Table 4.10. Multivariable analysis results the cause of the incidence of constipation in patients was treated in dr Slamet Garut Hospital.
Variables B
S.E. Wald Sig. ExpB
95.0 C.I. Lower
Upper diet
2.116 1.306 2.625 .105 8.295
.642 107.212
Fluid -.327
1.367 .057
.811 .721
.049 10.522
Exercise 1.055 .906
1.354 .245 2.871
.486 16.959
In Table 4.10, shows the modeling done to 3 variables. In multiple logistic regressions, of the three variables tested were no significant values. However there was variable approaching the
diet with p = 0105. With OR 8.3 means that stroke patients who consume a poor diet had 8.3 times the likelihood of getting constipation in patients taking a good diet.
4.2. Discussion
4.2.1. Picture of stroke patients cared for in hospitals dr Slamet Garut.
Based on the analysis of the study found that stroke patients who were admitted to the neurological mostly aged between 41-60 years and there are patients who are elderly 5. In
this age of stroke patients were into the category of middle age and elderly. Old age will experience some setbacks or degenerative the physiological body system and also in line with
Saparinah 1983 found that at age 55 to 65 years old is the age group that reaches pension stage, at this stage will experience a variety of lower resistance or health and various
psychological pressures. Thus there will be changes in his life. Also it was confirmed again by Constantinides 1994 in Mary et al 2008 in the elderly will be the disappearance of the
networks ability to self-repair or replace and maintain normal function slowly so it can withstand the infection and repair the damage. For the digestive system in the elderly there is a
change in the form of a reduction in absorption, decreased intestinal peristalsis. Therefore, the assessment and treatment of attention is required when caring for stroke patients especially
those who fit into the category elderly.
Patients treated in the inpatient neurological part is very susceptible to incidence of constipation as shown in the results of the study found that nearly half experience constipation
32.5. Constipation condition is closely related to sharing things can be because of aging or degenerative process may also due to other factors that can exacerbate the cycle of bowel
movements defecation physiological. This was in line with what was expressed by Mary et al 2008 about the decline of physiological functions of the digestive system, especially in the
elderly. Constipation can also be caused by physical or psychological disorders may be physically impaired neurological disorders other factors could be due to a lack of fiber, muscle
weakness or stress and anxiety Asdie, 1999. In this research found that intake of dietary fiber on stroke patients by nearly half in
poor condition 30. The food is the main factor affecting the elimination of feces. Adequacy of cellulose, fiber in foods, it is important to increase the volume of stool. Certain foods in
some people are difficult or cannot be digested. The inability will have an impact on gastrointestinal disorders. Eat regularly affect defecation. Irregular eating can interfere with the
regularity of bowel habit. Individuals who eat at the same time each day will have a regular timing, physiological response to food intake patterns and regularities in the colonic peristaltic
activity. It was closely related to the condition of constipation experienced by almost half of stroke patients admitted to hospital as much 32.5. These findings were also confirmed by
Asdie 1999 Physical and psychological disorders can be due to a lack of fiber and can lead to constipation.
The results showed that exercise sports in bed stroke patients were admitted to the neurology more than half 52.5 in the category of poor. Inadequate exercise will affect the
normal process of defecation. Tone abdominal, pelvic muscles and diaphragm are essential for defecation. Also stimulates peristaltic activity that facilitates the movement of chyme along the
colon. Weak muscles that are often not effective in increasing intra-abdominal pressure during defecation or bowel control. The muscles are weakened as a result of reduced training
exercise, immobility or impaired nerve function.
4.2.2. The relationship between diets with the incidence of constipation in patients treated in dr Slamet Garut hospital.
From the results of statistical analysis showed that the apparent significant relationship between constipation with dietary intake stroke patients treated with
value of 0.004 α 0.05. In the fiber contained a substance called lignin. This substance is the most difficult to
digest. The nature of this substance is to inhibit the digestion of other fiber components. Fiber serves to soften the stool and stool volume boost. Thus the fiber makes bowel movements and
increase intestinal gas production. Spending ones stool with diet eating high fiber is about 80-160 grams per day. Fiber also affect the transit time of food taken into the digestive tract.
