الفهرس 
Elderly clientsOnly 14 pages are availabe for public view
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Abstract
Aging is a complex and dynamic process with intricately, interrelated and inseparable physiologic, psycho logic and sociologic components. It is a normal process that implies continued growth development and adaptation until death. Aging is a universal human experience that culminates in an end. It is a dynamic state of existence that changes with one’s perspective. Moreover, aging is a time of confusion and vulnerability to certain risk taking behaviors, which may lead to serious complications as constipation. Accordingly, there is an urgent need to focus more attention on elderly health both physical, and psychological (Salminen &Antero, 2014).
Successful aging: deals with evaluating the present health and life style,identifying risky behaviors and then considering changing these behaviors. Planning for the future financial needs can help enjoy retirement years by maintaining a healthy weight and eat nutritious, low – fat diet that includes plenty of whole grains, fruits,and vegetables, and being physically active, and exercising daily (Rowe and Kahn, 2015).
It is reported that the prevalence of constipation increases with age, especially those over the age of 65 years. In elderly patients living in the community, the prevalence of constipation is 50%. This number is even higher in nursing home residents, with 74% using daily laxatives. Likewise, elderly women are 2 to 3 times more likely to report constipation than their male counterparts. Constipation is also more commonly seen in patients taking multiple medications (Griebling et al., 2016).
Aim of the study
The aim of this study was to evaluate the effect of prevention program of constipation among elderly attending geriatric clubs at Fayoum governorate, through
1- Assessing the knowledge, practice and health habits of the elderly related to constipation.
2- Assessing activities of daily living related to constipation to detect client’s needs.
3- Planning& implementing prevention program to improve knowledge, practice and health habits of elderly to prevent constipation according to clients’ needs.
4- Evaluating the effect of prevention program on knowledge, activities of daily living, practice and habits of elderly clients related to constipation.
Research hypothesis:
The prevention program improve practices, activity of daily living and habits of the elderly related to constipation after implementation of prevention program construction.
Subjects and Methods: are described under the following four designs technical, operational, administrative, and statistical.
Design: A quasi – experimental design was used.
Setting:
The study carried out in two geriatric clubs at fayoum city
1- Community Development Association (Elhelal Elahmar Association, El Mohafza club.
2- El Eskandanafia Association, El hadka, El Eskandanafia club.
Subjects: It consisted of subjects presenting in geriatric clubs. The sample nearly (98) clients which were taken randomly.
The sample was chosen according to the following inclusive criteria:
1- Free from mental disorder.
2- Free from hearing disorder.
3- Free from visual disorder.
4- Accept to participate in the study.
Tools: one tool was used for data collection:
First tool:
A structured interviewing questionnaire developed by the researcher after reviewing the related literature in Arabic language. it was composed of six parts:
First part: A questionnaire to assess socio- demographic characteristic .
Second Part: Medical history for elderly clients with constipation .
Third part: Patient’s knowledge about factors leading to constipation.
Fourth part:Client habits such as defecation habits.
Fifth part:Elderly client’s practices such as daily living activities related to constipation .
Sixth part: Home environment as reported by elderly related to constipation .
Content validity done to the tool. tested through 5 experts from the staff of community health nursing in community health nursing department in faculty of nursing Ain Shams University.
The actual field work started from January 2017up to September 2017, at two geriatric clubs at fayoum city (El Mohafza club El helal el ahmar- El Eskandanafia club). Data collection was conducted over a period of nine consecutive months. The researcher visited the geriatric club three days /week (Sunday, Tuesday and Thursday) from 9 am to 12 midday to get new cases and conduct the educational program for the elderly. Then, introducing herself and explaining the aim of the study and then distributed the questionnaire sheet after clear explaining the way to fill out. Each tool from both knowledge and practices took about 20 minutes to fill from each individual.
The study results revealed the following:
• Elderly clients with constipation had two third (77.6%) of the elderly clients were males, with a mean age of 69.54+- 3.23; years;and 52%of the studied sample were primary education, 44.9%were widow, and 51.0%were Businessman free.
• Concerning medical history of elderly clients with constipation had other associated diseases, 53.1%of cases had hypertension, while 56.1%had arthritis. 34.7%had anemia.
• Concerning knowledge only 13.3%of the studied sample determine that GIT was The area of its surface area of football field and the length of the digestive system is 9 meters in pretest,in the other hand in posttest about67.3% with a highly statistically significance differences..
• Concerning knowledge about constipation about 64.3% of the elderly knowing the definition of constipation is dry stool in pretest while 80.6% in posttest with a highly statistically significance differences.
• Concerning the factors leading to constipation about 39.8%of them in pretest determine cause of constipation was lack of fiber intake, while70.4% in posttest with a highly statistically significance differences.
• Concerning personal hygiene about 59.2%of the elderly clients with constipation were having shower every day in pre and posttest.while 25.5%of them were wash the teeth twice a day in pretest while in posttest was 52.0%, 82.7% wash the hands before and after eating in pretest while89.8% in posttest.
• Concerning methods of prevention the risk of complication about 55.1%avoid eat between meals to avoid obesity in pretest while 71.4% in posttest, and 35.7% reduce smoking gradually to avoid risks of smoking in pretest while 67.3% in posttest with a highly statistically significance. Concerning psychological status are moderate.
• Concerning nutritional habits about 15.3% of the elderly eat three times or more per day in pretest while 36.7% of them in posttest with a highly statistically significance differences.
• Concerning defecation habits about 29.6% of the elderly clients always enter the toilet on a regular schedule in pretest while in posttest were50.0% with a highly statistically significance differences, 26.5% of them number of toileting every other day in pretest while in posttest were48.0%, and25.5% of them having normal stool strength in pretest while in posttest increased (67.3%) with a highly statistically significance differences.
• Concerning practices regarding constipation, about 23,5% of the elderly eat foods containing fibers in pretest while 63,3% of them in posttest with a highly statistically significance,31,6% of them taking regular dates of defecation in pretest while in posttest was 64,3% to avoid constipation.
• Concerning ways of prevention of constipation,about 11.2% of the elderly doing abdominal massage to relieve constipation in pretest while 57.1% of them in posttest with highly statistical significance with p<0.001, the elderly knowing the steps of abdominal massage to prevent constipation in pretest was little while in posttest increased, with highly statistically significance p<0.001.
• Concerning the home environment of the elderly clients with constipation was generally moderate in all items. About (22.4%) of drinking water was un save, about (63.2%) save for lighting, about 39.7 un save for type of toilet, and about (34.6%) un safe for distance between toilet and bedroom.
Conclusion: Based on the findings and research hypothesis, of the study it was concluded that The implementation of health prevention program led to improvement in both knowledge and practices regarding diet, medication intake, elimination habits, and self-management. The improvement in knowledge is essential to improve practice.
Recommendations:
In the light of the findings of the present study, the following recommendations can be suggested:
- Health programs include the following, important exercises and other practices programmed according to health status, proper practices of exercise, health diet and adequate oral hygiene.
- Assessment of elderly home environment and suggestions of possible changes to the environment, especially home facilitation modifications should be performed in place before the person becomes frail and training in the use of adaptive equipment is highly recommended.
- Emphasizing the importance of raising awareness for the elderly and their caregivers, that will consequently improve their physical condition and their ability to perform daily living activities.
- More attention should be given to screen older adult’s medications to identify those associated with an increased risk for developing constipation, including chronic laxatives use and history of laxatives use.
- Early detection and management of elderly related functional capacity may improve the effectiveness of physical therapist and encourage person’s participation in the occupational therapy.