A Nursing intervention using dietary fiber to prevent constipation of orthopedic patients




Schmelzer, Marilee

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The purpose of this study was to determine whether an increase in dietary fiber intake can prevent constipation of hospitalized orthopedic patients. Orthopedic patients are susceptible to constipation because of decreased mobility, the use of constipating analgesics, and dependence on bedpans. Wheat bran is a dietary fiber that had been used effectively to treat constipation of other populations, but it had not been tested with orthopedic patients.

Nine men and 7 women, ages 42 to 81, were recruited from three hospitals and randomly assigned to experimental and control groups. The patients had orthopedic surgery that would decrease their physical activity.

Following surgery, when they resumed eating solid foods, the eight experimental subjects received additional wheat bran fiber daily, baked into muffins and cookies. The eight control subjects ate muffins and cookies containing no wheat bran. Neither group received routine laxatives or stool softeners, although laxatives were given when the patients complained of constipation.

All participants remained in the study for seven days beginning with the day of surgery. Both groups were encouraged to drink at least 1500 ml of fluid daily and food and fluid intakes were recorded. Subjects described their own bowel movements using a checklist. Additional descriptive information was collected, including previous eating, activity, and bowel habits, as well as medication use and activity during the study.

The multivariate Hotelling T\sp2 procedure was used to test whether the groups differed in stool frequency, number of laxatives used, and the time between surgery and the first bowel movement and no significant differences were found. A Fisher Exact Probability test was used to determine if the incidence of constipation differed between the two groups and no significant difference was found.

Members of the experimental group complained that the muffins and cookies were dry and ate less than the recommended amount of 20 grams daily. This might account for the lack of effect on bowel function. Pearson correlation coefficients found a significant positive relationship between the amount of the muffins and cookies ingested and the number of stools, and a significant negative relationship between the amount of the muffins and cookies eaten and laxative intake.

In conclusion, the high fibers foods did not help prevent constipation of the orthopedic patients, possibly because the patients did not eat a sufficient amount.



Orthopedic patients, Dietary fiber, Constipation prevention, Invervention, Nursing care