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Volume 24, Issue 3 (Autumn 2022)                   JHC 2022, 24(3): 276-288 | Back to browse issues page

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Kojaei/Bidgoli A, Alizadeh-Khoei M, Ghorbanzadeh K. Experiences of Nurses Caring for Patients with Delirium: A Qualitative Study. JHC 2022; 24 (3) :276-288
URL: http://hcjournal.arums.ac.ir/article-1-1407-en.html
Kashan University Of Medical Science
Abstract:   (714 Views)
Background & aim: Delirium is a prevalent disorder that frequently appears in inpatients and is followed by undesirable consequences and complications. Considering the role of nurses in determining and preventing delirium, investigating nurses’ understanding of the care of patients with delirium is crucial. The present study was conducted in order to explain the experiences of nurses caring for patients with delirium.
Methods: The research population consisted of nurses who work in Shahid Beheshti hospital. Eleven nurses were selected by purposive sampling method. The selection criteria of participants included consent to participate in the study, having at least a Bachelor’s degree, and working experience of more than 5 years. For data collection, a semi-structured focus group discussion method was used. The time, place, and duration of the sessions were coordinated based on the participants’ preferences. Every Focus Group Discussion session lasted about 60 minutes. Data were analyzed by conventional content analysis method with an inductive approach.
Results: The result of the study showed that nurses differently understood delirium, considering their experiences and based on this, they stated variable factors in its occurrence. According to this study, individual factors, family neglect, ineffective communication, fear of the unknown and unstable environment were identified as the roots of delirium. The three main categories of the findings of the present study were ‘lost in time and space’, ‘unbridled behaviors’, and ‘the underlying cause of delirium’.
Conclusion: As reported by nurses, delirium is characterized by some features including loss of time and space and unbridled behaviors. Also, they listed other factors such as individual underlying factors, fear of the uncertainty, ineffective communication, and unstable environment as effective roots in the occurrence of delirium. Based on the results of the present study and considering the role of nurses in the prevention and control of delirium, compiling delirium prevention guidelines and programs in accordance with international guidelines is recommended to be used by nurses.
Full-Text [PDF 244 kb]   (484 Downloads)    
Type of Study: article | Subject: nursing
Received: 2022/10/8 | Accepted: 2023/01/14 | Published: 2022/12/1

