| Objective: To investigate the risk factors of elderly CHD patients with constipation through the use of abdominal massage with acupoint therapy. Through clinical nursing practice, the study aims to evaluate the intervention effect in terms of its improvement on the defecation of elderly CHD patients with constipation, and thus their quality of life, as well as its reduction of the risk of adverse cardiac events caused by constipation.Method: 1 Objects and GroupingThere were 119 elderly CHD patients with constipation in the Internal Cardiology Department of No. 2 Beijing Hospital from October 2013 to October 2014. They were divided into 59 control groups and 60 experimental groups under randomized method. During the experiment, four were eliminated from the experimental group(due to aggravation of medical condition; two were considered inappropriate for abdominal massage, while the rest left the hospital) and three were eliminated from the control group(there was one case of worsened medical condition and two cases of less than ten days of stay at the hospital). Both groups now have 56 each; when compared, the two groups have no statistical differences(P> 0.05) in terms of age structure, sex, occupation, and education level. 1.1 Introduction to standards: age≥60; All samples accorded with CHD diagnosis standard of WHO, heart function≤level2; accord with constipation diagnosis standard of The Rome Ⅲ; have the ability to answer question, have no difficulty communicating; no digestive issues; volunteered to join this research. 1.2 Rejection standard: cannot undergo abdominal massage; have serious organ issues or other serious medical conditions 1.3 Elimination standard: patients’ medical condition has changed during the research, heart function ≧ level 3; hospital stay less than 10 days; rejection standards appear; 2 Nursing MethodsThe two groups of patients were treated using different nursing methods while they were under CHD treatment. The control group received usual care while the experimental group were given abdominal massage with accupoint therapy in addition to usual care. 3 Research MethodsQuestionnaires and surveys were filled on the first day and the tenth day in the hospital. A variety of indicators and changes before and after the experiment, between and within the control group and experimental group were compared. The clinical nursing effects of abdominal massage with acupoint therapy were evaluated. 3.1 usual condition questionnaireInvestigate patient’s age, sex, education level, occupation. 3.2 Wexner constipation chartThere are 8 topics, 38 conditions, each topic consists of 0,1,2,3,4 points and five levels, point total is 30, healthy group<eight points; higher the points, more severe the constipation condition 3.3 anxiety self-survey(SAS)SAS consists of 15 positive questions and 5 negative questions, with a total of 20 projects. Each project is set to have 1,2,3,4 points, the sum of each value multiplies by 1.25 to yield the resultant point value. SAS results can be grouped into 50 points, 50-59 points are considered slightly anxious, 60-69 points moderately anxious, 70 and above is considered severely anxious. Higher the value, greater the anxiety. 4 Research ToolsTwo types of authoritative research tools that were recognized and applied globally were used to evaluate the interventional effects. 4.1 General questionnaireThe survey of patients’ name, age, sex, education level and former occupation was taken. 4.2 Wexner constipation score tableWexner constipation score table sets 8 entries 38 kinds of circumstances.Each entry can be assigned 0, 1, 2, 3, or 4 points, creating five levels and a possible total of 30 points. A healthy individual has <8 points; the higher the score, the more severe the constipation. 4.3 Self-Rating Anxiety Scale(SAS)SAS includes 15 positive rating questions and five reverse rating questions, all of which add up to 20 items. Each category can be assigned 1, 2, 3, or 4 points, and the total number of points are multiplied by 1.25, giving the assessment score. The Boundary value of SAS is 50 points; 50 to 59 is mild anxiety, 60-69 is moderate anxiety, and over 70 points is severe anxiety; the higher the score, the more severe the anxiety.5 Statistical processingUsing SPSS 17.0 statistical software to make data processing. The comparison of measured data between two groups was made using t test. The comparison within each group was made using paired t test. The comparison between two groups was made using two independent samples t test. The comparison of the constituent ratios of counted data was made using χ2 test. All comparisons were made under the condition that P <0.05 was the statistical difference.Results:1 general situational comparison of the two groupsThere was no statistical difference(P> 0.05) in the age structure, sex, occupation, education, etc. between the control group and the experimental group. The two groups were comparable.2 comparison of patients’ Wexner constipation score between the two groupsThere was no significant score difference at the beginning of admission between the two groups(P> 0.05). Scores of both groups on the tenth day in the hospital were lower than that of the time of admission. The difference was statistically significant(P <0.05). The experimental group was better than the control group, so the difference was statistically significant(P <0.001).3 Comparison of patients’ defecation between the two groupsDefecation in the two groups exhibit was no significant difference during the time of admission(P> 0.05). Weekly defecation frequency increased on the 10 th day after admission in the stool of both groups, but the defecation frequency improvement of the experimental group was more significant than that of the control group; defecation difficulty decreased; the sense of incomplete bowel evacuation was reduced; pain was relieved; the time of defecation was shortened; assist defecation decreased; bowel failure reduced, and the difference was statistically significant(P <0.05).4 comparison of patients’ anxiety scores patients between two groupsThe statistical results of the anxiety scale before and after the intervention showed that there was a certain degree of anxiety symptoms in both groups before the intervention, there was no statistical difference between the two groups(P> 0.05). Patients’ anxiety after the intervention of the two groups was controlled at a certain degree compared with that before the intervention. The difference was statistically significant(P <0.05 and P <0.01), but the comparison of anxiety scores between the two groups showed that the anxiety reduction in the intervention group was significantly better than that of the control group(P <0.05).5 Comparison of patients’ complications between the two groups during the period of hospitalizationOne patient in the control group did not defecate for three days, and was accompanied by chest discomfort and sweating during bowel movement(in a sitting position). There was no significant changes compared to that of the previous ones on urgent ECG. There was no significant performance of ischemia. The discomfort was relieved after the patient received oxygen, rested in bed, and taken sublingual nitroglycerin 0.5mg. The above situation did not appear in the intervention group. No cardiovascular complications happened in the two groups during hospitalization.Conclusion:1 constipation problems of elderly CHD patients with constipation in the intervention group can be improved by applying abdominal massage with acupoint therapy.2 Anxiety symptoms of elderly CHD patients with constipation can be relieved after applying abdominal massage with acupoint therapy.3 Abdominal massage with acupoint therapy is easy to be accepted by elderly CHD patients with constipation, and does not happen any complications caused by defecation difficulties in the process of implementation. |
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