The constipation severity instrument: A validated measure
ABSTRACT This study was designed to develop and test the validity and reliability of the Constipation Severity Instrument.
Scale development was conducted in two stages: 1) 74 items were generated through a literature review and focus groups of constipated patients and medical providers; and 2) a preliminary instrument was administered to 191 constipated patients and 103 healthy volunteers. Test-retest reliability of the constipated group was assessed (N=90). Content, convergent, divergent, and discriminant validity were evaluated by using other validated measures by performing one-way analysis of variance and Pearson correlations.
Exploratory and confirmatory factor analysis revealed three subscales: obstructive defecation, colonic inertia, and pain. Internal consistency (alpha=0.88-0.91) and test-retest reliability (intraclass correlation coefficients=0.84-0.91) were high for all subscales. Constipated patients were grouped by Rome II criteria: functional constipation (22 percent), pelvic floor dyssynergia (15 percent), constipation predominant irritable bowel syndrome (23 percent), and no specific criteria (40 percent). Those with constipation predominant irritable bowel syndrome or pelvic floor dyssynergia scored higher on the Obstructive Defecation and Colonic Inertia subscales than those with functional constipation or no specific criteria (P=0.001-0.058). Subjects with functional constipation had much lower scores on the pain subscale than constipation predominant irritable bowel syndrome, functional constipation, or no specific criteria (P<0.009). The Constipation Severity Instrument subscale and total score correlated very highly with the subscales and total score of the Patient Assessment of Constipation Symptom measure. The Constipation Severity Instrument subscales discriminated well between constipated patients and healthy volunteers (P<0.001) and demonstrated excellent divergent validity. Higher Constipation Severity Instrument scores inversely correlated with general quality of life.
The Constipation Severity Instrument is a reliable and valid instrument for assessing constipated patients. Administration of the Constipation Severity Instrument to other constipated patients will further validate its use.
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- "and CSI average total score is 14.27±11.28. This result is similar to results of another study implemented on healthy individuals   , and showed that this group, who came to the neurosurgery clinic in order to be operated formed the sample of the study, carries low risk in terms of pre-operative constipation. Postoperative absolute bed rest for a while, suppression of defecation feeling, the use of bedpans, lack of privacy in the hospital setting, patients' difficulty to express discomfort and analgesic drugs (opioid and nonopioid agents) used in pain management might cause in patients intestinal excretion problems. "
ABSTRACT: Background. Preventing constipation is very important for patients in neurosurgery clinics and especially for those who had cerebral hemorrhage and brain tumor surgery as it might lead to elevated intracranial ressure. Therefore, it is necessary to diagnose constipation especially in individuals in neurosurgery clinics. Aim. This study has been designed as a descriptive and a cross-sectional study intending to identify constipation risk and the factors affecting it in neurosurgery patients. Material and methods. The population of the study consists of patients who stayed at a university hospital in Turkey between April 2011 and April 2012, and the sample population consists of 231 people selected by random sampling method. Data were collected using a Patient Information Form, Constipation Severity Instrument (CSI) and Constipation Risk Assessment Scale (CRAS). Data were analyzed using the SPSS version 11.5 for Windows Results. 55,4% of the patients in the study were women and the average age was 43,80±13,65. CSI Total score average of the patients at admission was low (14,27±11,28). According to CRAS, 14,3% of the patients at admission, 40,7% of the patients on the 3rd day of surgery, and 32,5% of the patients at discharge were in medium and high risk group in terms of constipation. It has been determined that women, old people, people who use analgesics, and people who stay long at a hospital are at higher constipation risk. Conclusions. As result of the data gathered in the study, it has been concluded that nurses working in neurosurgery clinics should not ignore preoperative and postoperative constipation risk in order to be able to give integrated care.
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- "Subscales: Obstructive Defecation (0-28); Colonic Inertia (0-29); and Pain (0-16)) with higher scores indicating more frequent, severe, and bothersome constipation symptoms (Varma, et al., 2008 "
ABSTRACT: The multisystem nature of female chronic pelvic pain (CPP) makes this condition a challenge for physical therapists and other health care providers to manage. This article uses a case scenario to illustrate commonly reported somatic, visceral, and neurologic symptoms and their associated health and participation impact in a female with CPP. Differential diagnosis of pain generators requires an in-depth understanding of possible anatomic and physiologic contributors to this disorder. This article provides a detailed discussion of the relevant clinical anatomy with specific attention to complex interrelationships between anatomic structures potentially leading to the patient's pain. In addition, it describes the physical therapy management specific to this case, including examination, differential diagnosis, and progression of interventions. Clin. Anat., 2012. © 2012 Wiley Periodicals, Inc.Clinical Anatomy 01/2013; 26(1). DOI:10.1002/ca.22187 · 1.16 Impact Factor
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ABSTRACT: Durch eine strukturierte Anamnese, die Erfassung von Konsensuskriterien und die klinische Untersuchung lässt sich die überwiegende Zahl proktologischer Erkrankungen diagnostizieren. Zur weiterführenden Diagnostik von Analfisteln sind Endosonographie und Magnetresonanztomographie (MRT) gleichwertige Verfahren. Die MRT bietet Vorteile bei der Darstellung von komplexen Fisteln und Rezidivfisteln. Anorektale Funktionsstörungen sind multifaktoriell und mit Veränderungen im Bereich der Beckenbodenkompartimente vergesellschaftet. Bei der Beckenbodendiagnostik nimmt die MR-Defäkographie eine zentrale Stellung ein. Andere funktionelle diagnostische Methoden und neurophysiologische Untersuchungen treten wegen fehlender Standards und hoher physiologischer Variabilität in den Hintergrund. Zur Objektivierung der vielschichtigen Symptomenkomplexe und der Lebensqualität ist die subjektive Einschätzung des Patienten anhand von Scores notwendig. Problematisch sind die Vielzahl, die unterschiedliche Güte und fehlende Standards bei der Anwendung von Scores. Die Zusammenführung der bildmorphologischen Untersuchungsbefunde mit der in Scores erfassten subjektiven Wahrnehmung ist Voraussetzung für eine Optimierung der Diagnostik und Therapiebewertung in der Proktologie.Der Chirurg 12/2012; 83(12). DOI:10.1007/s00104-012-2296-8 · 0.52 Impact Factor