medicine
| | - Yin-Li Shen
- Department of Rehabilitation, Affiliated Hospital of Chengdu University of Traditional Chinese Medicine
| | - Yun-Lan Jiang
- College of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, PR China
| | - Dong-Shuang Li
- Nursing School, Chengdu University of Traditional Chinese Medicine
| | - Song Jin
- Department of Rehabilitation, Affiliated Hospital of Chengdu University of Traditional Chinese Medicine
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