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Wu Y, Ying Q, He Y, Xie X, Yuan X, Wang M, Fei X, Yang X. Effect of external therapies of traditional Chinese medicine on constipation in patients with CRF: A meta-analysis. PLoS One 2023; 18:e0291968. [PMID: 37796899 PMCID: PMC10553223 DOI: 10.1371/journal.pone.0291968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Accepted: 09/10/2023] [Indexed: 10/07/2023] Open
Abstract
OBJECTIVE The purpose of this study was to evaluate the curative effect of external therapies of traditional Chinese medicine on constipation in patients with chronic renal failure and to provide scientific theoretical basis for clinical practice. METHOD We searched the English database of PubMed, EMBASE, the Cochrane Library and the Web of Science and Chinese database of CNKI, Wan fang database, VIP Database and China Biomedical Literature Database up to December 2022. Randomized controlled trials (RCTs) involving constipation in patients with CRF that compared external therapies of traditional Chinese medicine and routine treatment to routine treatment were eligible for the analysis. A meta-analysis of the outcome indicators including total efficiency, weekly defecation times, defecation time, defecation difficulty score, patient-assessment of constipation quality of life and adverse events of treatment were performed. The analysis was performed by using Review Manager version 5.3. RESULT A total of 23 studies were included, with 1764 patients. Meta-analysis results showed that compared with the control group, the test group could significantly increase weekly defecation times(MD = 0.94, 95%CI(0.70, 1.18), Z = 7.74, P < 0.00001), reduce defecation time(MD = -2.92, 95%CI(-3.69, -2.16), Z = 7.49, P < 0.00001), reduce defecation difficulty score(MD = -1.92, 95%CI(-2.45, -1.39), Z = 7.11, P < 0.00001), improve the quality of life in patients with constipation(MD = -7.57, 95%CI(-10.23, -4.91), Z = 5.58, P < 0.00001) and obtain a higher total effective rate of treatment(OR = 4.53, 95%CI(3.27, 6.29), Z = 9.07, P < 0.00001). In terms of safety, there was no statistical significance in the incidence of adverse events between two groups(OR = 0.35, 95%CI(0.04, 2.95), Z = 0.96, P = 0.34). CONCLUSION The combination of external therapies of traditional Chinese medicine and routine treatment could achieve an excellent curative effect, and there was no specific adverse event. However because of the limited level of current evidence, more high-quality trials are needed in the future.5.
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Affiliation(s)
- Yu Wu
- Department of Nephrology, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Qisu Ying
- Department of Nephrology, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yajing He
- Department of Nephrology, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xiangcheng Xie
- Department of Nephrology, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xiao Yuan
- Department of Nursing, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Ming Wang
- Department of Nephrology, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xiao Fei
- Department of Nephrology, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xiu Yang
- Department of Nephrology, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
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Bulbul E, Cepken T, Caliskan F, Palabiyik B, Sayan C, Kazancioglu R. The quality of life and comfort levels of hemodialysis patients with constipation: A descriptive and cross-sectional study. Hemodial Int 2022; 26:351-360. [PMID: 35451169 DOI: 10.1111/hdi.13009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 01/24/2022] [Accepted: 03/24/2022] [Indexed: 11/30/2022]
Abstract
INTRODUCTION This study was conducted to determine the constipation-related quality of life, bowel habits, and comfort levels of constipated hemodialysis patients. It is known that the prevalence of constipation is high in hemodialysis patients. METHODS This was a cross-sectional and correlational study. The study included 164 hemodialysis patients who were determined to have constipation by examining the constipation statuses of 385 patients based on the Rome-IV criteria. The study was reported according to the STrengthening the Reporting of OBservational studies in Epidemiology Declaration. FINDINGS It was determined that as the constipation-related quality of life of the patients increased, their comfort levels also increased. Constipation-related quality of life increased in parallel with an increasing Bristol Stool Scale (BSS) score and an increasing number of bowel movements. The BSS scores of the patients were found to have a significant positive correlation with the patients' bowel movement frequencies and a significant negative correlation with their constipation frequencies. There was a negative correlation between years of dialysis and bowel movement frequencies. The presence of a previous gastrointestinal system complaint, the presence of an impact of constipation on the patient's dialysis session, and comfort levels were determined to be significant predictors of constipation-related quality of life that explained 26.3% of the total variance in constipation-related quality of life. DISCUSSION In patients receiving hemodialysis treatment, constipation is an important and frequently encountered problem. Constipation leads to a reduction in quality of life and hemodialysis-related comfort.
