Functional constipation: implications for nursing interventions.

Abstract

To verify the correlation between anorectal function and psychological conditions of depression/anxiety in patients with functional constipation. The aim of this study is to explore why people with depression/anxiety have higher incidence of functional constipation and recommend innovative interventions to advance patient care of functional constipation.
A prospective correlational design.
Anorectal manometry was performed on functional constipation patients (n=70) through the Medtronic Synectics PC Polygraf, while the psychological condition was tested by Self-Rating Anxiety Scale and Self-Rating Depression Scale. Twenty normal controls were also studied.
Compared with controls, (1) functional constipation patients displayed higher squeezing pressure, defaecation thresholds and maximal volume of tolerance (p<0·01), and there was no significant difference in anorectal resting pressure, defaecating pressure, minimum relaxation volume and first sensation (p>0·05). (2) Functional constipation patients showed higher depression/anxiety scores (p<0·01). (3) The anorectal squeezing pressure was negatively correlated with anxiety and depression scores, while the first sensation and maximal volume of tolerance was positively correlated with depression score (p<0·05).
Abnormal anorectal function correlates to depression/anxiety levels indicating that depression/anxiety may contributes to functional constipation. The possible pathology is via brain-gut axis.
The study indicates that nurses should pay attention to the patients' psychological needs, especially to those interested in seeing the physician and doing unnecessary examinations repeatedly to find any organic disease. Integrated nursing intervention should be applied to improve patients' psychological adaptation and boost the functional constipation therapeutic effect.