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As they age, the intestinal elimination function can be altered by external factors. Sleeping is also a vital need for maintaining health. Sleep time varies with age (from 18h / day for an infant to 7h30 on average for an adult) and sleep disorders increase with age (INSERM source). In our study, the night is from 9 pm to 7 am, corresponding to the working hours of the night shift. Between 42% and 50% of episodes of wakefulness of more than 4 minutes in EHPAD are due to noise, light or the practice of care related to incontinence. 87% of all incontinence care practices have been associated with wake-up episodes. A personalized day care program would allow residents to improve the quality of their sleep by minimizing stools at night and therefore interventions by caregivers.
The ritual of stools, can be defined as the set of rules to observe to defecate in good physiological, physical conditions:
The establishment of the stool ritual is not intended to reduce the amount of stool by day, but it aims to postpone the nighttime exemption on the day, and does not prevent the stool emission to other times of the day or night.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Ritual of stool | Experimental | During the first 4 weeks, data will be collected on an individual stool diary with usual care of the resident After randomization will start the implementation period of ritual of stool. From the stool diary: - will be determined the stool profile of each resident over 1 week and application of the ritual of stool the following week At the end of this second period, data will be collected on an individual stool diary in for 4 weeks |
|
| Usual practice | Other | During the first 4 weeks, data will be collected on an individual stool diary with usual care of the resident After randomization will start 2 weeks without data collection. Patient will be follow in usual practice. At the end of this second period, data will be collected on an individual stool diary in for 4 weeks |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Ritual of stool | Other | During the first 4 weeks, data will be collected on an individual stool diary with usual care of the resident After randomization will start the implementation period of ritual of stool. From the stool diary: - will be determined the stool profile of each resident over 1 week and application of the ritual of stool the following week At the end of this second period, data will be collected on an individual stool diary in for 4 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Number of nights with stools during the follow-up period | Number of nights with stools during the follow-up period | Week 10 |
| Measure | Description | Time Frame |
|---|---|---|
| Evolution in number of nights with stool | Difference in number of nights with stool between initial observation period and follow-up period in each of the 2 randomization groups | Week 10 |
| Evolution in number of laxative medication |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Pascale SEIGNEURIN-HERISSE | Ussel Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| EHPAD les Ecureuils | Ussel | 19208 | France |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 36088731 | Result | Seigneurin-Herisse P, Toniolo J, Marchat N, Micallef L, Labrunie A, Delaide V, Beloni P. Impact of a person-centered bowel program on the frequency of nights with bowel movement in dependent elderly people in nursing home: A single-centre randomized controlled trial. Int J Nurs Stud. 2022 Nov;135:104348. doi: 10.1016/j.ijnurstu.2022.104348. Epub 2022 Aug 13. |
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At the end of the first 4 weeks of collection of the data on an individual stool diary with usual care of the resident, a randomization will be carried out dividing the patients according to the following groups:
At the end of this second period, data were collected on an individual stool diary in each of the two groups for 4 weeks
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|
| Usual practice | Other | During the first 4 weeks, data will be collected on an individual stool diary with usual care of the resident After randomization will start 2 weeks without data collection. Patient will be follow in usual practice. At the end of this second period, data will be collected on an individual stool diary in for 4 weeks |
|
Difference in the number of laxative medication between initial observation period and follow-up period in each of the 2 randomization groups
| Week 10 |
| Satisfaction questionary | At the end of the study, satisfaction of the caregivers who participated in the implementation of the ritual of stools concerning the interest of this ritual by means of a satisfaction questionary | Week 10 |