Effect of Abdominal Massage Training Provided to Caregivers on Constipation Management

Constipation is a common and uncomfortable problem among patients receiving palliative care. Alongside usual treatment and nursing care, abdominal massage may help manage constipation. Teaching caregivers how to perform this massage may also help them feel more confident in supporting the patient. This study aims to evaluate the effects of abdominal massage training for caregivers on patients' constipation, caregiver burden, and caregivers' confidence in contributing to patient self-care. Patients and their primary caregivers will participate together. Both patients and caregivers must be aged 18 years or older. Patients must have constipation, have been hospitalized in a palliative care unit for at least two weeks, and have no clinical condition that prevents abdominal massage. Participants will be randomly assigned to one of two groups. Caregivers in the intervention group will receive a single 45-minute training session that includes an explanation and a practical demonstration of abdominal massage. They will also receive a training booklet. After training, caregivers will perform abdominal massage for 15 minutes in the morning and 15 minutes in the evening, three days per week, for two weeks. Patients will continue receiving their usual treatment and care. Patients and caregivers in the control group will continue with usual treatment and care during the study. Control-group caregivers will be offered abdominal massage training after their study participation is completed. Patients' constipation severity and stool form, as well as caregivers' burden and confidence in contributing to patient self-care, will be assessed at the start of the study and on Days 7 and 14. Ethical approval has been obtained from the University of Health Sciences Hamidiye Ethics Committee for Interventional Research Not Involving Drugs or Medical Devices. Institutional permission has been obtained from the study hospital before data collection. Written informed consent has been obtained from patients and caregivers. Participation is voluntary, and personal information will be kept confidential.

Inclusion Criteria: Patients: * Aged 18 years or older. * Hospitalized in a palliative care unit for at least two weeks. * Experiencing constipation. * No clinical contraindication to abdominal massage. * No open surgical wound, percutaneous endoscopic gastrostomy (PEG), stoma, or active surgical sutures in the abdominal region. Caregivers: * Aged 18 years or older. * Serving as the patient's primary caregiver. * No physical or cognitive condition that prevents learning and performing abdominal massage. * Willing to participate voluntarily in the study. Exclusion Criteria: Patients: * Constipation caused by an acute surgical or pathophysiological condition, such as ileus. * Any clinical condition that makes abdominal massage unsafe. * Active surgical complications in the abdominal region. * A clinical condition that prevents completion of the study procedures. Caregivers: * Insufficient cognitive or physical capacity to perform the techniques taught during training. * A health or social condition that prevents completion of the study procedures. Criteria for Discontinuation: * Participant requests withdrawal from the study. * Patient is discharged from the hospital. * Patient dies. * The data collection process cannot be completed.