Effect of Abdominal Massage on Bowel Movements in Patients With Subarachnoid Hemorrhage

The study will be conducted as a randomized controlled trial to determine the effect of postoperative abdominal massage on bowel movements in patients who underwent surgery after subarachnoid hemorrhage and are hospitalized in the neurosurgery intensive care unit. The sample of the study will consist of a total of 64 patients, 32 in the experimental group and 32 in the control group, hospitalized in the tertiary neurosurgery intensive care unit. Data collection tools are the "Descriptive Characteristics Form" and the "Patient Follow-up Form".The statistician will determine whether the patients who meet the sampling criteria will be assigned to the experimental or control group through randomization. The stratified randomization method will be used in the study. In this context, patients who meet the inclusion criteria from the start date of the study in the Neurosurgery Intensive Care Unit will be randomized by assigning them to the control group and abdominal massage groups, respectively. Patients will be assigned to the control and abdominal massage groups in this order until the sample size is reached. The CONSORT diagram will be used in the randomization of patients.

Inclusion criteria

• • 18 years of age or older

• Underwent neurovascular surgery
• Received general anesthesia
• Have no wounds, surgical intervention, or radiotherapy in the abdominal region
• Have no bowel obstruction, irritable bowel syndrome, inflammatory bowel disease, abdominal herniation, or bowel cancer
• Began oral feeding at the 6th hour post-surgery
• Stayed in the intensive care unit for 3 or more days
• Have a Glasgow Coma Scale (GCS) score of 9 or above
• Have no signs of acute abdomen
• Have no intra-abdominal infection
• No mechanical ventilation
• Mobilezed in the preoperative period
• Unable to mobilize after surgery
• Evaluated by the intensive care physician with no contraindications for abdominal massage
• Have a first-degree relative who has given consent

Exclusion criteria

• Patients with the following conditions will be excluded from the sample:

• Those with chronic constipation, fecal incontinence, or diarrhea
• Those fed with a fiber-enriched nutritional solution (e.g., Nutrison Protein Plus Multifibre®, Fresubin Original Fibre®, Isosource Fiber®, Jevity Plus®)
• Those fed via nasogastric enteral tube
• Those receiving parenteral nutrition
• Patients with a BMI > 40 (morbid obesity)