Actual Conditions of Postoperative Dyschezia Recognized by Rectal Cancer Patients and Self-Care

The purpose of this study is to reveal the actual conditions of dyschezia as recognized by postoperative rectal cancer patients and their self-care, as well as the subjective QOL (Schedule for the Evaluation of Individual Quality of Life-Direct Weighting: SEIQoL-DW), and to obtain suggestions for the nursing intervention for improving the self-care of dyschezia and QOL. The subjects were 88 patients (age: 62.2 ± 9.3 years), consisting of 33 and 55 patients that received intersphincteric resection (ISR) and low anterior resection (LAR), respectively. The mean of the SEIQoL-DW index was 66.7 ± 15.3 for ISR and 63.8 ± 14.8 for LAR, showing no significant difference. The dyschezia was grouped into seven categories such as [frequent defecation], [irregular number of defecations], [defecation on oral drug administration], [frequent nocturnal defecation], [fecal incontinence], and [anal pain]. The proportions of [irregular number of defecations], [frequent nocturnal defecation], and [fecal incontinence] were significantly higher for ISR than LAR. The self-care of dyschezia can be summarized into eleven categories such as [washing anus], [applying diapers and pads], [controlling dietary intake], and [controlling defecation]. In conclusion, it is important to understand in detail the fecal control, local anal care, food content, and intake method as nursing interventions using a checklist, and to instruct the patients individually in cooperation with physicians and physical therapists. Hirosaki Med.J. 62:186―198,2011