Constipação intestinal em pacientes com paralisia cerebral: avaliação dos resultados das intervenções de enfermagem

Abstract

Constipation affects about 74% of cerebral palsy patients. This study evaluatednursing interventions in the management of constipation among Cerebral Palsy patients,used in an Ambulatory for reeducation of the bowel in a Rehabilitation Hospital Network.This is a quantitative, longitudinal prospective study. Sample was composed by 50 patientswho presented Quadriplegic Cerebral Palsy and constipation. The study evaluatedreeducation of the bowel through conservative management of constipation, using astructured form in 2 appointments for familiar orientation and training, in an interval of 2 to3 months. Data related to the frequency of bowel movement and feces consistency werecollected using a form filled up by the caregivers. The conservative orientation given to thefamilies were: daily intake of laxative food such as fruits and vegetables, vegetal oil withthe main meals, and increased fluid intake. The caregivers were also trained for systematicabdominal massage and pressure. Seventy per cent of the patients had complete relief fromthe constipation, 20% had partial relief, and 10% had little relief, remaining with theconstipation. At the end of the study, the patients presented better quality of life related toimproved sleep, nutrition, irritability, and significant decrease of complications like rectalbleeding, anal fissure, maneuver to retain feces, and pain while evacuating. Reeducation ofthe bowel through conservative management of constipation was effective in this study. Werecommend this management mainly for Quadriplegic Cerebral Palsy patients, and the useof medication just to start the therapy, as needed.