SCI: Fiber (2003)

Citation:
 
Study Design:
Class:
- Click here for explanation of classification scheme.
Quality Rating:
Research Purpose:
  • To describe the disease process after acute hospitalization and the role of the nurse in care and empowerment of the spinal cord injured patient in the rehabilitation phase.
  • Identify common complications and methods to prevent their occurrence.
Inclusion Criteria:
None given.
Exclusion Criteria:
None given.
Description of Study Protocol:

Recruitment

Methods for study inclusion not described.

Design

Medical Opinion.

Blinding Used (if applicable):  not applicable

Intervention (if applicable):  not applicable

Statistical Analysis:  Statistical analysis not completed.

 

Data Collection Summary:

Timing of Measurements:  not applicable

Dependent Variables:  not applicable

Independent Variables:  not applicable

Control Variables:  not applicable

Description of Actual Data Sample:

Initial N:  20 references cited

Attrition (final N):  20

Age:  not applicable

Ethnicity:  not applicable

Other relevant demographics:  not applicable

Anthropometry:  not applicable

Location:  Worldwide studies

Summary of Results:

Other Findings

About one-third of all persons with spincal cord injuries will develop pressure ulcers during the year after discharge from the hospital.  Education of the patient remians a key element in the prevention of pressure ulcers.

Foods high in fiber and proper hydration are essential in maintaining regular bowel movements and reducing the risk of impaction.  Patients can reduce the risk of constipation and bowel impaction by following a diet of 25-30 grams/day of insoluble fiber, wheat bran, fresh fruit, vegetables, legumes, and dried beans.

Proper amounts and type of fluid are essential to reduce complications and the risk of urinary problems such as kidney, bladder stones, and UTI.  A distended bladder is the most common cause of dysreflexia with fecal impaction being the second.  A fluid intake should be 2 to 3 liters/day for patients with indwelling catheters, and 1500 to 2000 cc/day for patients on intermittent catherization programs.

In the rehabilitation phase, muscle atrophy, lack of physical activity, and weight concerns need to be addressed. 

Author Conclusion:

The ultimate goal is for the patient to direct and plan his or her own care.

Funding Source:
University/Hospital: Munson Medical Center
Reviewer Comments:

This article is dated. The recommended level of fiber intake had been reduced by studies in the late 1990s.(PS)

The author provides a recommendation for fluid intake related to type of bladder management that may merit consideration and verification by other sources. (PS)

A good overview of problems seen in the acute rehab stage from a nursing perspective. (SB)

Quality Criteria Checklist: Review Articles
Relevance Questions
  1. Will the answer if true, have a direct bearing on the health of patients? N/A
  2. Is the outcome or topic something that patients/clients/population groups would care about? Yes
  3. Is the problem addressed in the review one that is relevant to dietetics practice? Yes
  4. Will the information, if true, require a change in practice? N/A
 
Validity Questions
  1. Was the question for the review clearly focused and appropriate? Yes
  2. Was the search strategy used to locate relevant studies comprehensive? Were the databases searched and the search termsused described? No
  3. Were explicit methods used to select studies to include in the review? Were inclusion/exclusion criteria specified andappropriate? Wereselectionmethods unbiased? No
  4. Was there an appraisal of the quality and validity of studies included in the review? Were appraisal methodsspecified,appropriate, andreproducible? No
  5. Were specific treatments/interventions/exposures described? Were treatments similar enough to be combined? Yes
  6. Was the outcome of interest clearly indicated? Were other potential harms and benefits considered? Yes
  7. Were processes for data abstraction, synthesis, and analysis described? Were they applied consistently acrossstudies and groups? Was thereappropriate use of qualitative and/or quantitative synthesis? Was variation in findings among studies analyzed? Were heterogeneity issued considered? If data from studies were aggregated for meta-analysis, was the procedure described? No
  8. Are the results clearly presented in narrative and/or quantitative terms? If summary statistics are used, are levels ofsignificance and/or confidence intervals included? Yes
  9. Are conclusions supported by results with biases and limitations taken into consideration? Are limitations ofthe review identified anddiscussed? Yes
  10. Was bias due to the review's funding or sponsorship unlikely? Yes