Background
Delirium is defined as a sudden onset of confusion due to disruption in normal brain functioning. Although it is highly prevalent in post‐operative patients, most significantly the older adult population, limited information exists explaining why its onset occurs.
Purpose
This integrative review aimed to synthesise specific comorbidities that can contribute to the development of post‐operative delirium in older adult cardiac surgical patients.
Methods
PRISMA statement was used to report the identification, selection, appraisal and synthesis of articles and the PRISMA diagram reports the selection process. The Johns Hopkins Evidence‐Based Practice Tools were used as guide in literature review, critical analysis, levelling of evidence and quality rating. PubMed, ProQuest, CINAHL plus, EMBASE, MEDLINE, Ovid Nursing Collection and Cochrane databases were searched from 2015 to 2020.
Results
The initial search yielded 1529 articles. Following the removal of duplicates and screening, 14 articles were included for this review. The following comorbidities were identified in the studies: Diabetes mellitus, atrial fibrillation, depression, impaired olfaction, pre‐existing cerebrovascular disease, pre‐existing cardiovascular disease, insomnia and frailty.
Conclusion
There was a strong indication of the development of post‐operative delirium among older adult cardiac surgical patients with comorbidities.
Relevance to clinical practice
Awareness of the impact of comorbidities in developing post‐operative delirium may help healthcare providers to plan and implement proper care management among older adult cardiac surgical patients with comorbidities.
Black American individuals have a higher rate of Alzheimer's disease and related dementias (ADRD) diagnoses compared to other racial/ethnic groups, and their family caregiver population is expected to increase rapidly over the next 2 decades. The current study aimed to explore Black American women's experiences caring for family members with ADRD. An interpretative phenomenology approach was used to gain a deeper understanding of the caregiving experiences of Black American women. Participants in the study were all Black American married women aged 63 to 81 years (mean = 71.3 years,
SD
= 6.6 years). Key themes that emerged from the study included: (a)
Family Care Obligation
, (b)
Caregiving Journey
, (c)
Prioritizing Health Concerns
, (d)
Coping Behaviors
, and (e)
Support Needs and Challenges
. Family caregivers require ongoing support, education, and guidance. Implications for nursing practice include focusing on family assessments, increased education and awareness, and collaboration with interdisciplinary teams to provide the best resources. [
Journal of Gerontological Nursing, 49
(6), 19–26.]
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