Journal of Multidisciplinary Healthcare (Nov 2020)
Healthcare Professionals’ Experiences of Assessing, Treating and Preventing Constipation Among Older Patients During Hospitalization: An Interview Study
Abstract
Veronica Lundberg,1 Anne-Marie Boström,1– 3 Kristina Gottberg,1 Hanne Konradsen1,4,5 1Division of Nursing, Department of Neurobiology, Care Science and Society, Karolinska Institutet, Huddinge, Sweden; 2Theme Aging, Karolinska University Hospital, Huddinge, Sweden; 3Research and Development Unit, Stockholms Sjukhem, Stockholm, Sweden; 4Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; 5Department of Gastroenterology, Herlev and Gentofte University Hospital, Herlev, DenmarkCorrespondence: Veronica LundbergDepartment of Neurobiology, Caring Sciences and Society, Karolinska Institutet, Alfred Nobels Allé 23, Huddinge 141 83, SwedenTel +46 8 52483760Email [email protected]: Constipation is a common and troublesome condition among older patients and can result in a variety of negative health consequences. It is often undiagnosed or undertreated. Healthcare professionals have a responsibility to understand and address patients’ overall healthcare needs; so exploring their experiences is, therefore, highly relevant. The purpose of the study was to explore healthcare professionals’ experiences of assessing, treating and preventing constipation among older patients.Methods: A qualitative design with an exploratory approach was used. The participants (registered nurses and physicians) were purposively sampled from three wards in a geriatric department in a medium-sized hospital in Sweden. Data were collected through focus group discussions and individual interviews, and analyzed using content analysis.Results: Three categories were generated: Reasons for suboptimal management of constipation, Strategies for management, and Approaching the patients’ needs. In the care of older patients at risk of or with constipation, decisions were made based on personal knowledge, personal experience and clinical reasoning. A person-centered approach was highlighted but was not always possible to incorporate.Conclusion: Different strategies for preventing and treating constipation were believed to be important, as was person-centered care, but were found to be challenging in the complexity of the care situation. It is important that healthcare professionals reflect on their own knowledge and clinical practice. There is a need for more support, information and specific guidance for healthcare professionals caring for older patients during hospitalization. Overall, this study underscores the importance of adequate access to resources and education in constipation management and that clinical guidelines, such as the Swedish Handbook for Healthcare, could be used as a guide for delivering high-quality care in hospitals.Keywords: bowel, constipation, healthcare professionals, management, older patients
