Subjective strain of care experienced by pulmonary and critical care medical nurses when caring for patients with delirium: a cross-sectional study

Abstract

Background Delirium, a disorder of consciousness, often occurs for a period of time during hospitalisation. It is characterised by a disturbance of attention or awareness. Hyperactive delirium may lead to accidental removal of medical equipment, while hypoactive delirium may inhibit patients from participating in nursing interventions, medical treatment, and physical therapy. However, there are limited relevant studies of the strain of care of nurses in China when caring for patients with delirium. This study, thus, aimed to investigate the subjective level of the strain of care experienced by pulmonary and critical care nurses when caring for patients with delirium. Methods This was a descriptive, cross-sectional study. A survey was conducted with 100 nurses in the Chinese pulmonary and critical care medical (PCCM) department in 2018. The Strain of Care for Delirium Index (SCDI) was used to measure nurses’ strain of care. Participants were instructed to rate the degree of perceived difficulty in managing patients who displayed the behaviours listed in the SCDI, on a scale from 1 (quite easy) to 4 (very difficult). The mean ± standard deviation (SD) scores of the ranked difficulty scores were calculated. Results In our sample, 47 % of the nurses had received delirium-related training previously. The three wards with the highest strain of care scores when caring for patients with delirium were the chronic obstructive pulmonary disease ward (3.29 ± 0.72), interstitial lung disease ward (3.11 ± 1.31), and respiratory intensive care unit (3.02 ± 0.78). The three types of patient behaviours associated with the highest degree of nursing strain of care were being uncooperative and difficult to manage (3.37 ± 0.84), pulling out tubes and tearing out dressings (3.33 ± 0.98), and irritability (3.22 ± 0.95). Conclusions This study is the first to focus on nurses’ subjective strain of care when caring for patients with delirium in PCCM departments in China. The findings suggest the need to pay more attention to the working status of Chinese nurses. Further trials with large samples assessing relevant outcomes of patients with delirium are warranted.

Nurses\' Knowledge and Subjective Strain in Delirium Care: Impact of a Web-based Instructional Module on Nurses Competence

“… 32 It is plausible to infer that the improvement in knowledge, facilitated by the online teaching intervention in our study, may act as a catalyst in reducing subjective strain. 33 By emphasizing early detection and management of delirium, the educational intervention not only contributes to enhanced knowledge but also potentially mitigates subjective strain through proactive prevention strategies. This reinforces the interconnectedness between knowledge improvement and the subsequent reduction in subjective strain, underscoring the comprehensive benefits of the educational intervention.…”

Delirium in elderly patients with COPD combined with respiratory failure undergoing mechanical ventilation: a prospective cohort study

“…The APACHE II score represents the severity of the disease, and the score is positively correlated with the severity of the disease. The higher the APACHE II score of the patient, the more severe the stress response caused by the disease, the more obvious the acute disorder of high-level nerve center activity, and the more prone to delirium [ 41 ]. Therefore, while paying attention to disease treatment, medical staff should comprehensively evaluate the patient's condition, closely observe the patient's consciousness, blood oxygen saturation, disease manifestations, laboratory indicators, etc., and take timely measures [ 42 ].…”

A predictive nomogram for assessing the likelihood of consciousness disturbances in individuals with chronic obstructive pulmonary disease

“…Long-term recurrent exacerbations of COPD can result in severe dyspnea, causing anxiety, hypoxemia, and hypercapnia, and are often complicated by disorders of consciousness (DOC) [5] , which include coma, unresponsive arousal syndrome/vegetative state, and minimally conscious state [6] . Once it occurs it is di cult to correct and has a very high morbidity and mortality rate [7] , so predicting the occurrence of DOC in patients with COPD ahead of time is conducive to lowering the risk of patient death.…”