Breaking ground: nursing-led approach to alleviating constipation in Parkinson's disease

Constipation is one of the most common non-motor symptoms in PD patients, and the constipation, can appear before motor symptoms. Incorrect treatment of constipation in PD patients can result in colonic volvulus and pseudo intestinal obstruction, as well as a reduction in the therapeutic effect of anti-PD drugs due to absorption issues. There is, however, no comprehensive and scientific nursing intervention plan for PD patients' constipation who are constipated.

A multi-disciplinary nursing research group of five people was established to construct the first draft of intervention plan through literature review. We chose 15 experts from 7 universities and tertiary hospitals spread over 5 provinces (cities), including 4 neurologists, 9 clinical nursing specialists in neurology, 1 dietician, and 1 rehabilitator. Two rounds of consultations were held from April to July 2022 with 15 experts to screen and revise the indicators at each level, confirming their importance and feasibility at each level.

There were three primary indicators (pre-intentional stage, intentional stage, and action stage) in the two rounds of expert correspondence, nine secondary indicators (disease risk perception, adverse consequence expectation, self-efficacy and intention of action; action plan, coping plan and coping self-efficacy; produce healthy behaviors, maintain healthy behaviors, recover behaviors and recover self-efficacy), and 22 tertiary indicators.

After the implementation of two rounds of Delphi method, the final formed constipation intervention program for PD patients provides the basis for clinical nursing practice, which has the characteristics of convenience, comprehensiveness, dependence, scientific and feasibility. Therefore, it has application and promotion value.