Constipation is a multifactorial digestive disorder highly prevailing among the hospitalized elderly Orthopaedic patients. Unlike Western countries, laxative therapy is used to be the first line remedy for constipation in many hospitals of Hong Kong although fiber-rich diet has been proven by numerous studies as the best alternative with low cost and less complications. This dissertation is a translational nursing research which aims at formulating a programme of using fiber-rich food products for relieving constipation in elderly Orthopaedic patients, based on the best available research evidences. It was started with an integrated and systematic review of papers studying the dietary interventions for relieving constipation and reducing laxative consumption in elderly with ADL dependency. Seven relevant studies were identified and critically appraised using the methodology checklist for RCTs designed by Scottish Intercollegiate Guidelines Network (SIGN). After summarizing and synthesizing the data, three dietary interventions with 1+ level of evidence were concluded as the most effective strategies for eradicating the clinical issue. Following assessment of the implementation potential of the proposed innovation in designated clinical setting in terms of transferability, feasibility and cost-benefit ratio, an evidence-based dietary fiber enrichment programme was developed with recommendations for patient recruitment, intervention and evaluation. Furthermore, to assure a smooth change of practice and to determine the effectiveness of the programme, comprehensive plans of communication with different stakeholders, pilot study and evaluation were also subsequently established. With this evidence-based programme, the prevalence of functional constipation and laxative consumption are hoped to be reduced in elderly Orthopaedic patients. / published_or_final_version / Nursing Studies / Master / Master of Nursing

M.Tech.

M.Tech. / Estimates extrapolated from the UK, USA and Canada, suggest a prevalence of chronic constipation in South Africa of approximately 700-720,000 in a population of 44 million (Cure Research, 2007). According to Rivkin and Chagan (2006) these US statistics do not accurately represent the true incidence of the problem which is predominantly self managed. The yearly US sale of over the counter laxatives exceeds $600 million (2006). Allopathic treatments only temporarily alleviate constipation, and overuse of laxatives results in many side-effects. The objective of this study was to determine the efficacy of Constipation 6c®, in the treatment of symptoms of functional chronic constipation, in females using the modified Rome II criteria for chronic constipation. This double blinded study was conducted using matched pairs. Thirty female participants between the ages of 18-35 were recruited using advertisements placed at the Health Training Centre on the UJ Doornfontien campus and Weleda Pharmacy (Fourways). The study was conducted over six weeks, during which time the participants attended weekly consultations. At the first consultation participants signed an information and consent form (Appendix B). For the first week no medication was administrated, however participants were asked to complete a daily recording sheet rating their symptoms (Appendix D) based on the modified Rome II criteria for chronic functional constipation. At the second visit participants were match-paired according to age, severity of symptoms and duration of symptoms (Appendix K). Participants were randomly assigned to either the experimental or the placebo group by an independent administrator. During the follow up consultations participants received the complex homoeopathic remedy, Constipation 6c® or placebo, and were instructed to take five pillules three times a day, and to record changes in symptoms on the daily recording sheet (Appendix D). At each follow up visit, the researcher collected the daily recording sheets, completed a focused physical examination and documented any changes in symptoms.