Authors (including presenting author) :
Chui KS(1), Chan KF(1), Wong HS(1), Mok M(1), Lam YF(1), Lo E(1), Cheung CM(1)
Affiliation :
(1)Department of Medicine, Pamela Youde Nethersole Eastern Hospital
Introduction :
Constipation commonly occurs in stroke patients. They are prone to develop constipation as a result of changing bowel habit, decreased bowel movement, immobility and cognitive impairment. Constipation would cause severe impact on patient’s physical and psychosocial health which would prolong rehabilitation progress and hospital stay. Abdominal massage has been used to treat constipation since 1870. However, literatures support on the effectiveness of abdominal massage is lacking.
Objectives :
To study the effectiveness of abdominal massage on relieving constipation symptoms and enhancing bowel movement in stroke patients in Acute Stroke Unit of PYNEH and Stroke Rehabilitation Unit of TWEH.
Methodology :
It was a prospective cohort and quasi-experimental study. The study period was from November 2017 to June 2018.
The sample included 50 intervention (abdominal massage) and 50 control subjects. A 15-minute abdominal massage was introduced by nurses to patients and their relatives. Each candidate was followed up every day until being discharged from either unit. The result was measured by comparing the Constipation Assessment Scales (CAS) and Bristol Stool Chart (BSC). Collected data sets were analysed by Microsoft Excel.
Result & Outcome :
The pre-intervention mean CAS of patients was 9.9/16. After abdominal massage, the mean CAS dropped to 9.2/16 (p>0.05) while the mean CAS in control group was 7.8/16 (p< 0.00). However, the study has shown clinical significance as 3 parameters in the CAS dropped significantly after the abdominal massage. Moreover, a secondary outcome derived was the closer bonding between patient and relative during the massage time. Relatives claimed they were physically contributing to patients and participating in rehabilitation which would exert a positive psychological effect to patients.
The limitations of the study included inadequate sample size; the unequal length of stay among patients; the incoherence of the massage technique among patients, and the use of laxatives in the intervention group which affected the result measurement.
Abdominal massage could be used as a non-pharmacological method to relieve constipation and thus patients could less rely on laxatives. Moreover, building up a rapport among nurse, patient and relative is beneficial to patient’s rehabilitation. This project will continue to carry out in ASU in 2020 to further increase the sample size and evaluate the effectiveness.
