Vpliv različnih položajev odvajanja na zdravje ljudi in vloga zdravstvene nege pri odvajanju v postelji

• Main Author: Vovk, Tomaž
• Other Authors: Vettorazzi, Renata
• Format: Bachelor Thesis
• Language: Slovenian
• Published: 2017
• Subjects: položaj telesa; kakanje; defekacija; stranišče; čepenje; nočna posoda; medicinska sestra; body position; poop; defecation; toilet; squat; bed pans; nurse; Kap; The Buttocks; sami
• Online Access: https://repozitorij.uni-lj.si/IzpisGradiva.php?id=92582; https://repozitorij.uni-lj.si/Dokument.php?id=99361&dn=; https://plus.si.cobiss.net/opac7/bib/5276523?lang=sl

Uvod: Na odvajanje blata vplivajo psiho-vedenjski dejavniki, peristaltika, volumen in konsistenca blata, prehrana, starost, spol, položaj odvajanja, in drugi vplivi. V zdravstveni negi se priporočajo različni koti dvignjenega vzglavja za odvajanje v postelji po namestitvi nočne posode. Namen: Raziskati vpliv različnih položajev odvajanja na zdravje in počutje ljudi ter opredeliti vlogo zdravstvene nege pri odvajanju v postelji. Metode dela: Uporabljena je deskriptivna metoda dela s pregledom znanstvene in strokovne literature. Pregled literature je bil opravljen med julijem 2015 in majem 2016. V analizo je bilo vključenih 24 člankov. Rezultati: Sedeči položaj odvajanja je dejavnik tveganja za nastanek hemoroidov, obstipacije, raka, prolapsa medeničnih organov, urinske inkontinence, vnetne črevesne bolezni, divertikuloze, hiatusne hernije, gastro-ezofagealne refluksne bolezeni, kardio-vaskularnih dogodkov in akutne pulmonalne tromboembolije. Čepeči položaj odvajanja je dejavnik tveganja za možgansko kap in globoko venozno trombozo pri ogroženih osebah. Pri pacientih z že motenim pretokom krvi zaradi periferne arterijske bolezni čepenje povzroči nadaljnje ishemične poškodbe perifernega tkiva. Vsaka epizoda čepenja pri teh bolnikih pospeši potek bolezni. Čepenje je najbolj naraven in fiziološki položaj odvajanja. Pacienti navajajo neprijetne značilnosti klasičnih nočnih posod, kot so trdota, hladnost in pritisk robu na zadnjico. Pacienti, ki morajo odvajati v postelji, se pogosto izogibajo uporabi nočne posode, tako da zmanjšajo vnos tekočine v telo ali tako, da na skrivaj vstajajo in sami odidejo na stranišče. To vedenje je nevarno in ima lahko negativne posledice na zdravje. Pri ležečem levem bočnem položaju se pri nekaterih pojavijo disinergični vzorci odvajanja. Razprava in zaključek: Pri sedečem položaju odvajanja je potreben veliko večji napor za odvajanje, ki je vzročni dejavnik za številne zdravstvene težave. Z informiranjem javnosti o tveganjih, povezanih z modernimi stranišči, lahko preprečimo veliko nepotrebnega trpljenja. Zaradi nefleksibilnosti bi imelo mnogo ljudi težave pri prilagajanju na čepeča stranišča. V 40 letih lahko dosežemo, da bo 90% populacije sposobna odvajati v čepečem položaju. Optimalen položaj pri odvajanju v postelji je položaj s čim bolj dvignjenim vzglavjem in podprtim ledvenim delom. Nekatere medicinske sestre težko zagotavljajo čustveno oskrbo, kar se kaže z negativnim odnosom do pacientov. Sistem je potrebno preoblikovati tako, da bo zaznal te odklone in se ustrezno odzval na to. Percepcija pacientov o kakovosti zdravstvene nege je v veliki meri odvisna od sposobnosti medicinske sestre, da prepozna potrebe pacienta. Najbolj vidna vloga medicinske sestre pri odvajanju v postelji je namestitev pacienta v optimalen položaj in nega, nekoliko manj vidna pa še nudenje čustvene podpore, zmanjševanje zadrege ter ostalih neprijetnih občutij v povezavi z aktivnostjo odvajanja. Introduction: Defecation is influenced by: psycho-behavioral factors, peristalsis, volume and consistency of the stool, diet, age, gender, position of defecation and other influences. In health care different bed reclining angles are recommended for defecation in bed after installing bedpans. Purpose: To investigate the effect of different positions of defecation on human health and well-being and to define the role of nursing in defecation in bed. Methods: We used the descriptive method with a review of the scientific and technical literature. A literature review was made between July 2015 and May 2016. In the analysis it included 24 articles. Results: The sitting position of defecation is a risk factor for hemorrhoids, constipation, cancer, pelvic organ prolapse, urinary incontinence, inflammatory bowel disease, diverticulosis, hiatal hernia, gastroesophageal reflux disease, cardio-vascular events, acute pulmonary thromboembolism. The squatting position of defecation is a risk factor for stroke and deep venous thrombosis in persons at risk. In patients with an already disturbed blood flow due to peripheral arterial disease squatting can cause further damage to ischemic peripheral tissues. Each episode of squatting in these patients accelerates the course of the disease. Squatting is the most natural and physiological status of defecation. Patients indicate the unpleasant characteristics of traditional bedpans, such as hardness, coldness and pressure within the buttocks. Patients who must defecate in bed often avoid the use of bedpans by reducing the intake of fluids, or secretly getting up and going to the toilet by themselves. This behavior is dangerous and can have negative effects on their health. In the left lateral lying position a dyssynergic pattern of defecation appears in some people. Discussion and conclusion: The sitting position requires much more effort for defecation, which is the causative factor in many health problems. By informing the public about the risks associated with modern toilets we can prevent a lot of unnecessary suffering. Due to inflexibility many people would have difficulties in adapting to squatting toilets. In 40 years we can achieve that 90% of the population are capable of defecation in a squatting position. The optimal position for defecation in bed is the position with the headboard most elevated and a supported lumbar part. Some nurses find it difficult to provide emotional care, which is reflected by the negative attitude towards patients. The system must be restructured in a way that will detect these deviations and adequately respond to it. The perception of patients about the quality of care is largely dependent on the ability of nurses to recognize the needs of the patient. The most visible role of the nurse in defecation in bed is the installation of the patient in the optimal position and care for the patients, a little less visible one is providing emotional support, reducing embarrassment and other unpleasant feelings in connection with the activity of defecation.