Developing and Testing a Nursing Care Model to Prevent Fecal Incontinence after Digital Extraction

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  • 摘便後の便失禁を予防する看護実践モデルの作成および適用による実証的検討
  • テキベン ゴ ノ ベン シッキン オ ヨボウ スル カンゴ ジッセン モデル ノ サクセイ オヨビ テキヨウ ニ ヨル ジッショウテキ ケントウ

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Fecal incontinence after digital extraction causes much distress and burden for those who receive home care and their family. The purpose of this study is to clarify techniques to prevent fecal incontinence after digital extraction that have not been documented but have been used by some practitioners, and to examine their effectiveness. We interviewed 4 nurses and a family caregiver regarding the techniques they use to prevent fecal incontinence and summarized it. Then home care nurses utilized the techniques documented in the summary in their practice, and whether the techniques were effective to prevent incontinence was examined. Data on the total of 68 digital extractions were collected from 12 clients and their home care nurses (n＝8). 1) Fecal incontinence did not decrease by using the model; 2) when there was the sign of “mucus discharge” at the end of digital extraction, the episodes of fecal incontinence was significantly fewer than the digital extractions without the sign; 3) the sign of “mucus discharge” was seen only when enema was used prior to the digital extraction; 4) when there was the sign of “feeling of rectum descending/closing,” the fecal incontinence tended to be fewer. Based on the findings, it was suggested that in order to prevent fecal incontinence nurses should not complete digital extraction before the mucus discharge appears if the enema is used. We need to collect more data to examine the effectiveness of the sign of “feeling of rectum descending/closing” as a sign to prevent fecal incontinence.

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