Nursing Interventions for Patients With Neurogenic Bowel Dysfunction Arising From Complete Spinal Cord Injury: A...

Area of Science:

• Nursing
• Rehabilitation Medicine
• Neuroscience

Background:

• Neurogenic bowel dysfunction (NBD) is a common complication following complete spinal cord injury (SCI).
• Effective bowel management is crucial for maintaining patient dignity, quality of life, and preventing secondary complications.

Purpose of the Study:

• To map key concepts and identify fundamental nursing interventions for NBD in patients with complete SCI.
• To synthesize evidence on conservative management strategies for NBD in this population.

Main Methods:

• A scoping review was conducted following Joanna Briggs Institute recommendations.
• Searches encompassed major electronic databases and gray literature, guided by a specific research question on manual nursing interventions for NBD in complete SCI.
• Study selection involved independent review by two researchers, with disagreements resolved by a third reviewer and expert consensus.

Main Results:

• Thirteen studies (1998-2019), including five randomized clinical trials, were selected.
• Four primary conservative interventions for NBD in complete SCI were identified: digital-anal stimulation, manual fecal extraction, abdominal massage, and gastrocolic reflex stimulation.
• These interventions can be performed by nurses and taught to patients or caregivers.

Conclusions:

• The identified interventions, individually or combined, aid bowel evacuation in patients with complete SCI.
• An individualized bowel management program is essential for regular evacuation, continence, dignity, and quality of life.
• Conservative interventions should be integrated into protocols for managing NBD in SCI patients.