The troublesome bowel: A qualitative study of intensive care nurses' experiences with constipation in critically ill children in a pediatric intensive care unit

Purpose: The purpose of this study was to explore nurses' experiences and perceptions of constipation in a pediatric intensive care unit (PICU) in Norway. Design and methods: A qualitative approach using a reflexive thematic analysis was employed. Two focus group interviews were conducted using a semi-structured interview guide. Results: Three themes were identified: challenging individual assessment of bowel function, high responsibility and knowledge gaps in managing constipation for severely ill children, and challenges in maintaining dignity when a child requires assistance with bowel movements. Conclusion: The study's most important findings were the uncertainty surrounding constipation treatment, the challenges nurses face with critically ill children that affect prevention and treatment, and the lack of timely treatment initiation. Practice implications: Risk scoring and protocols for treating constipation in critically ill children should be established. Enhancing staff knowledge about constipation and the administration of various medications in the intensive care setting are essential. (c) 2025 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY license (http:// creativecommons.org/licenses/by/4.0/).