The aim of this study is to examine the effect of abdominal massage applied by caregivers to patients in palliative care clinics on gastrointestinal symptoms.

Hypotheses H0a: Abdominal massage applied by caregivers to patients in palliative care clinics has no effect on gastrointestinal symptoms.

H1a: Abdominal massage applied by caregivers to patients in palliative care clinics has an effect on gastrointestinal symptoms.

In this study, the effect of abdominal massage applied to patients following abdominal massage training provided to caregivers in the intervention group will be evaluated by comparing the intervention group, which receives abdominal massage, with the control group, which receives routine care.

On the first day of the study, the aim, scope, and procedural steps were thoroughly explained to the patients and their caregivers in both groups, written informed consent was obtained, and baseline assessments were conducted. These assessments included the Individual Descriptive Characteristics Form, Barthel Index of Activities of Daily Living, Defecation Diary, Bristol Stool Form Scale, and the Gastrointestinal Symptom Rating Scale. Subsequently, caregivers in the intervention group received abdominal massage training, and the Abdominal Massage Training Manual prepared by the researchers was provided to support the correct application of the massage techniques.

In the intervention group, patients received abdominal massage administered by their caregivers twice daily for 15 minutes between Days 2 and 7, and each application was recorded on the Abdominal Massage Application Follow-up Form. Patients in the control group continued to receive routine care during the same period. In both groups, Defecation Diary parameters and the Bristol Stool Form Scale were evaluated daily by the researcher between Days 2 and 7.

At the end of Day 7, the Gastrointestinal Symptom Rating Scale was administered again, final assessments were completed, and the study was concluded.

Inclusion Criteria:

• Patients identified as constipated according to the Rome IV diagnostic criteria, as assessed by a clinical specialist.
• Patients whose hospitalization in the palliative care unit was planned for at least 7 days.
• Patients who were able to receive oral nutrition during the study period.
• Individuals aged 18 years or older.
• Patients who provided written informed consent, or whose first-degree relatives provided consent on their behalf.
• Caregivers responsible for administering the abdominal massage who provided written informed consent to participate in the study.

Exclusion Criteria:

• Patients with known gastrointestinal diseases such as ulcerative colitis, Crohn's disease, or irritable bowel syndrome.
• Patients who had received abdominal radiotherapy within the last six weeks or who had undergone abdominal surgery within the past year.
• Patients with acute abdomen, colostomy or ileostomy, significant abdominal distension, abdominal hernia, abdominal tumors, diarrhea, or fecal impaction.
• Patients who were pregnant or suspected of being pregnant.
• Patients receiving enteral nutrition via percutaneous endoscopic gastrostomy (PEG), nasogastric tubes, or similar feeding methods.

Individual participant data (IPD) will not be shared because the study is a single-center academic thesis project and the collected data contain sensitive clinical information that cannot be made publicly available. Data will be used only for the purposes of this research and will not be shared with external investigators.