The short transit time is due to the amount of water retained in the gut cavity by materials that are difficult to digest. Cellulose and hemicelluloses contained in the fibers are laxatives or
facilitate defecation. Low-fiber diet causes the amount of stool and a little harder, to remove waste types require contraction of the muscular wall of the colon. Tremendous pressure on the
intestinal cavity facilitates the lump. Fiber can also prevent colon cancer. The results were consistent with research conducted by Sari 2010 which examined the
relationship fibrous diet with the incidence of constipation in Dr H. Adam Malik, who showed an association between the occurrence of fiber constipation p 0.001 0.05. This research was
also supported by research conducted by Gardiarini 2010 which examines the student defecation patterns related to fiber and fluid intake and physical activity results show that there
is a connection between bowel habit with fiber and fluid intake 0.00 p 0.05 . Thus, adequate consumption of fiber in the diet of stroke patients in particular will help
facilitate bowel movements patterns. Besides, there are a lot of benefits if you consume enough fiber in the diet to maintain health.
4.2.3. The relationship between exercise and the incidence of constipation in patients treated in dr Slamet hospital Garut.
Statistical analysis addressing the significant relationship between constipation with exercisesports in bed stroke patients treated with
value of 0.034 α 0.05. These results indicated that exercise performed by patients on a regular basis will increase the
improvement especially in bowel habit. Abdominal muscles are very important in the process
of defecation, sports ROM exercises performed by stroke patients will help to strengthen the muscles which in turn will facilitate the process of defecation.
The results were consistent with research conducted by Koniyo 2011 Effectiveness of Passive ROM Overcoming Constipation In Stroke Patients In Room Neuro Regional Public
Service Board BLUD RSU Dr. MM Dunda Gorontalo regency with the result that 75 of the effectiveness of passive ROM to overcome the constipation in patients with non-hemorrhagic
stroke in BLUD RSU DR. M.M. Dunda Gorontalo regency. The research was also supported by research conducted by Gardiarini 2010 which examines the bowel habit Student Relation
to Fiber and Fluid Intake and Physical Activity that shows the result that there was a connection between bowel habit with fiber and fluid intake 0.00 p 0.05 .
Exercise or sport either passive or active ROM was played in the patients bowel habit. Therefore, for patients hospitalized stroke patients both by him and assisted by nurses and
families should exercise regularly.
4.2.4. The relationship between the liquid with the incidence of constipation in patients treated in dr Slamet hospital Garut.
From the analysis of apparent significant that there was relationship between constipation with fluid intake among stroke patients treated with
value of 0.019 α 0.05. Fluid consumed by the patient will obviously affect the consistency of the stool, the less fluid
intake, and the harder at the consistency of the stool. Conversely, if the liquid is consumed is adequate the stool softer and easier to get out at the time of defecation. This of course affects
bowel habit in patients during hospitalization The study was in line with research conducted by Tampubolon 2008 which examines
the effect of water treatment on the process of defecation in constipated patients Delitua Deli Serdang Hospital Sembiring with results showing that water therapy affects patients
constip ation defecation frequency P = 0.022, α = 0, 05. Adequacy of water consumed in the
diet plays an important role in preventing constipation and maintaining normal bowel movement process.
4.2.5. The most dominant factor causing the incidence of constipation in stroke patients treated in dr Slamet hospital Garut.
Based on the results of the multivariate analysis of the three variables, namely dietary fiber, fluid intake and exercise shows that the results of multiple logistic regression, no
significant variable nevertheless diet was the most dominant factor compared to other factors with p = 0105. From the analysis it was found that among adult stroke who consume a poor
diet likely to get constipated 8.3 times compared with stroke patients who consume a good diet. This shows that diet ws the most dominant factor that can cause constipation as well as
two other factors, namely fluid intake and exercise. Thus, prevention of constipation, particularly in stroke patients can be done by raising
the intake of fiber into the diet consumed, since the majority of stroke patients experiencing disordersneurological deficit that causes patients with eating disorders and paralysis.
Nevertheless, because the third variable has more than a value of α = 0.05 then both dietary
intake, fluid intake and exercise play an important role in the prevention of constipation. So that stroke patients admitted to hospital should pay attention to three aspects in order to avoid
complications of constipation that can cause discomfort to the stroke patient.
4.3. Limitations of Research
