Nursing interventions for pediatric functional constipation: a systematic review of evidence and clinical implications.

BACKGROUND: Functional constipation (FC) is one of the most common gastrointestinal disorders in children and may substantially affect physical well-being, emotional health, and quality of life. Nurses play an important role in providing behavioral support, education, and implementing supportive interventions; however, evidence regarding the effectiveness of nursing interventions in pediatric FC remains fragmented. This systematic review aimed to synthesize current evidence on nursing-led and nursing-integrated interventions for pediatric functional constipation and evaluate their clinical implications. METHODS: A comprehensive literature search was conducted across PubMed, Scopus, Web of Science, Medline, Embase, and other relevant databases to identify studies evaluating nursing-related interventions in children with FC. Nurse-led educational, behavioral, supportive, and complementary interventions were eligible. Risk of bias was assessed using study design-specific tools. RESULTS: Eleven studies involving approximately 65,500 children were included. Of these, 64,985 participants were enrolled in cohort, cross-sectional, and observational studies, whereas 530 participants were included in intervention-based studies (randomized controlled trials, clinical trials, and quasi-experimental studies). The evaluated interventions included nurse-led educational programs, structured bowel management strategies, abdominal massage, and technology-assisted approaches such as mobile applications and digital educational games. Overall, nursing-related interventions were associated with improvements in stool frequency, stool consistency, constipation symptoms, treatment adherence, self-management, and quality of life among children and their caregivers. CONCLUSIONS: Nursing-led and nursing interventions appear to be valuable adjuncts in the management of pediatric functional constipation. However, the available evidence remains heterogeneous, and additional high-quality studies are needed to establish standardized approaches and determine long-term effectiveness. CLINICAL TRIAL NUMBER: Not applicable.