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Affiliation(s)
- Elif Bulbul
- Hamidiye Faculty of Nursing, Internal Medicine Nursing Department, University of Health Sciences Turkey, Istanbul, Turkey
| | | | | | | | - Canan Sayan
- Hemodialysis Center, Bezmialem Vakif University, Istanbul, Turkey
| | - Rumeyza Kazancioglu
- Faculty of Medicine, Division of Nephrology, Bezmialem Vakif University, Istanbul, Turkey
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Maatz A, Wainwright M, Russell AJ, Macnaughton J, Yiannakou Y. What's 'difficult'? A multi-stage qualitative analysis of secondary care specialists' experiences with medically unexplained symptoms. J Psychosom Res 2016; 90:1-9. [PMID: 27772554 DOI: 10.1016/j.jpsychores.2016.09.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Revised: 09/04/2016] [Accepted: 09/07/2016] [Indexed: 01/28/2023]
Abstract
BACKGROUND The term 'difficult' is pervasively used in relation to medically unexplained symptoms (MUS) and patients with MUS. This article scrutinises the use of the term by analysing interview data from a study of secondary care specialists' experiences with and attitudes towards patients suffering from MUS. DESIGN Qualitative design employing semi-structured open-ended interviews systematically analysed in three stages: first, data were analysed according to the principles of content analysis. The analysis subsequently focused on the use of the term 'difficult'. Iterations of the term were extracted by summative analysis and thematic coding revealed its different meanings. Finally, alternative expressions were explored. SETTING Three NHS trust secondary care hospitals in North-East England. PARTICIPANTS 17 senior clinicians from seven medical and two surgical specialities. RESULTS Unsolicited use of the term 'difficult' was common. 'Difficult' was rarely used as a patient characteristic or to describe the therapeutic relationship. Participants used 'difficult' to describe their experience of diagnosing, explaining, communicating and managing these conditions and their own emotional reactions. Health care system deficits and the conceptual basis for MUS were other facets of 'difficult'. Participants also reported experiences that were rewarding and positive. CONCLUSIONS This study shows that blanket statements such as 'difficult patients' mask the complexity of doctors' experiences in the context of MUS. Our nuanced analysis of the use of 'difficult' challenges preconceived attitudes. This can help counter the unreflexive perpetuation of negative evaluations that stigmatize patients with MUS, encourage greater acknowledgement of doctors' emotions, and lead to more appropriate conceptualizations and management of MUS.
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Affiliation(s)
- Anke Maatz
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital, Zurich CH-8032, Switzerland.
| | - Megan Wainwright
- Division of Social and Behavioural Sciences, School of Public Health and Family Medicine, University of Cape Town, Cape Town 7925, South Africa
| | - Andrew J Russell
- Department of Anthropology, Durham University, Durham DH1 3LE, United Kingdom
| | - Jane Macnaughton
- Centre for Medical Humanities, Durham University, Durham DH1 1SZ, United Kingdom
| | - Yan Yiannakou
- County Durham and Darlington NHS Foundation Trust, Durham DH1 5TW, United Kingdom
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Björkman I, Simrén M, Ringström G, Jakobsson Ung E. Patients' experiences of healthcare encounters in severe irritable bowel syndrome: an analysis based on narrative and feminist theory. J Clin Nurs 2016; 25:2967-78. [PMID: 27218818 DOI: 10.1111/jocn.13400] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/10/2016] [Indexed: 11/27/2022]
Abstract
AIMS AND OBJECTIVES This study aimed to explore patients' experiences of healthcare encounters in severe irritable bowel syndrome. BACKGROUND Irritable bowel syndrome is a common functional disorder with symptoms such as abdominal pain and disturbed bowel habits, the cause of which is not completely known. Treatments options are limited, and healthcare encounters in irritable bowel syndrome have been described as unsatisfying and frustrating for both patients and professional healthcare providers. Furthermore, the influence of power on healthcare encounters has long been recognised, especially regarding the disadvantaged position of those suffering from functional illness which cannot be identified by commonly used tests or investigations. METHODS We interviewed 10 patients during 2014, all attending an outpatient clinic and suffering from severe irritable bowel syndrome. Relying on narrative and feminist theory, we explored how they actively negotiate professional discourse communicated to them in the clinical encounter. RESULTS The patients' experiences of healthcare encounters in irritable bowel syndrome were mostly described as negative, and often induced feelings of confusion and self-doubt. Positive encounters were described as being listened to, believed and taken seriously. Narrators found it especially problematic when healthcare professionals described irritable bowel syndrome as a minor disorder with primarily stress or psychological aetiology and put the responsibility for recovery onto the patient. Patients' actively negotiated such professional discourse by presenting a counternarrative describing their own suffering and strengths, experienced healthcare shortcomings and possible organic aetiology of irritable bowel syndrome. CONCLUSIONS Patients suffering from severe irritable bowel syndrome described how they often felt a need to protect their positive identities in the face of trivialisation and disbelief by healthcare professionals. RELEVANCE TO CLINICAL PRACTICE A deepened understanding of patients' experiences of healthcare encounters in irritable bowel syndrome could enable more helpful and supporting interventions by healthcare professionals.
