| Objective:(1)To understand the current situation of constipation care and needs of stroke patients.(2)Evaluate and summarize relevant evidence for stroke constipation nursing.(3)To construct an evidence-based constipation nursing program for stroke patients.(4)To evaluate the effect of evidence-based constipation nursing program on the incidence of constipation and defecation quality of stroke patients.To compare the nurses’awareness and implementation of the evidence before and after the application of the evidence-based constipation nursing program.Methods:(1)The researcher conducted semi-structured interviews with nurses and patients in the neurology department of a tertiary hospital in Baise City to understand the the current status and needs of constipation nursing program for stroke patients.(2)This study took the JBI evidence-based health care model as the theoretical framework and based on the"6S evidence model"to search from the top to the bottom of the clinical practice guidelines,systematic reviews,expert consensus and other documents related to constipation intervention.In the process of research,the researcher conducted rigorous literature quality evaluate.According to JBI evidence classification and evidence recommendation level system(2014),the above evidence was integrated and analyzed.(3)Expert Meeting Law was conduct to revise the evidence-based practice program.The group analyzed the barriers to the application of evidence at the practitioner level,patient level,and department level,and proposed corresponding intervention strategies;To construct an evidence-based constipation nursing program for stroke patients.(4)The researcher used historical controlled trials to evaluate its application effects in clinical practice.From July 2021 to August 2021,stroke patients who were hospitalized in the Neurology Department of a Tertiary A hospital in Baise City were selected as the control group.From September 2021 to October 2021,stroke patients who were hospitalized in the Neurology Department of a Tertiary A hospital in Baise City were selected as the experimental group.Patients in the experimental group received constipation nursing program,while patients in the control group received conventional nursing methods.Evaluate the effect of evidence-based constipation nursing program on the Incidence of constipation and defecation quality of defecation of stroke patients.Through training and evidence-based practice review to evaluate the awareness and implementation of evidence for nurse.Results:(1)Ten stroke patients(7 constipation)and 7 clinical nurses were interviewed.There are 4 themes the current status of constipation nursing program for stroke patients:(1)lack of screening and nursing process system for stroke patients with constipation;(2)The nurses did not pay enough attention to the intervention of stroke patients with constipation,and the intervention of constipation depended on drug therapy;(3)Lack of nurses;(4)The nurse’ability of evidence-based is low and them lack of confidence in evidence-based practice.There are 2themes the needs of constipation nursing program for stroke patients:(1)Stroke patients’needs for knowledge acquisition of constipation were not satisfied;(2)the Stroke patients lacks the correct cognition to the constipation.(2)A total of 14 pieces of evidence were included,including 5 guidelines,2 expert consensus papers,5 systematic reviews,and 2meta-analyses.21 pieces of evidence(14 grade A recommendations and 7 grade B recommendations)were summarized from five aspects of assessment,diagnosis,intervention,treatment,and health education.(3)In the expert discussion meeting,the experts put forward10 amendments to the included evidence.The constructed program includes 16 items in three parts:assessment,intervention and evaluation.In this study,the researcher filmed 6 videos of constipation management videos(defecation barrier-free environment,anatomy and physiology of digestive system,dietary fiber,probiotics,massage laxative,active bed activities)for a total of 29 minutes and 25 seconds,wrote 1 defecation management manual with a total of 11 chapters,and created a We Chat public account of"Home Rehabilitation and Nursing".(4)After the program was implemented,the incidence of constipation in the experimental group was significantly lower than that in the control group(35.3%VS 81.4%,X~2=20.162,P<0.001),and the average defecation duration in the experimental group was lower than that in the control group(4.795±1.222 VS 6.884±2.492,t=5.283,P=0.001),defecation frequency(4.120±1.669 VS 1.950±1.068,t=-7.328,P=0.003)and stool quality score(4.008±0.775 VS 2.723±1.041,t=-6.851,P=0.047)were higher in the control group.There was a statistically significant difference in the knowledge and behavior level of nurses(P<0.05).The implementation rate of each item by nurses was greater than 70%.Conclusion:(1)The constipation nursing program for stroke patients is based on the best evidence,combined with the current situation and expert opinions,and can provide a reference for the clinical practice of stroke constipation nursing intervention.(2)The constipation nursing program for stroke patients can reduce the incidence of post-stroke constipation and improve the defecation quality,which has certain feasibility and effectiveness.(3)The constipation nursing program for stroke patients can improve the nurse’knowledge level of stroke constipation nursing intervention and compliance with evidence-based practice. |
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