title: Evaluation of the structured bowel management program in inpatient rehabilitation: a prospective study.
abstract: OBJECTIVE
  The purpose of this study is to evaluate the impact of the structured bowel management program (SBMP) in an inpatient rehabilitation service.
  
  
  METHODS
  Prospective recruitment of consecutive patients admitted to the rehabilitation unit (n = 100). Each patient was assessed for bowel dysfunction on admission and an individualised SBMP was instituted based on the clinical needs. The assessments were at baseline (T1), and discharge from ward (T2) using validated questionnaires. Program evaluation was at 3-month (T3) post-discharge.
  
  
  RESULTS
  Participants were predominantly female (52%), mean age 68 ± 13 years. Almost one-half (43%) had neurological conditions and 41% musculoskeletal problems. At admission, 62% self-reported bowel dysfunction, mainly constipation (82%) and faecal incontinence (FI) (11%). At T2, participants showed significant improvement in bowel habit and stool consistency (Bristol stool chart, p < 0.001); severity of bowel symptoms such as FI (Wexner FI score, p < 0.05); and impact on quality of life (FI Quality of Life (QoL) subscales: "life style" and "coping/behavior", p < 0.05 for both). All functional independent measure "motor" and "cognition" subscales improved significantly (p < 0.01 for all), with moderate to large effect sizes (r = 0.5-0.7). No adverse effects were reported.
  
  
  CONCLUSIONS
  Bowel management should be a priority within rehabilitative services. Evidence-based SBMP can improve bowel symptoms and enhance overall QoL in patients admitted to rehabilitation settings.
  
  
  CONCLUSIONS
  Bowel dysfunction is common in inpatient rehabilitation settings. A structured bowel management program can improve bowel symptoms and enhance overall QoL in patient. Bowel management should be a priority for patients admitted to rehabilitation settings.
authors.forename: Bhasker
authors.initials: B
authors.lastname: Amatya
authors.forename: Alaedin
authors.initials: A
authors.lastname: Elmalik
authors.forename: Matthew
authors.initials: M
authors.lastname: Lowe
authors.forename: Fary
authors.initials: F
authors.lastname: Khan
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003248:Constipation / Q000453:epidemiology*; D019468:Disease Management; D005242:Fecal Incontinence / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007297:Inpatients / Q000523:psychology*; D007410:Intestinal Diseases / Q000534:rehabilitation*; D008019:Life Style; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015397:Program Evaluation; D011446:Prospective Studies; D011788:Quality of Life; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D062606:Tertiary Care Centers; D016896:Treatment Outcome; D014739:Victoria