Authors (including presenting author) :
LO NSR(1), KAM LM(2), LI CY(1), FU ML(1), TAI SM(4), KO PS(3), CHEUNG KK(1), MA SYA(1)
Affiliation :
(1)Department of Medical & Geriatrics, United Christian Hospital, (2)Palliative Care Service, Department of Medicine, Haven of Hope Hospital, (3)Nursing Service Division, United Christian Hospital, (4)Community Nursing Service, United Christian Hospital
Introduction :
Constipation is one of the most troublesome and persistent symptoms in palliative patients. It can cause abdominal and rectal pain and exacerbate vomiting and nausea. This study aimed to enhance constipation management skills and promote preventive measures in patients and caregivers.
Objectives :
1) To enhance knowledge and skills including pharmacological and non-pharmacological in constipation
2) To empower patient's and caregiver's confidence in managing constipation in community
3) To promote healthy bowel habits in end-of-life care
Methodology :
Patients and caregivers were recruited from the inpatient and outpatient palliative care units of United Christian Hospital and Haven of Hope Hospital, aged 18 year or above, and mentally competent and communicable. The patient participants scored 40% or more in Palliative Performance Scale(PPS) and were currently receiving opioids and laxatives. A questionnaire was designed for both patients and caregivers as the primary assessment which focused on demographic data, bowel habits, cause of constipation and bowel-related interventions. A health talk was held with an educational pamphlet. Participants were invited to participate in abdominal massage with demonstration provided. An evaluation form was completed after the education section.
Result & Outcome :
This study was conducted from Mid-May to End-May 2019. A total of 30 participants (23 main caregivers and 7 patients) were recruited. Among the patients participants, 70% experienced constipation. Among all participants, only 10% were aware that constipation was affected by medications such as opioid and iron supplement. Inadequate fluid intake (47%) was the most common factor of constipation, and other causes were inadequate fiber intake (43%) and immobile (23%). 57% reported that decreased appetite was the most distressing impact of constipation which negatively affected their quality of life. 50% reported that increased water intake could relieve constipation. Around 30% were aware that laxatives were effective.
In the health talk session, all participants agreed that their knowledge in constipation improved and the prevention tips were useful. Over 77% had confidence to tackle constipation. All participants completed the abdominal massage and felt pleasurable and comfortable with their bowel function. It is recommended to hold regular health talk for patients with advanced diseases in the long run.
