老年病人慢性便秘干预方案的构建及效果评价

Construction and effectiveness evaluation of intervention program for chronic constipation in elderly patients

目的构建老年病人慢性便秘的分级标准及干预方案,降低老年病人慢性便秘的发生率,提高老年病人生活质量。方法纳入江苏省人民医院老年神经消化科于2022年1—6月收治的老年慢性便秘病人50例作为研究对象,按随机数表法分为干预组与对照组,每组25例。干预组应用已制定的老年人群慢性便秘干预计划,根据不同便秘程度给予适当的治疗方案,对病人进行心理照护、膳食管理、运动指导、康复训练和针灸推拿等护理干预措施。对照组给予与其疾病相关的知识及健康宣教,并告知病人和家人在防治便秘和出现便秘时的应对策略;有焦虑抑郁的病人给予心理护理,关心其精神面貌,安抚情绪。比较2组间焦虑、抑郁情况及便秘治疗有效率的差异。结果干预组病人持续3 d未排便发生率小于对照组,病人焦虑自评量表、抑郁自评量表、便秘病人生活质量量表(PAC-QOL)得分均低于对照组,差异均有统计学意义(P<0.05)。观察组临床总有效率高于对照组,差异有统计学意义(P<0.05)。结论构建的老年病人慢性便秘干预方案能降低便秘发生率,减少便秘带来的焦虑、沮丧、不适等身心健康问题,改善老年慢性便秘人群的生活质量。

Objective To construct a grading criteria and intervention program for chronic constipation in the elderly patients,and to reduce the incidence of chronic constipation and improve the quality of life.Methods A total of 50 elderly patients with chronic constipation who were admitted to Department of Geriatric Neurodigestion in Jiangsu Province Hospital from January to June 2022 were enrolled in this study,and were randomly divided into the intervention group and the control group,with 25 patients in each group.The established intervention plan for chronic constipation in the elderly were applied in the intervention group,including appropriate treatment plans according to the degree of constipation,such as psychological care,dietary management,exercise guidance,rehabilitation training and acupuncture.In the control group,the patients received knowledge and health education about chronic constipation,the education of the strategies for preventing and treating constipation,and the patients with anxiety and depression received psychological care.The anxiety,depression and quality of life between two groups were compared.Results The incidence of 3-d non-defecation in the intervention group was lower than that in the control group,and the scores of the Patient Self-rating Anxiety Scale,the Self-rating Depression Scale and the Patients with Constipation Quality of Life Scale(PAC-QOL)in the intervention group were all lower than those in the control group,with statistically significant difference(P<0.05).The total clinical effective rate in the observation group was higher than that in the control group(P<0.05).Conclusions The intervention program for chronic constipation in elderly patients can reduce the incidence of constipation,decrease the incidence of physical and mental health problems such as anxiety,depression,and discomfort caused by constipation,and improve the quality of life in the elderly patients.