References
1. Diagnostic and statistical manual of mental disorders: DSM-5. American Psychiatric Association. Washington DC; 2013. [DOI:10.1176/appi.books.9780890425596]
2. Hagerling FL. Nurse attitudes toward caring for older patients with delirium. For the Degree of Master of Science. Colorado State University: Department of Human Development and Family Studies; 2015.
3. Jackson P, Khan A. Delirium in critically ill patients. Critical Care Clinics. 2015;31(3):589-603. [DOI:10.1016/j.ccc.2015.03.011] [PMID]
4. Wilson JE, Mart MF, Cunningham C, Shehabi Y, Girad TD, Maclullich AMJ, et al. Delirium. Nature Reviews Disease Primers. 2020;6(90):1-26. [DOI:10.1038/s41572-020-00223-4] [PMID] []
5. Vasilevskis EE, Han JH, Hughes CG, Ely EW. Epidemiology and risk factors for delirium across hospital settings. Best Practice & Research Clinical Anaesthesiology. 2012;26(3):277-87. [DOI:10.1016/j.bpa.2012.07.003] [PMID] []
6. Agarwal V, O'neill PJ, Cotton BA, Pun BT, Haney S, Thompson J, et al. Prevalence and risk factors for development of delirium in burn intensive care unit patients. Journal of Burn Care & Research. 2010;31(5):706-15. [DOI:10.1097/BCR.0b013e3181eebee9] [PMID] []
7. Leslie DL, Inouye SK. The importance of delirium: economic and societal costs. Journal of the American Geriatrics Society. 2011;59(s2):S241-S243. [DOI:10.1111/j.1532-5415.2011.03671.x] [PMID] []
8. Gomes MM. Decreasing the incidence of postoperative delirium in the high risk elderly population: a plan for translating best practices guidelines into anesthesia practice. The University of Southern Mississippi; 2015.
9. Beiranvand A, fallahi khoshkneb M, Ashayeri H, Rahgozar M. Comparison between prevalence of delirium after hip surgery and general surgery in hospitalized female elderly. Journal of Geriatric Nursing. 2014;1(1):83-93.
10. Javanmardifard S, Heidari S, Sanjari M, Yazdanmehr M, Shirazi F. The relationship between spiritual well-being and hope, and adherence to treatment regimen in patients with diabetes. Journal of Diabetes & Metabolic Disorders. 2020;19(2):941-50. [DOI:10.1007/s40200-020-00586-1] [PMID] []
11. Sörensen Duppils G, Wikblad K. Patients' experiences of being delirious. Journal of Clinical Nursing. 2007;16(5):810-18. [DOI:10.1111/j.1365-2702.2006.01806.x] [PMID]
12. Yevchak A, Steis M, Diehl T, Hill N, Kolanowski A, Fick D. Managing delirium in the acute care setting: a pilot focus group study. International Journal of Older People Nursing. 2012;7(2):152-62. [DOI:10.1111/j.1748-3743.2012.00324.x] [PMID] []
13. Tabet N, Hudson S, Sweeney V, Sauer J, Bryant C, Macdonald A, et al. An educational intervention can prevent delirium on acute medical wards. Age and Ageing. 2005;34(2):152-56. [DOI:10.1093/ageing/afi031] [PMID]
14. Inouye SK, Baker DI, Fugal P, Bradley EH, Project HD. Dissemination of the hospital elder life program: implementation, adaptation, and successes. Journal of the American Geriatrics Society. 2006;54(10):1492-99. [DOI:10.1111/j.1532-5415.2006.00869.x] [PMID]
15. Fick DM, Hodo DM, Lawrence F, Inouye SK. Recognizing delirium superimposed on dementia: assessing nurses' knowledge using case vignettes. Journal of Gerontological Nursing. 2007;33(2):9-40. [DOI:10.3928/00989134-20070201-09] [PMID] []
16. Schuurmans MJ, Duursma SA, Shortridge-Baggett LM. Early recognition of delirium: review of the literature. Journal of Clinical Nursing. 2001;10(6):721-29. https://doi.org/10.1111/j.1365-2702.2001.00548.x [DOI:10.1046/j.1365-2702.2001.00548.x]
17. Inouye SK, Foreman MD, Mion LC, Katz KH, Cooney Jr LM. Nurses' recognition of delirium and its symptoms: comparison of nurse and researcher ratings. Archives of Internal Medicine. 2001;161(20):2467-73. [DOI:10.1001/archinte.161.20.2467] [PMID]
18. Mistarz R, Eliott S, Whitfield A, Ernest D. Bedside nurse- patient interactions do not reliably detect delirium: an observational study. Australian Critical Care. 2011;24(2):126-32. [DOI:10.1016/j.aucc.2011.01.002] [PMID]
19. Westert GP, Berg MJ, Zwakhals SLN, Jong JD, Verkleii H. Dutch health care performance report 2010. National Institute for Public Health and the Environment, In: Inspectorate DH. Editor; 2012.
20. Schuurmans MJ. The neecham confusion scale and the delirium observation screening scale: capacity to discriminate and ease of use in clinical practice. BMC Nursing. 2007;6(1):3. [DOI:10.1186/1472-6955-6-3] [PMID] []
21. Van De Steeg L, Langelaan M, Ijkema R, Nugus P, Wagner C. Improving delirium care for hospitalized older patients: a qualitative study identifying barriers to guideline adherence. Journal of Evaluation in Clinical Practice. 2014;20(6):813-19. [DOI:10.1111/jep.12229] [PMID]
22. Kim M, Park S-Y. Factors affecting the self-directed learning of students at clinical practice course for advanced practice nurse. Asian Nursing Research. 2011;5(1):48-59. [DOI:10.1016/S1976-1317(11)60013-3] [PMID]
23. Cho JY, Lee E-H. Reducing confusion about grounded theory and qualitative content analysis: similarities and differences. The Qualitative Report. 2014;19(32):1-20. [DOI:10.46743/2160-3715/2014.1028]
24. Speziale HS, Streubert HJ, Carpenter DR. Qualitative research in nursing: Advancing the humanistic imperative: Lippincott Williams & Wilkins; 2011.
25. AdibhagBagheri M, Parvizi S, Salsali M. Qualitative Research. Tehran: Boshra; 2007
26. Graneheim UH, Lundman B. Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Education Today. 2004;24(2):105-12. [DOI:10.1016/j.nedt.2003.10.001] [PMID]
27. Streubert HJ, Carpenter DR. Qualitative research in nursing: advancing the humanistic imperative; 1999.
28. Siddiqi N, House A. Delirium: an update on diagnosis, treatment and prevention. Clinical Medicine. 2006;6(6):540-43. [DOI:10.7861/clinmedicine.6-6-540] [PMID] []
29. Hosie A, Lobb E, Agar M, Davidson PM, Phillips J. Identifying the barriers and enablers to palliative care nurses' recognition and assessment of delirium symptoms: a qualitative study. Journal of Pain and Symptom Management. 2014;48(5):815-30. [DOI:10.1016/j.jpainsymman.2014.01.008] [PMID]
30. Faught DD. Delirium: the nurse's role in prevention, diagnosis, and treatment. Medsurge Nursing Journal. 2014;23(5):301-305.
31. McCusker J, Cole M, Abrahamowicz M, Han L, Podoba JE, Ramman‐Haddad L. Environmental risk factors for delirium in hospitalized older people. Journal of the American Geriatrics Society. 2001;49(10):1327-34. [DOI:10.1046/j.1532-5415.2001.49260.x] [PMID]
32. Thomas N, Coleman M, Terry D. Nurses' experience of caring for patients with delirium: systematic review and qualitative evidence synthesis. Nursing Reports. 2021;11(1):164-74. [DOI:10.3390/nursrep11010016] [PMID] []
33. Eghbali-Babadi M, Shokrollahi N, Mehrabi T. Effect of family-patient communication on the incidence of delirium in hospitalized patients in cardiovascular surgery ICU. Iranian Journal of Nursing and Midwifery Research. 2017;22(4):327. [DOI:10.4103/1735-9066.212985] [PMID] []
34. Hoonakker P, Carayon P, Douglas S, Schultz K, Walker J, Wetterneck TB. Communication in the ICU and the relation with quality of care and patient safety from a nurse perspective. International Journal of Healthcare Information Systems 2011;1(6):1.
35. Tropea J, Slee JA, Brand CA, Gray L, Snell T. Clinical practice guidelines for the management of delirium in older people in Australia. Australasian Journal on Ageing. 2008;27(3):150-56. [DOI:10.1111/j.1741-6612.2008.00301.x] [PMID]
36. Delirium: diagnosis, prevention and management. London: National Clinical Guideline Centre - Acute and Chronic Conditions; 2010.
37. Zaal IJ, Spruyt CF, Peelen LM, van Eijk MM, Wientjes R, Schneider MM, et al. Intensive care unit environment may affect the course of delirium. Intensive Care Medicine. 2013;39(3):481-88. [DOI:10.1007/s00134-012-2726-6] [PMID]

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