title: Constipation in specialized palliative care: factors related to constipation when applying different definitions.
abstract: BACKGROUND
  For patients in palliative care, constipation is primarily a result of opioid treatment. Impacts from other factors related to constipation in palliative care are rarely studied.
  
  
  OBJECTIVE
  The aim was to identify factors related to constipation in patients in palliative care, and then to compare these factors between patients with different types of constipation and patients without constipation.
  
  
  METHODS
  Cross-sectional data on constipation was collected with a 26-item questionnaire from 485 patients in 38 specialist palliative care units in Sweden. Three different constipation groups were used; MC ONLY, PC ONLY, and MC & PC. Logistic regression analyses were used to calculate odds ratios.
  
  
  RESULTS
  Patients with <3 defecations/week, MC ONLY, (n = 36) had higher odds of being hospitalized, bed-restricted, in need of personal assistance for toilet visits, and of having a poor fluid intake. Patients with the perception of being constipated, PC ONLY, (n = 93) had higher odds of having poor appetite, hemorrhoids, hard stool, more opioid treatment, less laxative treatment and of being more dissatisfied with constipation information. Patients with both <3 defecations/week and a perception of being constipated, MC & PC, (n = 78) had higher odds of having cancer- disease.
  
  
  CONCLUSIONS
  There were several significant factors related to constipation with higher odds than opioid- treatment, for patients in palliative care, such as; hard stool, cancer diagnosis, dissatisfaction with information, low fluid intake, hemorrhoids, bed restriction, hospitalization, and need of personal assistance for toilet visits.
authors.affiliation: Department of Social and Welfare Studies, Linköping University, Norrköping, Sweden. eva.erichsen@liu.se.|Department of Advanced Home Care and Department of Social and Welfare Studies, Linköping University, Norrköping, Sweden. eva.erichsen@liu.se.|Palliative Education and Research Centre and Department of Social and Welfare Studies, Linköping University, Norrköping, Sweden. eva.erichsen@liu.se.
authors.forename: E
authors.identifier: http://orcid.org/0000-0003-2966-9579
authors.initials: E
authors.lastname: Erichsén
authors.affiliation: Department of Social and Welfare Studies, Linköping University, Norrköping, Sweden.|Department of Advanced Home Care and Department of Social and Welfare Studies, Linköping University, Norrköping, Sweden.|Palliative Education and Research Centre and Department of Social and Welfare Studies, Linköping University, Norrköping, Sweden.
authors.forename: A
authors.initials: A
authors.lastname: Milberg
authors.affiliation: Department of Social and Welfare Studies, Linköping University, Norrköping, Sweden.
authors.forename: T
authors.initials: T
authors.lastname: Jaarsma
authors.affiliation: Department of Social and Welfare Studies, Linköping University, Norrköping, Sweden.|Palliative Education and Research Centre and Department of Social and Welfare Studies, Linköping University, Norrköping, Sweden.
authors.forename: M
authors.initials: M
authors.lastname: Friedrichsen
mesh_terms: D000368:Aged; D000701:Analgesics, Opioid / Q000009:adverse effects* / Q000627:therapeutic use; D003248:Constipation / Q000139:chemically induced* / Q000188:drug therapy / Q000503:physiopathology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D010166:Palliative Care / Q000379:methods*; D012307:Risk Factors; D011795:Surveys and Questionnaires
chemical_list: D000701:Analgesics, Opioid
keywords: Constipation; Palliative care; Risk factors; Symptom assessment