{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T15:02:46Z","timestamp":1784991766991,"version":"3.55.0"},"reference-count":47,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T00:00:00Z","timestamp":1784937600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T00:00:00Z","timestamp":1784937600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100024693","name":"Aged Care Research and Industry Innovation Australia","doi-asserted-by":"publisher","award":["GA00065"],"award-info":[{"award-number":["GA00065"]}],"id":[{"id":"10.13039\/501100024693","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Clinical Nursing"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim(s)<\/jats:title>\n                    <jats:p>To develop a care\u2010bundle of non\u2010pharmacological strategies with the potential to prevent constipation in people with dementia in Residential Aged Care (RAC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Mixed\u2010methods intervention development study using Modified Delphi and co\u2010design, informed by evidence, current constipation prevention practices and stakeholder collaboration to define best practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The draft bundle was developed using evidence from a scoping review, consultations with aged care professionals and staff at two RAC homes and field observations. It was then refined through expert and lived\u2010experience panels via an online Modified Delphi survey (rating relevance, acceptability and feasibility) and a face\u2010to\u2010face workshop to finalise items for the constipation prevention care\u2010bundle.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Sources<\/jats:title>\n                    <jats:p>Health data, interviews, observations, surveys and workshops.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The draft care\u2010bundle comprised 24 items; 13 reached \u2265\u200978% agreement in the Modified Delphi, including dietitian consultation, adequate fibre, individualised hydration and toileting plans, beverage cart, constipation risk assessment, privacy during toileting, dementia\u2010friendly signage, toileting positioning, contrasting toilet seat, electronic alerts, staff education and resident\/family information.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>An evidence\u2010informed and co\u2010designed care\u2010bundle was co\u2010developed with potential to prevent constipation in residents with dementia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Implications for the Profession and\/or Patient Care<\/jats:title>\n                    <jats:p>This research has implications for nursing practice by offering an alternative to reliance on pharmacological strategies for preventing constipation in people with dementia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Impact<\/jats:title>\n                    <jats:p>This co\u2010designed and evidence\u2010informed care\u2010bundle has potential to reduce the incidence of constipation among the growing population with dementia. To ensure sustained use, it was co\u2010designed with stakeholders to be fit\u2010for\u2010purpose.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Reporting Method<\/jats:title>\n                    <jats:p>There were no reporting guidelines for this co\u2010design study identified.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patient or Public Contribution<\/jats:title>\n                    <jats:p>End\u2010users, including frontline staff and older people receiving care, as well as carers of people with dementia, were engaged in the co\u2010design as equal partners in the constipation prevention care\u2010bundle development process.<\/jats:p>\n                  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