The Effect Of Comprehensive Intervention To Prevent Constipation In Hospitalized Patients With Acute Coronary Syndromes

Objective:1 To develop and test the AFS intervention (A: acupressure message; F: footbath; S: sweet potato) as a safe treatment for prevention constipation; and to increase satisfaction with bowel emptying in hospitalized patients with ACS.2 To investigate the correlation between constipation in three days in hospital stay and the severity of anxiety and depression in admission in 48 hours in original acute coronary syndrome patients.3 To save economical expenditure for patients.Methods:The study was conducted in The First Affiliated Hospital of Soochow University, China. The study was a prospective, randomized controlled trial with a sample of 93 patients (AFS group, n=44; usual care group, n=49). Patients in AFS group received AFS intervention combined with usual care.Results:1. There were statistical differences between the two groups in terms of: (1) theincidence of constipation and heart related complications; (2) the use of laxatives and enemas; and (3) patients'subjective satisfaction with their bowel emptying during hospitalization(P <0.05). Participants'were assessed for subjective feeling and objective evaluation of defecation and no significant differences were found with regard to straining and lumpy/dry stools (P >0.05). Sensation of incomplete evacuation and of anorectal obstruction/blockade revealed a significant difference (P<0.05). No significant differences (P >0.05) were found the first defecation time and frequency of diarrhea.2. The Incidence of constipation in mood disorder population is great higher than no-mood disorder. The difference has statistical significance(P <0.05). There was a positive correlation among constipation and the severity of anxiety or depression (r=0.43, 0.27; P <0.05);Anxiety level classification values can be in regression model (P =0.0042).3. The average cost per person in intervention group was RMB 21.44 Yuan less than that in control group on cursing constipation.Conclusions:1. The AFS intervention combined with usual care was more effective, economical and practical than usual care alone in managing constipation and satisfaction with defecation in patients hospitalized with ACS.2. The more severity of anxiety and depression in admission for 48 hours is, the higher the incidence of constipation is. Anxiety can be used as a predictable indicator of early constipation.3. The application of AFS based on routine nursing care can effectively reduce the cost for constipation and coordinate complications and save direct or indirect economical expenditure for patients.