Effectiveness of Squatting Position on Constipation Severity and Defecation Problems

Study Overview
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Brief Summary
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One of the most common nursing care problems after surgery is defecation problems and the risk of constipation. The aim of the study was to determine the effectiveness of the squatting position with footstool on the constipation severity and defecation problems in the postoperative period in patients with hernia surgery.

Detailed Description
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In this study, after the surgical procedure, the patients were placed in a squatting position by placing a stool under their feet in the toilet.

Official Title
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Effectiveness of Squatting Position on Constipation Severity and Defecation Problems in the Postoperative Period of Hernia Surgery

Conditions
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Constipation, Postoperative Care, Nursing Care

Intervention / Treatment
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* Other: Squatting position by footstool


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Hernia surgery in the general surgery clinic Between 18 and 65 years of age BMI between normal and overweight (18.50-24,99 kg/m2: Normal,25-29,99 kg/m2: Overweight) Being able to establish verbal communication Volunteering to participate in the study Absence of mental confusion Having full consciousness and orientation Having no communication difficulties Having a constipation risk between moderate to high Using a water closet type toilet at home Exclusion Criteria: Having a low risk of constipation Patient who declined to participate in the study

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: pretest-posttest time series model with the different control group
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Squatting position by footstool<br>After the first postoperative ambulation, stable patients whose bowel movements resumed met their initial defecation needs with the squatting position created using a footstool at the appropriate height on the water closet type toilet. The patients used footstools in the hospital and throughout a week after discharge at home for defecation. | Other: Squatting position by footstool<br>* Before the study, the height of the toilet bowls in the patient rooms was measured as 42 cm. The stools to be used for the study are manufactured by ordering laminated with white medium density fiberboard and synthetic resin resistant to harsh chemicals. Stools are made of high quality non-slip materials for patient safety. After the first postoperative ambulation, stable patients whose bowel movements resumed met their initial defecation needs with the squatting position created using a stool at the appropriate height on the water closet type toilet. The patients used footstools throughout a week after discharge at home and in the hospital for defecation.<br>|
| No Intervention: Control Group<br>The control group received the routine care provided to all the patients in the clinic with no additional interventions. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change from before surgery in The Constipation Severity Scale (CSS) average score | Constipation Severity Scale (CSS) aims to determine individuals' defecation frequency, intensity, and difficulty. The CSS consists of 16 items and three sub dimensions, namely Excrement Congestion, Large Bowel Laziness, and Pain. The lowest score that can be attained from the CSS is 0 while the highest score that can be attained is 73. | Data were collected before surgery, post-op 1st day, post-op 2nd day and on the 7th day after discharge. All of the patients were discharged on the 2nd postoperative day. | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Difficulty pushing in defecation average score | Average score on a scale from 0 to 4. 0 I did not experience any difficulties, 1 I had mild difficulties, 2 I had some difficulties, 3 I had a lot of difficulties, 4 I experienced extreme difficulties. | Data were collected post-op 2nd day and on the 7th day after discharge. All of the patients were discharged on the 2nd postoperative day. | 
| Duration of defecation, average minutes | The time (minutes) the patient spent defecation. | Data were collected post-op 2nd day and on the 7th day after discharge. All of the patients were discharged on the 2nd postoperative day. | 
| Defecation pain average score | The Visual Analog Scale (VAS) consists of a 10 cm line used to evaluate defecation pain by scoring it between 1 and 10. | Data were collected post-op 2nd day and on the 7th day after discharge. All of the patients were discharged on the 2nd postoperative day. | 
| Stool consistency | Bristol Stool Scale (BSS) is designed to classify the form of human faeces into seven categories. Types 1-2, hard; types 3-5, normal; types 6-7, loose/liquid | Data were collected post-op 2nd day and on the 7th day after discharge. All of the patients were discharged on the 2nd postoperative day. | 
| Fear of pushing in defecation average score | Average score on a scale from 0 to 4. 0 No Fear, 1 Slightly Scared, 2 Slightly Scared, 3 Very Afraid, 4 Extremely Too Afraid. | Data were collected post-op 2nd day and on the 7th day after discharge. All of the patients were discharged on the 2nd postoperative day. | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Squatting Position, Constipation, Defecation problems, Clinical Nursing Research