Background <p>Delirium occurs in about one fourth of hospitalized older adults and is associated with multiple adverse outcomes. Despite efforts to improve the prevention and treatment of delirium, it remains a burden for patients, their relatives, and healthcare professionals. Currently, little is known about how people experience delirium episodes.</p> Methods <p>A sample of 77 inpatients who had been recently treated for delirium were recruited from acute geriatric care units at four hospitals. A semi-structured interview was conducted to explore memories and feelings associated with the delirium episode. The interview included both, dichotomous answers (yes/no) as well as the possibility to provide in-depth comments. Quantitative data were analysed using descriptive statistics. Qualitative data were analysed with content analysis. After three months, a follow-up interview was conducted with a subgroup (<i>n</i> = 29) via telephone.</p> Results <p>A majority (<i>n</i> = 66, 85.7%) of participants could recall the delirium episode. The main emotion reported by patients related to the previous delirium episode were anxiety and/or fear (67.5%, <i>n</i> = 52). Visual hallucinations and/or dream-like experiences were recalled by nearly 60% (<i>n</i> = 46). Approximately one-fourth (<i>n</i> = 21) reported that they felt fully recovered from the episode, although another 25% (<i>n</i> = 21) reported lasting symptoms. Three months after the initial interview, ten participants reported persistent negative feelings associated with the episode of delirium. Conversations with staff and family members were found to be the most helpful intervention during and after the delirium. Likewise, guidance on orientation was found to be helpful during delirium.</p> Conclusions <p>Anxiety and/or fear were the most common feelings reported after recovering from delirium. Negative memories and anxiety about cognitive decline were prevalent among those who failed to cope with delirium. Opportunities to talk about delirium and to provide reassurance to those affected should be integrated in usual care.</p> Trial registration <p>https//www.drks.de/on07/01/2022 (DRKS00024078).</p>

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The subjective experiences of patients recovering from delirium in acute geriatric care: An analysis of quantitative and qualitative interview data

  • Svenja Tietgen,
  • Isabell Behnen,
  • Jessica Koschate-Storm,
  • Milena von Kutzleben,
  • Steffi Wiards,
  • Tania Zieschang,
  • Brooke C. Schneider,
  • Alexander Rösler

摘要

Background

Delirium occurs in about one fourth of hospitalized older adults and is associated with multiple adverse outcomes. Despite efforts to improve the prevention and treatment of delirium, it remains a burden for patients, their relatives, and healthcare professionals. Currently, little is known about how people experience delirium episodes.

Methods

A sample of 77 inpatients who had been recently treated for delirium were recruited from acute geriatric care units at four hospitals. A semi-structured interview was conducted to explore memories and feelings associated with the delirium episode. The interview included both, dichotomous answers (yes/no) as well as the possibility to provide in-depth comments. Quantitative data were analysed using descriptive statistics. Qualitative data were analysed with content analysis. After three months, a follow-up interview was conducted with a subgroup (n = 29) via telephone.

Results

A majority (n = 66, 85.7%) of participants could recall the delirium episode. The main emotion reported by patients related to the previous delirium episode were anxiety and/or fear (67.5%, n = 52). Visual hallucinations and/or dream-like experiences were recalled by nearly 60% (n = 46). Approximately one-fourth (n = 21) reported that they felt fully recovered from the episode, although another 25% (n = 21) reported lasting symptoms. Three months after the initial interview, ten participants reported persistent negative feelings associated with the episode of delirium. Conversations with staff and family members were found to be the most helpful intervention during and after the delirium. Likewise, guidance on orientation was found to be helpful during delirium.

Conclusions

Anxiety and/or fear were the most common feelings reported after recovering from delirium. Negative memories and anxiety about cognitive decline were prevalent among those who failed to cope with delirium. Opportunities to talk about delirium and to provide reassurance to those affected should be integrated in usual care.

Trial registration

https//www.drks.de/on07/01/2022 (DRKS00024078).