Comparison of the incidence of diarrhea to nutrition status related with enteral nutrition feeding method

Enteral nutrition is recommended as a preferred method of nutrition support for the critically ill patients. However, more than 50% of the nutritional requirement is not fulfilled due to diarrhea that frequently occurs in the critically ill patient who is dependent on tube feeding. This Study, which is a quasi-experimental research conducted under the application of a nonequivalent control group pre-test post-test design, aims to compare the incidence of diarrhea and nutrition status when a dietary fiber enteral formula is fed intermittently and continuously to a critically ill patient. In this study, 64 patients consisting of 32 patients from an experimental group and 32 patients from a control group were involved. These patients are the ones belonging to the severity score of 5, and 18 years old and above age group. These patients who have adopted mechanical ventilation and are being tube-fed with antibiotics for the first time after hospitalization are selected out of the patients hospitalized in the medical intensive care unit of a university hospital. The dietary fiber enteral formula was continuously fed to the experimental group, while intermittently fed to the control group. For all the subject patients, the incidence of diarrhea were determined from Day 1 up to Day 5 since the time tube feeding began using King's Stool Chart, and the biochemical data including the count of serum albumin, hemoglobin, total lymphocyte count were checked using an automatic analyzer on the day before tube feeding and 5days after tube feeding. The data have been collected during the period from July 2008 up to May 6, 2009, and were analyzed using Chi-square test, Mann Whitney U test, Independent sample t-test and Repeated measures ANOVA with SPSS WIN 12.0 program. The result of study can be outlined as follows; 1. From experimental group (32 patients) and control group (32 patients) involved in this study, the incidence of diarrhea in the experimental group (10; 31.3%) and the incidence of diarrhea in the control group (9; 28.1%) didn't show a statistically significant difference. 2. For the date when diarrhea began and the elapsed period during which diarrhea occurred for both the experimental group and control group, it did not show a statistically significant difference. 3. For the difference of diarrhea score according to the feeding method, and the diarrhea score according to its feeding method and period, it did not show a statistically significant difference. 4. For stool frequency related with the feeding method, it showed a statistically significant difference on Day 1 (t=2.189 p=.034), while for stool consistency related with the feeding method, it showed a statistically significant difference on Day 4 (t=-2.563, p=.014) and Day 5 (t=-2.225, p=.032). 5. For the diarrhea score related with general characteristics such as sex, age, diagnosis, mental status, period of fasting, nasogastric tube size, usage of H₂-receptor antagonists, it did not show a statistically significant difference. 6. For the change in nutrition status related with the feeding method, it did not show a statistically significant difference between the two groups. Through the result of this study, the necessity of adopting the method of intermittent feeding of dietary fiber enteral formula for a tube-fed patient was confirmed as a method of reducing the incidence of diarrhea. The nutrition status related with the feeding method was not significantly changed. However, it would be necessary to address the evaluation on nutrition status of a critically ill patient using measurement scales when conducting further studies. In addition, it is suggested that diversified and actual methods should be studied to help critically ill patients for adapting enteral nutrition.

Author dc:creator

• 김, 보형

Contributors dc:contributor

• 박, 지원
• 대학원 간호학과
• 200724091

• 경장영양
• 경관급식
• 설사
• 영양상태
• 중환자

Language dc:language

ko

Identifier

http://dcoll.ajou.ac.kr:9080/dcollection/jsp/common/DcLoOrgPer.jsp?sItemId=000000010054
000000010054

OAI identifier oai:identifier

oai:repository.ajou.ac.kr:201003/980