METHODS: A scoping review was conducted according to the recommendations of the Joanna Briggs Institute.
METHODS: Searches were performed in PubMed, LILACS, CINAHL, COCHRANE, and SCOPUS electronic databases. We use searched the gray literature using the Google Scholar search engine. We formulated a question to guide the search, based on the participants, concept, and context format: \"What are the key manual nursing interventions performed in patients with neurogenic bowel dysfunction resulting from complete spinal cord injury?\" We included nursing intervention strategies that may be performed by health professionals, patients, or caregivers. Two reviewers independently participated in the selection; disagreements were resolved by a third reviewer and 5 experts.
RESULTS: Thirteen studies conducted between 1998 and 2019 were selected; 5 were randomized clinical trials. Four main interventions were identified for conservative management of neurogenic bowel dysfunction in patients with complete SCI. They were digital-anal stimulation, manual extraction of feces, abdominal massage, and strategies used to stimulate the gastrocolic reflex.
CONCLUSIONS: Research suggests that each of these interventions, administered alone or in combination, supports bowel evacuation in patients with a complete SCI. Each of these interventions may be performed by a nurse, and taught to the patient and/or lay caregiver.
CONCLUSIONS: An individualized bowel management program for patients with neurogenic bowel dysfunction due to SCI is necessary to ensure regular bowel evacuation, preserve fecal continence, and support dignity and health-related quality of life. The conservative interventions identified in this scoping review should be incorporated in protocols or guidelines for management of neurogenic bowel dysfunction in this vulnerable population.
方法:根据JoannaBriggs研究所的建议进行了范围审查。
方法:在PubMed中进行搜索,LILACS,CINAHL,Cochrane,和SCOPUS电子数据库。我们使用谷歌学者搜索引擎搜索灰色文献。我们制定了一个问题来指导搜索,基于参与者,概念,和背景格式:“对完全脊髓损伤引起的神经源性肠功能障碍患者进行的关键手动护理干预措施是什么?”我们包括了可能由卫生专业人员进行的护理干预策略,病人,或看护者。两名审稿人独立参与了选择;第三名审稿人和5名专家解决了分歧。
结果:选择了1998年至2019年进行的13项研究;5项是随机临床试验。确定了四种主要的干预措施,用于保守治疗完全性SCI患者的神经源性肠功能障碍。它们是数字肛门刺激,手工提取粪便,腹部按摩,和刺激胃结肠反射的策略。
结论:研究表明,这些干预措施中的每一种,单独或联合给药,支持完全SCI患者的肠排空。这些干预措施中的每一个都可以由护士进行,并教导患者和/或外行护理人员。
结论:脊髓损伤引起的神经源性肠功能障碍患者的个性化肠道管理计划对于确保定期肠排空是必要的,保持大便失禁,并支持尊严和健康相关的生活质量。本范围审查中确定的保守干预措施应纳入该脆弱人群的神经源性肠功能障碍治疗方案或指南中。