Constipation is casting a shadow over everyday life - a systematic review on older people's experience of living with constipation

Abstract

Aims and objectives: To explore and summarise best evidence of how constipation affects the daily living of older people from their own perspective. Furthermore, to assess how interventions aimed at treating constipation in older people affect patient-reported outcome such as quality of life.

Background: Constipation is a common and overlooked problem with an impact on everyday life, especially among older people. Older people seem to have individual preconceptions on constipation which can influence the strategies used to prevent and treat constipation.

Design: A systematic review, integrating findings from both qualitative and quantitative studies.

Method: Systematic searches were carried out in PubMed, CINAHL, PsycINFO and EMBASE on the 31st of July 2014. A search strategy was constructed with key concepts identified using PICO to identify quantitative studies and PIC(o) to identify qualitative studies. Search terms included constipation, elderly, aged, elderly people, aged people, quality of life, patient experience, patient perspective, meaning, emotion, psychological. Reference lists were searched manually.

Results: A total of nine studies were included in the review, five quantitative and four qualitative. Three main themes crystallised from the results of the included studies: bodily experiences, everyday life shadowed by constipation and adverse psychological effects.

Conclusion: Constipation among older people was connected to subjective and comprehensive experiences. It had a negative impact on physical and mental well-being as well as the social life of older people. The review also showed that older people had individual and personal strategies, based on their own beliefs.

Relevance to clinical practice: Healthcare professionals need to be aware of the experiences of living with constipation as well as the range of strategies used by patients to prevent and treat constipation. The patient perspective on constipation needs to be integrated in the strategies and actions carried out by healthcare professionals.

Keywords: aged; constipation; everyday life; older people; patient perspective; patients’ experiences; quality of life.