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Affiliation(s)
- Ida Björkman
- Department of Internal Medicine & Clinical Nutrition, Institute of Medicine and the Centre for Person-Centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
| | - Magnus Simrén
- Department of Internal Medicine & Clinical Nutrition, Institute of Medicine and the Centre for Person-Centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Gisela Ringström
- Department of Internal Medicine & Clinical Nutrition, Institute of Medicine and the Centre for Person-Centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Eva Jakobsson Ung
- Institute of Health and Care Sciences and the Centre for Person-Centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Zhang J, Huang C, Li Y, Chen J, Shen F, Yao Q, Qian J, Bao B, Yao X. Health-related quality of life in dialysis patients with constipation: a cross-sectional study. Patient Prefer Adherence 2013; 7:589-94. [PMID: 23814466 PMCID: PMC3693922 DOI: 10.2147/ppa.s45471] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVES To evaluate differences in the health-related quality of life (HRQoL) between patients with constipation receiving hemodialysis (HD) and those receiving peritoneal dialysis (PD). METHODS In this cross-sectional study, 605 dialysis patients (478 HD cases and 127 PD cases; all patients were older than 18 years) from our hospital were included. A questionnaire was used to evaluate their constipation statuses. The effect of constipation on HRQoL was assessed, using the Chinese version of the 12-item short-form (SF-12) general health survey. Karnofsky score, sociodemographic, and clinical data were also collected. We performed multiple logistic regression analysis to define independent risk factors for constipation and impaired HRQoL. RESULTS A total of 605 participants (326 men [53.9%] and 279 women [46.1%]) were surveyed. The incidence of constipation was 71.7% in HD patients and 14.2% in PD patients. Dialysis patients with constipation had significantly lower mean SF-12 Physical Component Summary scale and Mental Component Summary scale scores than the nonconstipation group (P < 0.05), whereas HD patients had better SF-12 Physical Component Summary and Mental Component Summary scores than PD patients (P < 0.05). When we performed multivariate logistic regression analysis, dialysis modality, diabetes, and the number of constipation-related medications were three independent risk factors associated with constipation. As for impaired HRQoL in the constipated dialysis population, dialysis modality was found to be another independent risk factor in addition to age and diabetes. CONCLUSION PD patients with constipation had worse HRQoL than HD control participants. We should pay more attention to the patients with constipation receiving PD, as peritonitis caused by constipation was associated with a higher mortality.
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Affiliation(s)
- JiSheng Zhang
- Division of Nephrology, School of Medicine, Ningbo Urology and Nephrology Hospital, Ningbo University, Ningbo, Zhejiang, People’s Republic of China
| | - CongYang Huang
- Division of Nephrology, School of Medicine, Ningbo Urology and Nephrology Hospital, Ningbo University, Ningbo, Zhejiang, People’s Republic of China
| | - YanLi Li
- Division of Nephrology, School of Medicine, Ningbo Urology and Nephrology Hospital, Ningbo University, Ningbo, Zhejiang, People’s Republic of China
| | - Jun Chen
- Blood Purification Center, School of Medicine, Ningbo Urology and Nephrology Hospital, Ningbo University, Ningbo, Zhejiang, People’s Republic of China
| | - FangYuan Shen
- Division of Nephrology, School of Medicine, Ningbo Urology and Nephrology Hospital, Ningbo University, Ningbo, Zhejiang, People’s Republic of China
| | - Qiang Yao
- Baxter Healthcare Pty Ltd, Shanghai, People’s Republic of China
| | - JiaQi Qian
- Division of Nephrology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| | - BeiYan Bao
- Division of Nephrology, School of Medicine, Ningbo Urology and Nephrology Hospital, Ningbo University, Ningbo, Zhejiang, People’s Republic of China
- Correspondence: BeiYan Bao, Division of Nephrology, School of Medicine, Ningbo Urology and Nephrology Hospital, Ningbo University, Ningbo, Zhejiang, People’s Republic of China Tel +86 574 8303 9291 Fax +86 574 8303 8510 Email
| | - XuPing Yao
- Division of Urology, School of Medicine, Ningbo Urology and Nephrology Hospital, Ningbo University, Ningbo, Zhejiang, People’s Republic of China
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