Delirium in patients with head and neck cancer in the outpatient treatment setting

Bond, Stewart M.; Dietrich, Mary S.; Shuster, John L.; Murphy, Barbara A.

doi:10.1007/s00520-011-1174-0

Cited by 23 publications

(18 citation statements)

References 30 publications

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“…DSM criteria were most commonly used to identify delirium ( n = 11) . The Memorial Delirium Assessment Scale was used in five papers , the Confusion Assessment Method (CAM) was used in 10 papers and the Confusion Rating Scale was used in two papers . Three delirium detection studies used the Family Confusion Assessment Method (FAM‐CAM) .…”

Section: Resultsmentioning

confidence: 99%

The experiences of caregivers of patients with delirium, and their role in its management in palliative care settings: an integrative literature review

et al. 2016

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ObjectivesTo explore the experiences of caregivers of terminally ill patients with delirium, to determine the potential role of caregivers in the management of delirium at the end of life, to identify the support required to improve caregiver experience and to help the caregiver support the patient.MethodsFour electronic databases were searched—PsychInfo, Medline, Cinahl and Scopus from January 2000 to July 2015 using the terms ‘delirium’, ‘terminal restlessness’ or ‘agitated restlessness’ combined with ‘carer’ or ‘caregiver’ or ‘family’ or ‘families’. Thirty‐three papers met the inclusion criteria and remained in the final review.ResultsPapers focused on (i) caregiver experience—distress, deteriorating relationships, balancing the need to relieve suffering with desire to communicate and helplessness versus control; (ii) the caregiver role—detection and prevention of delirium, symptom monitoring and acting as a patient advocate; and (iii) caregiver support—information needs, advice on how to respond to the patient, interventions to improve caregiver outcomes and interventions delivered by caregivers to improve patient outcomes.ConclusionHigh levels of distress are experienced by caregivers of patients with delirium. Distress is heightened because of the potential irreversibility of delirium in palliative care settings and uncertainty around whether the caregiver–patient relationship can be re‐established before death. Caregivers can contribute to the management of patient delirium. Additional intervention studies with informational, emotional and behavioural components are required to improve support for caregivers and to help the caregiver support the patient. Reducing caregiver distress should be a goal of any future intervention.© 2016 The Authors. Psycho‐Oncology Published by John Wiley & Sons Ltd.

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Section: Resultsmentioning

confidence: 99%

The experiences of caregivers of patients with delirium, and their role in its management in palliative care settings: an integrative literature review

et al. 2016

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“…In one of the few studies of delirium in cancer outpatients, caregivers of patients with head and neck cancer retrospectively reported higher rates of delirium compared with provider clinical assessments. 5 To incorporate the family perspective, the developers of the CAM created a second delirium screening instrument to be administered by caregivers, the Family-CAM (FAM-CAM). 80 The FAM-CAM has a sensitivity of 86% and a specificity of 98% compared with the CAM and is designed to be used in conjunction with or confirmed by providers.…”

Section: Gap 4: Patients With Cancer Are Not Routinely Screened Fomentioning

confidence: 99%

“…The lack of awareness of delirium incidence and prevalence is especially problematic in the outpatient setting where much of cancer care is delivered. 5 …”

Section: Introductionmentioning

confidence: 99%

Understanding cognition in older patients with cancer

Karuturi

Wong

Hsu

et al. 2016

Journal of Geriatric Oncology

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Cancer and neurocognitive disorders, such as dementia and delirium, are common and serious diseases in the elderly that are accompanied by high degree of morbidity and mortality. Furthermore, evidence supports the under-diagnosis of both dementia and delirium in older adults. Complex questions exist regarding the interaction of dementia and delirium with cancer, beginning with guidelines on how best measure disease severity, the optimal screening test for either disorder, the appropriate level of intervention in the setting of abnormal findings, and strategies aimed at preventing the development or progression of either process. Ethical concerns emerge in the research setting, pertaining to the detection of cognitive dysfunction in participants, validity of consent, disclosure of abnormal results if screening is pursued, and recommended level of intervention by investigators. Furthermore, understanding the ways in which comorbid cognitive dysfunction and cancer impact both cancer and non-cancer-related outcomes is essential in guiding treatment decisions. In the following article, we will discuss what is presently known of the interactions of pre-existing cognitive impairment and delirium with cancer. We will also discuss identified deficits in our knowledge base, and propose ways in which innovative research may address these gaps.

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“…One small study reported that the incidence and prevalence of delirium were 45% and 7%, respectively, during outpatient treatment for head and neck cancer. 21 However, delirium is often misunderstood or misdiagnosed as anxiety disorder or depression. 22 Thus, the incidence or prevalence may be underreported.…”

Section: Definition and Incidencesmentioning

confidence: 99%

Comprehensive approaches to managing delirium in patients with advanced cancer

Kang

Shin

Bruera

2013

Cancer Treatment Reviews

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Delirium is a frequently under-recognized complication in patients with advanced cancer. Uncontrolled delirium eventually leads to significant distress to patients and their families. However, delirium episodes can be reversed in half of these patients by eliminating precipitating factors and using appropriate interventions. The purpose of this narrative review is to discuss the most recent updates in the literature on the management of delirium in patients with advanced cancer. This article addresses the epidemiology, cause, pathophysiology, clinical characteristics, and assessment of delirium as well as various treatment options, including nonpharmacologic intervention and palliative sedation.

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Delirium in patients with head and neck cancer in the outpatient treatment setting

Cited by 23 publications

References 30 publications

The experiences of caregivers of patients with delirium, and their role in its management in palliative care settings: an integrative literature review

The experiences of caregivers of patients with delirium, and their role in its management in palliative care settings: an integrative literature review

Understanding cognition in older patients with cancer

Comprehensive approaches to managing delirium in patients with advanced cancer

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