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Fecal Distribution Changes Using Colorectal Ultrasonography in Older People with Physical and Cognitive Impairment Living in Long-Term Care Facilities: A Longitudinal Observational Study

Nurses encounter difficulties evaluating constipation in elderly people with physical and cognitive impairment. Transabdominal ultrasonography (US) has been used to evaluate fecal impaction or fecal quality. However, it is unclear whether colorectal US can evaluate constipation symptoms in older peo...

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Autores principales: Tanaka, Shiho, Yabunaka, Koichi, Matsumoto, Masaru, Tamai, Nao, Noguchi, Hiroshi, Yoshida, Mikako, Nakagami, Gojiro, Sugama, Junko, Sanada, Hiromi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6023545/
https://www.ncbi.nlm.nih.gov/pubmed/29799515
http://dx.doi.org/10.3390/healthcare6020055
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author Tanaka, Shiho
Yabunaka, Koichi
Matsumoto, Masaru
Tamai, Nao
Noguchi, Hiroshi
Yoshida, Mikako
Nakagami, Gojiro
Sugama, Junko
Sanada, Hiromi
author_facet Tanaka, Shiho
Yabunaka, Koichi
Matsumoto, Masaru
Tamai, Nao
Noguchi, Hiroshi
Yoshida, Mikako
Nakagami, Gojiro
Sugama, Junko
Sanada, Hiromi
author_sort Tanaka, Shiho
collection PubMed
description Nurses encounter difficulties evaluating constipation in elderly people with physical and cognitive impairment. Transabdominal ultrasonography (US) has been used to evaluate fecal impaction or fecal quality. However, it is unclear whether colorectal US can evaluate constipation symptoms in older people. Using colorectal US, we continuously observed the elderly and clarified the relationship between patterns of fecal distribution changes and constipation symptoms in older people with physical and cognitive impairment at long-term care facilities. This study included patients aged ≥65 years with oral intake. US was performed once a day until the next defecation, and fecal hardness was assessed. US images were extracted and categorized. Then, patterns of fecal distribution changes in the colorectum were classified. Multiple logistic regression analysis was performed to examine related factors associated with a constipation pattern. Among 101 patients, US images of 95 patients were analyzed. In 74.4% of the patients, US showed continuation of reflection with acoustic shadow in the rectum, which was significantly associated with defecation on the bed. Of the patients with a continuous crescent-shaped reflection pattern (R3), 92.9% had hard stool. R3 was found to be significantly associated with a Mini-Mental State Examination score of ≤10. In most of the patients, US detected a continuation of reflection with acoustic shadow in rectal patterns, indicating fecal retention in the rectum. Point-of-care US can be used by nurses to visualize rectal fecal retention as constipation patterns in the older people with physical and cognitive impairment at long-term care facilities.
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spelling pubmed-60235452018-07-03 Fecal Distribution Changes Using Colorectal Ultrasonography in Older People with Physical and Cognitive Impairment Living in Long-Term Care Facilities: A Longitudinal Observational Study Tanaka, Shiho Yabunaka, Koichi Matsumoto, Masaru Tamai, Nao Noguchi, Hiroshi Yoshida, Mikako Nakagami, Gojiro Sugama, Junko Sanada, Hiromi Healthcare (Basel) Article Nurses encounter difficulties evaluating constipation in elderly people with physical and cognitive impairment. Transabdominal ultrasonography (US) has been used to evaluate fecal impaction or fecal quality. However, it is unclear whether colorectal US can evaluate constipation symptoms in older people. Using colorectal US, we continuously observed the elderly and clarified the relationship between patterns of fecal distribution changes and constipation symptoms in older people with physical and cognitive impairment at long-term care facilities. This study included patients aged ≥65 years with oral intake. US was performed once a day until the next defecation, and fecal hardness was assessed. US images were extracted and categorized. Then, patterns of fecal distribution changes in the colorectum were classified. Multiple logistic regression analysis was performed to examine related factors associated with a constipation pattern. Among 101 patients, US images of 95 patients were analyzed. In 74.4% of the patients, US showed continuation of reflection with acoustic shadow in the rectum, which was significantly associated with defecation on the bed. Of the patients with a continuous crescent-shaped reflection pattern (R3), 92.9% had hard stool. R3 was found to be significantly associated with a Mini-Mental State Examination score of ≤10. In most of the patients, US detected a continuation of reflection with acoustic shadow in rectal patterns, indicating fecal retention in the rectum. Point-of-care US can be used by nurses to visualize rectal fecal retention as constipation patterns in the older people with physical and cognitive impairment at long-term care facilities. MDPI 2018-05-25 /pmc/articles/PMC6023545/ /pubmed/29799515 http://dx.doi.org/10.3390/healthcare6020055 Text en © 2018 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Tanaka, Shiho
Yabunaka, Koichi
Matsumoto, Masaru
Tamai, Nao
Noguchi, Hiroshi
Yoshida, Mikako
Nakagami, Gojiro
Sugama, Junko
Sanada, Hiromi
Fecal Distribution Changes Using Colorectal Ultrasonography in Older People with Physical and Cognitive Impairment Living in Long-Term Care Facilities: A Longitudinal Observational Study
title Fecal Distribution Changes Using Colorectal Ultrasonography in Older People with Physical and Cognitive Impairment Living in Long-Term Care Facilities: A Longitudinal Observational Study
title_full Fecal Distribution Changes Using Colorectal Ultrasonography in Older People with Physical and Cognitive Impairment Living in Long-Term Care Facilities: A Longitudinal Observational Study
title_fullStr Fecal Distribution Changes Using Colorectal Ultrasonography in Older People with Physical and Cognitive Impairment Living in Long-Term Care Facilities: A Longitudinal Observational Study
title_full_unstemmed Fecal Distribution Changes Using Colorectal Ultrasonography in Older People with Physical and Cognitive Impairment Living in Long-Term Care Facilities: A Longitudinal Observational Study
title_short Fecal Distribution Changes Using Colorectal Ultrasonography in Older People with Physical and Cognitive Impairment Living in Long-Term Care Facilities: A Longitudinal Observational Study
title_sort fecal distribution changes using colorectal ultrasonography in older people with physical and cognitive impairment living in long-term care facilities: a longitudinal observational study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6023545/
https://www.ncbi.nlm.nih.gov/pubmed/29799515
http://dx.doi.org/10.3390/healthcare6020055
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