The Effect of Abdomınal Massage and Warm Water Consumptıon on Postoperatıve Constıpatıon Development and Qualıty of Recovery in Patıents Undergoıng Hıp Fractures Surgery

The Effect of Abdomınal Massage and Warm Water Consumptıon on Postoperatıve Constıpatıon Development and Qualıty of Recovery in Patıents Undergoıng Hıp Fractures Surgery: A Randomızed Comparatıve Study

There is a need for studies investigating the effects of abdominal massage and warm water consumption on the development of postoperative constipation and quality of recovery in patients who have undergone hip fracture surgery. The aim of the study is to investigate the effects of abdominal massage and warm water consumption on the development of postoperative constipation quality of recovery in patients who have undergone hip fracture surgery. The study will be conducted as a prospective, parallel, three-group (1:1:1) randomized controlled trial to determine the effect of abdominal massage alone versus standard care in preventing the development of postoperative constipation in patients who underwent surgery for hip fracture. The following instruments will be used to collect study data: "Patient Demographic Information Form", "Constipation Risk Assessment Scale" for determining the constipation risk group and for randomization, "Bristol Stool Scale" for determining the type of constipation, "Constipation Assessment Scale" for determining the severity of constipation, and "Quality of Recovery-40 Questionnaire". For data analysis, parametric (Independent Samples T-Test, ANOVA) or non-parametric tests (Mann-Whitney U, Kruskal-Wallis H) will be used for pairwise and multiple group comparisons, depending on the distribution of the data. The Chi-Square test will be used for categorical data, and logistic regression analysis will be performed to determine the effect of continuous variables obtained from constipation development status and patient follow-up on the development or absence of constipation.

Inclusion Criteria:

• Being 18 years of age or older
• Agreeing to participate in the study
• Undergoing open surgical treatment due to a hip fracture classified as 31A, 31B, or 31C according to the AO/OTA classification
• Initiation of postoperative oral feeding

Exclusion Criteria:

• Communication problems (speech and hearing impairments)
• Neurological and psychiatric problems such as Alzheimer's or dementia
• Problems preventing abdominal massage (surgery, wound site)
• Regular laxative use before surgery
• Previous colon surgery - physiological and structural abnormalities in the anal region that may hinder bowel movements
• Use of medications that reduce bowel motility before surgery (antipsychotics, antidepressants, etc.)
• Diagnosis of chronic constipation made by a physician before surgery
• Difficulty transitioning to oral feeding and inability to eat orally
• Multiple traumas affecting mobilization in addition to a hip fracture
• Surgery for hip fracture performed using a minimally invasive method