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Constipation in specialized palliative care: prevalence, definition and patient perceived symptom distress
Linköping University, Department of Social and Welfare Studies. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in East Östergötland, Department of Advanced Home Care in Norrköping. Region Östergötland, Local Health Care Services in East Östergötland, Center of Palliative Care.
Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Advanced Home Care in Linköping. Region Östergötland, Local Health Care Services in East Östergötland, Center of Palliative Care.
Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences. Region Östergötland, Local Health Care Services in East Östergötland, Department of Advanced Home Care in Norrköping. Region Östergötland, Local Health Care Services in East Östergötland, Center of Palliative Care.ORCID iD: 0000-0002-9606-3238
2015 (English)In: Journal of Palliative Medicine, ISSN 1096-6218, E-ISSN 1557-7740, Vol. 18, no 7, 585-592 p.Article in journal (Refereed) Published
Abstract [en]

Context: The prevalence of constipation among patients in palliative care has varied in prior research, from 18-90 %, depending on different study factors.

Objectives: The aim of this study was to describe and explore the prevalence and symptom distress of constipation, using different definitions of constipation, in patients admitted to specialized palliative care settings.

Methods: Data was collected in a cross-sectional survey from 485 patients in 38 palliative care units in Sweden. Variables were analyzed using logistic regression and summarized as odds ratio (OR).

Result: The prevalence of constipation varied between 7 – 43 %, depending on the definition used. Two constipation- groups were found: (i) Medical constipation- group (MCG; ≤ 3 defecations/week n=114; 23%); (ii) Perceived constipation- group (PCG; Patients with a perception of being constipated the last two weeks; n= 171; 35%). Three sub-groups emerged: patients with (a) only medical constipation (7 %), (b) only perceived constipation (19 %), and (c) with both medical and perceived constipation (16%). There were no differences in symptom severity between groups; 71% of all constipated patients had severe constipation.

Conclusion: The prevalence of constipation may differ, depending on the definition used and how constipation is assessed. In this study we found two main groups and three sub-groups, analyzed from the definitions of frequency of bowel movements and experience of being constipated. To be able to identify constipation, the patients’ definition has to be further explored and assessed.

Place, publisher, year, edition, pages
Mary Ann Liebert, 2015. Vol. 18, no 7, 585-592 p.
Keyword [en]
Palliative care, constipation, prevalence, definition, symptom-distress
National Category
Other Medical Sciences Nursing Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:liu:diva-117184DOI: 10.1089/jpm.2014.0414ISI: 000361880600005PubMedID: 25874474OAI: oai:DiVA.org:liu-117184DiVA: diva2:806756
Note

At the time for thesis presentation publication was in status: Manuscript

Available from: 2015-04-21 Created: 2015-04-21 Last updated: 2017-12-04Bibliographically approved
In thesis
1. Constipation in palliative care: Prevalence, definitions, symptom distress and risk-factors
Open this publication in new window or tab >>Constipation in palliative care: Prevalence, definitions, symptom distress and risk-factors
2015 (English)Licentiate thesis, comprehensive summary (Other academic)
Abstract [en]

Background and aims: Constipation for patients in palliative care is common and described with variations in prevalence. Side -effects from opioid- treatment, is considered to be one of the main factors leading to constipation. The overall aim of the thesis was to study constipation among patients admitted to specialized palliative care- settings in Sweden. The specific aims of the thesis were 1) To describe and explore the prevalence, definition and symptom distress of constipation by applying different definitions of constipation, in patients admitted to specialized palliative care settings in Sweden. 2) To identify factors related to constipation in patients in specialized palliative care and comparing these factors for patients with different types of constipation to patients without constipation.

Methods: A literature- search were conducted where prevalence of- and factors related to constipation was explored and included in a questionnaire, developed for this thesis. Data was collected in a cross- sectional design with a response rate of 50% and analysed with logistic regression.

Results: A total of 485 patients from 38 specialized palliative care- units in Sweden participated. Prevalence of constipation for patients in specialized palliative care varied between 7- 43 % depending on definition used. Two different constipation- groups were identified: Medical constipation- group 23% (MCG) and Perceived constipation- group 35% (PCG). Three sub- groups was also identified: patients with i) only ≤ 3 defecations/week, 7%, ii) only perception of being constipated, 19%, and iii) patients with both ≤ 3 defecations/ week and perception of being constipated,16%. Several factors were found to be related to constipation as hospitalisation, absence of laxative- treatment, haemorrhoids, poor appetite, hard stool form and opioids.

Conclusions: Prevalence of constipation may differ depending on definitions used. Distress from constipation and other factors related to constipation, than opioids, needs to be incorporated into the clinical constipation- assessment. Validated constipation assessment tool needs to be developed.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2015. 56 p.
Series
Linköping Studies in Health Sciences. Thesis, ISSN 1100-6013 ; 130
Keyword
Palliative care, constipation, prevalence, definition, symptom-distress, risk factors
National Category
Other Medical Sciences Nursing Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:liu:diva-117188 (URN)10.3384/lic.diva-117188 (DOI)978-91-7519-101-0 (ISBN)
Presentation
2015-05-21, K2, Kåkenhus, Campus Norrköping, Norrköping, 09:00 (Swedish)
Supervisors
Note

The series name Linköping University, Studies in Health Sciences, Thesis in the Licentiate thesis is incorrect. The correct name is Linköping Studies in Health Sciences. Thesis.

Available from: 2015-04-21 Created: 2015-04-21 Last updated: 2016-12-09Bibliographically approved

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Erichsén, EvaMilberg, AnnaJaarsma, TinyFriedrichsen, Maria

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Department of Social and Welfare StudiesFaculty of Medicine and Health SciencesDepartment of Advanced Home Care in NorrköpingCenter of Palliative CareDivision of Health, Activity and CareFaculty of Health SciencesDepartment of Advanced Home Care in Linköping
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Journal of Palliative Medicine
Other Medical SciencesNursingPublic Health, Global Health, Social Medicine and Epidemiology

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