運用腹部按摩改善長期臥床老人便秘問題之實證研究

Evidence-Based Abdominal Massage for Long-Term Bed Ridden Elderly With Chronic Constipation

10.6299/JHA.2017.4.2.R8.72

楊慧珊(Yang, Hui-Shan)；呂韻蘋(Lu, Yun-Ping)；汪素敏(Wang, Shu-Min)；徐南麗(Hsu, Nan-Ly)

腹部按摩 ； 便祕 ； abdominal massage ； constipation

健康與建築雜誌

4卷2期（2017 / 06 / 01）

72 - 80

繁體中文

背景：便秘是長期臥床病人常見且重要的照護問題，單位病人便祕人數佔90％以上，多以甘油球灌腸為主要的解決方式，為改善此問題藉由實證文獻『腹部按摩改善便秘』，將其運用臨床上。目的：本研究旨在降低長期臥床病人便秘發生率。方法：給予護理師及照顧服務員辦理教育訓練，並示範「腹部劃線按摩法」技巧。選取單位年齡大於65歲、臥床超過六個月及日常生活需要他人協助，符合條件共30人，以電腦進行隨機抽樣分為實驗組及對照組各15人。實驗組採行腹部劃線按摩方式，一星期五天進行，每次持續10-15分鐘，對照組則依原來方法每週一次甘油球灌腸，執行六星期。結　果：長期臥床病人便秘發生率降低為68.5％，護理人員及照服員非藥物處置便秘護理認知完整性各項目皆＞95.0％。結論與應用：執行結果可推行到普通病房，社區居家，達到接續性的照護，提升排便照護品質。

Background: Constipation is the most common gastrointestinal complaint reported in elderly living in long-term care facilities. Up to 90% of elderly chronic ward residents have the phenomenon of constipation and usually glycerol-ball enema are made use of treating it. Researchers try to use evidence-based of abdominal massage to manage clinical constipation problem for older patients. Purposes: The project aims to reduce the incidence rate of constipation. Methods: Researches performed abdominal scribing massage skill education training to nurses and care attendants. The patients included age ＞ 65 years, bed ridden for over 6 months and daily life needs others to help were selected. A total of 30 persons were recruited in this study and were randomized into intervention group, 15 patients (receiving 15 minutes of abdominal scribing massage a day, 5 days per week)and control group, 15 patients (receiving glycerol ball enema once a week), executed for 6 weeks. Results: (1) The incidence of constipation was reduced to 68.5% in elderly long-term bed ridden patients. (2) Nurses and care providers' non-drug treatment constipation care on cognitive scores of integrity of all items are greater than 95.0% Conclusions: This study can be implemented to the general ward and community home, in order to achieve the continuity of care and elevate quality of care.

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