Patients’ experiences of delirium: A systematic review and meta‐summary of qualitative research

Abstract

Aims The purpose of this systematic review and meta‐summary was the aggregation of the empirical qualitative literature on patients’ experiences of delirium in order to support the development and implementation of patient‐oriented delirium management and to guide future research. Design We conducted a systematic literature review of qualitative research published between January 1980 and June 2019. Data sources In June 2019, we searched in Medline, CINAHL, SSCI and PsycInfo to identify relevant reports. In addition, we conducted searches in three dissertation databases (BASE, DART and ProQuest) and Google Scholar. Review methods We used methods developed by Sandelowski and Barroso to construct a meta‐summary of the findings by extracting them from the reports, abstracting them into meta‐ findings and calculating their manifest interstudy frequency effect sizes. Results Out of the 742 identified records, 24 reports based on delirium experience accounts of 483 patients met our criteria and were included. One thousand ninety‐seven findings were extracted from these reports and abstracted into 92 meta‐findings. These were grouped to the five emerging themes ‘perception’, ‘emotions’, ‘interaction with others’, ‘dealing with delirium’ and ‘influence on further life’. Conclusion Delirium is commonly perceived as an overall distressing condition, which can accompany and influence patients even after hospital discharge. Impact This systematic review and meta‐summary is the most comprehensive aggregation of qualitative research of the patient delirium experience to date. It allows us to better understand, extract meaning from, and weigh the qualitative findings in their context by calculating their manifest frequency effect sizes. This can be used to support the development and implementation of delirium management concepts.

Delirium and COVID‐19: a narrative review of emerging evidence

“…The most common emotions were fear and anxiety. Other negative emotions reported were feeling threatened; insecurity; panic; anger; restlessness: powerlessness; helplessness; frustration; loneliness and hopelessness; vulnerability; guilt; shame; ‘going mad’; and emotional chaos [73]. Similar themes are observed in the ICU [74] and after transcatheter or surgical aortic valve replacement [75].…”

“…2). A large 2011 study of non‐COVID‐19 delirium used 24 reports based on delirium experience accounts from 483 patients [73]. This included 1097 findings that were extracted and abstracted into 92 meta‐findings.…”

The conscious state of the dying patient: An integrative review

“…This is consistent with other recent research, suggesting that delirium is often not recognized or not identified in palliative care patients (Watt et al, 2021), despite the availability of both diagnostic criteria (American Psychiatric Association, 2013) and validated delirium screening tools (Watt et al, 2021). Given that delirium is perceived as a very distressing condition by those who have experienced it and recovered (Kuusisto-Gussmann et al, 2021), it is possible that the dying patient with an altered level of consciousness is equally distressed. The findings of this integrative review agree with the previously reported findings regarding the lack of available guidance, and the difficulty in assessing the care needs of the voiceless and vulnerable dying patient with delirium (Gao et al, 2013; Lawlor et al, 2014; Blinderman and Billings, 2015; Mah et al, 2017).…”

SOP Delirmanagement

“…delirare), bemerken es zwar viele Betroffene selbst, kommunizieren dies aber nicht. Beispiele sind erste Schlaf-und Konzentrationsstörungen mit der Folge von Gedächtnislücken und Unverständnis oder verstörende Verkennungen und Halluzinationen [5]. Deshalb sind eine patienten-und familienorientierte Information und Zusammenarbeit essenziell sowie fachliche Kenntnisse aller Mitarbeiter [6].…”

“…[1][2][3][4][5][6][7][8][9][10][11][12][13][14][15] siehe Kapitel "Erläuterungen". Wegen fehlender verlässlicher Biomarker und technischer Befunde definieren klinische Befunde das Ende der deliranten Episode.…”