Development and validation of a constipation risk assessment scale for use in clinical practice

Abstract

Constipation presents as a perpetual problem in health care, particularly within oncology. It is frequently preventable and a prerequisite to prevention is assessment of risk for a condition occurring. Within the literature, there are no comprehensive constipation risk assessment tools. This study aimed to select, organise and score research validated risk factors for constipation to produce a tool that could assess risk of constipation. This theory framed research used the theory of self-care to frame the research.

A documentation audit and qualitative survey were performed at the commencement of the investigation. This ensured that there was a requirement for the tool within practice and that the theory framing the study was clinically appropriate. Following development of the tool, it was subjected to content and face validity analysis and then the three stage of reliability analysis. Construct validity was established using a retrospective correlational design contrasting constipated and non-constipated subjects. Subsequently a non-experimental prospective correlational design of patients attending for their first cancer treatment, determined the predictive value of the tool (n=155). Concurrent validity was established by comparing nurses' judgements on subjects' risk of constipation to the category of risk given to each subject by the tool. A feasibility study of patients attending for their first cancer treatment assessed the potential for using the tool to guide clinical practice on constipation prevention (n=150).

This research utilised appropriate medical knowledge on constipation, which existed at the exploratory level and adapted this knowledge for nursing. This produced a tool with high predictive power (85%). Furthermore, this tool can be used in practice to assign preventative nursing interventions to reduce incidence and severity of constipation. Ultimately this research extended theory on constipation to the predictive level and produced a comprehensive quantifiable method for assessing risk of constipation, which has been validated on oncology patients.

Date of Award	2002
Original language	English