New-onset Constipation After Stroke: Caspian Nursing Process Projects

Introduction: The impacts of new-onset constipation outcomes in stroke clients have remained unclear. It seems helpful to update the structure planning with nursing-led intervention.  Objective: The current study aimed to present a protocol and methods of Caspian Nursing Process Projects in new-onset constipation by nursing-led intervention considering the experts’ point of view. Materials and Methods: The current multi-stage evolutionary study describes the protocol and methods of Caspian Nursing Process Projects, which were conducted on stroke constipation, such as new-onset constipation. The study was conducted in several phases, including searching for scientific sources, formal-content validity, RAND and Delphi methods, and changes made at the Delphi stage and the experts’ panel. We selected 21 studies published between January 2004 and December 2019 in the Cochran database, Medline, Science Direct, PubMed, Elsevier, and Scopus. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and AGREE II (The Appraisal of Guidelines for Research & Evaluation) were used to evaluate the articles and guidelines. Results: After considering the inclusion and exclusion criteria, 14 articles and guidelines were entered. Most of the authorities were 16 men (72.7%), 11 cases had MD degrees (50%), and 4 (18.2%) were neurologists. Regarding the priority, the highest agreement was found on patient and companion education (98%) and the lowest on disability in daily activity (75.6%). In terms of benefits, patient education again achieved the highest agreement with 97.2%, and use of the Bartel index with 73.6% obtained the lowest agreement. Regarding the applicability, registration, and reporting, the water and electrolyte impairment and educational booklet obtained the highest agreement with 93.6%. Conclusion: All recommendations had reached over 70% agreement in all four areas of the initial draft, and some care should be taken only by stroke nurses or critical care nursing. The study results can be used for developing national guidelines or criteria.