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Delirium during Hospitalisation: Incidence, Risk Factors, Early Signs and Patients' Experiences of Being Delirious
Dalarna University, School of Health and Social Studies, Caring Science/Nursing.
2003 (English)Doctoral thesis, monograph (Other academic)
Abstract [en]

Delirium is common among old patients admitted to hospital, but is often a neglected problem in patient care. The principal aim of this thesis was to evaluate aspects of delirium in relation to incidence, risk factors, behavioural changes, cognitive function and health-related quality of life (HRQOL). A further aim was to describe patients’ experiences of being delirious. The study was prospective, descriptive and comparative, with repeated measures (six-month follow up). The sample consisted of 225 consecutive patients, aged 65 years or older, who were to be operated on due to hip fracture or hip replacement. Exclusion criteria were serious cognitive disorder or delirium on admission. Data were collected via frequent daily observations, cognitive functioning tests (MMSE), HRQOL questionnaires (SF-36) and interviews. Delirium was assessed according to the DSM-IV criteria. A total of 45/225 became delirious, with an incidence of 24.3% among patients undergoing hip fracture surgery and 11.7% among those with hip replacement surgery. A predictive model for delirium included four factors: impaired hearing, passivity, low cognitive functioning, and waiting more than 18h for hip fracture surgery. Disorientation and urgent calls for attention were the most frequent behavioural changes in the prodromal phase prior to delirium. Delirium in connection with hip fracture revealed deteriorated HRQOL and cognitive functioning when measured at a six-month follow-up. The experience of being delirious was described by the patients as a sudden change of reality. Such an experience gave rise to strong emotional feelings, as did recovery from delirium. Nurses’ observations of behavioural changes in old patients with impaired cognitive function may be the first step in managing and reducing delirium. The predictive model of delirium ought to be tested further before use in clinical practice.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis , 2003.
Series
Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN ISSN 0282-7476 ; 1311
Keywords [en]
delirium, Acute confusional state, hip surgery, hip fracture, replacement surgery, cognitive function, MMSE, Follow-up, health-related quality of life, HRQOL, SF-36
Research subject
Hälsa och välfärd, Delirium i samband med höftfraktur
Identifiers
URN: urn:nbn:se:du-127OAI: oai:dalea.du.se:127DiVA, id: diva2:523306
Available from: 2004-07-20 Created: 2004-07-20 Last updated: 2012-04-24Bibliographically approved

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CiteExportLink to record
Permanent link

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Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • chicago-author-date
  • chicago-note-bibliography
  • Other style
More styles
Language
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  • nn-NB
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More languages
Output format
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