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Factors Associated With Intestinal Constipation in Chronic Patients With Stroke Sequelae Undergoing Rehabilitation
Tânia Mara Nascimento de Miranda Engler1, Márcia Helena de Assis Aguiar, Íris Aline Brito Furtado
1Tânia Mara Nascimento de Miranda Engler, PhD, RN, is Nurse, Universidade de Brasília-UnB, Brasília (DF), Brazil; and Rede SARAH de Hospitais de Reabilitação, Brasília (DF), Brazil. Márcia Helena de Assis Aguiar, RN, is Nurse, Rede SARAH de Hospitais de Reabilitação, Brasília (DF), Brazil. Íris Aline Brito Furtado, RN, is Nurse, Rede SARAH de Hospitais de Reabilitação, Brasília (DF), Brazil. Samile Pereira Ribeiro, RN, is Nurse, Rede SARAH de Hospitais de Reabilitação, Brasília (DF), Brazil. Pérola de Oliveira, MD, MSc, is Neurologist, Rede SARAH de Hospitais de Reabilitação, Brasília (DF), Brazil. Paulo Andrade Mello, MD, PhD, is Professor of Neurosurgery, Faculdade de Medicina da Universidade de Brasília- Brasília (DF), Brazil. Marcele Pescuma Capeletti Padula, PhD, RN, is Professor of Nursing, Santa Casa de Sao Paulo School of Medical Sciences, São Paulo (SP), Brazil. Paulo Sérgio Siebra Beraldo, MD, PhD, is Medical Doctor, Faculdade de Medicina de Ribeirão Preto - FMRP/USP, Ribeirão Preto (SP), Brazil.
Abstract:
The objective of this study was to define which stroke-related factors constitute independent variables in the incidence of intestinal constipation (IC) of chronic patients admitted to a hospital rehabilitation program. All patients consecutively admitted for rehabilitation were recruited for the study. In the Poisson multiple regression analysis using a hierarchical model, sociodemographic variables, comorbidities, medication, previous history of constipation, life habits, and stroke-related variables were considered for defining factors associated with IC. A 31% prevalence (95% confidence interval [CI]: 25.3-37.1) of IC was detected. Among the factors associated, female gender (adjusted prevalence ratio [PRadjusted] = 1.79; 95% CI: 1.20-2.68), intestinal complaints prior to stroke (PRadjusted = 3.71; 95% CI: 2.60-5.31), intake of less than 800 ml of fluid per day (PRadjusted = 1.72; 95% CI: 1.20- 2.45), age greater than 65 years at brain injury (PRadjusted = 1.67; 95% CI: 1.01-2.75), and partially impaired anterior brain circulation (PRadjusted = 3.35; 95% CI: 1.02-10.97) were associated with IC. Female gender, elderly, prior history of IC, low fluid intake, and partial impairment of anterior brain circulation were factors independently associated with IC in stroke survivors undergoing rehabilitation. These findings require further validation and may serve toward improving bowel retraining programs for this patient group.
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