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Patients' experiences of being delirious
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences. (Vårdforskning Medicin)
2007 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 16, no 5, 810-818 p.Article in journal (Refereed) Published
Abstract [en]

The aim was to describe patients' experiences of being delirious. Background.  Delirium is a serious psychiatric disorder that is frequently reported from hospital care settings, particularly among older patients undergoing hip surgery. It involves disturbances of consciousness and changes in cognition, a state which develops over a short period of time and tends to fluctuate during the course of the day. It is a certified fact that delirium is poorly diagnosed and recognized although the state often is described as terrifying. To be able to give professional care, it is of the utmost importance to know more about patients' experience of delirium. Method.  Included in the interviews were patients who had undergone hip-related surgery and during the hospital stay experienced delirium. Fifteen patients participated in the interviews. Of these, six had experienced episodes of nightly delirium (sundown syndrome) and nine experienced delirium during at least one day. The interviews were analysed by qualitative content analysis. Results.  The entry of delirium was experienced as a sudden change of reality that, in some cases, could be connected to basic unfulfilled physiological needs. The delirium experiences were like dramatic scenes that gave rise to strong emotional feelings of fear, panic and anger. The experiences were also characterized by opposite pairs; they took place in the hospital but at the same time somewhere else; it was like dreaming but still being awake. The exit from the delirium was associated with disparate feelings. Relevance to clinical practice.  It is necessary to understand patients' thoughts and experiences during the delirious phase to be able to give professional care, both during the delirium phase and after the recovery.

Place, publisher, year, edition, pages
2007. Vol. 16, no 5, 810-818 p.
Keyword [en]
delirium, experiences, hip surgery, nurses, nursing, qualitative method
National Category
Medical and Health Sciences
URN: urn:nbn:se:uu:diva-91141DOI: 10.1111/j.1365-2702.2006.01806.xISI: 000245988900002PubMedID: 17462032OAI: oai:DiVA.org:uu-91141DiVA: diva2:163759
Available from: 2003-11-18 Created: 2003-11-18 Last updated: 2011-02-03Bibliographically approved
In thesis
1. Delirium during Hospitalisation: Incidence, Risk Factors, Early Signs and Patients' Experiences of Being Delirious
Open this publication in new window or tab >>Delirium during Hospitalisation: Incidence, Risk Factors, Early Signs and Patients' Experiences of Being Delirious
2003 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Delirium is common among old patients admitted to hospital, but is often a neglected problem in patient care. The principal aim of this thesis was to evaluate aspects of delirium in relation to incidence, risk factors, behavioural changes, cognitive function and health-related quality of life (HRQOL). A further aim was to describe patients’ experiences of being delirious. The study was prospective, descriptive and comparative, with repeated measures (six-month follow up). The sample consisted of 225 consecutive patients, aged 65 years or older, who were to be operated on due to hip fracture or hip replacement. Exclusion criteria were serious cognitive disorder or delirium on admission. Data were collected via frequent daily observations, cognitive functioning tests (MMSE), HRQOL questionnaires (SF-36) and interviews. Delirium was assessed according to the DSM-IV criteria. A total of 45/225 became delirious, with an incidence of 24.3% among patients undergoing hip fracture surgery and 11.7% among those with hip replacement surgery. A predictive model for delirium included four factors: impaired hearing, passivity, low cognitive functioning, and waiting more than 18h for hip fracture surgery. Disorientation and urgent calls for attention were the most frequent behavioural changes in the prodromal phase prior to delirium. Delirium in connection with hip fracture revealed deteriorated HRQOL and cognitive functioning when measured at a six-month follow-up. The experience of being delirious was described by the patients as a sudden change of reality. Such an experience gave rise to strong emotional feelings, as did recovery from delirium. Nurses’ observations of behavioural changes in old patients with impaired cognitive function may be the first step in managing and reducing delirium. The predictive model of delirium ought to be tested further before use in clinical practice.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2003. 58 p.
Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 0282-7476 ; 1311
Nursing, delirium, Acute confusional state, hip surgery, hip fracture, replacement surgery, cognitive function, MMSE, Follow-up, health-related quality of life, HRQOL, SF-36, Omvårdnad
National Category
Research subject
Caring Sciences
urn:nbn:se:uu:diva-3814 (URN)91-554-5820-3 (ISBN)
Public defence
2003-12-11, Föreläsningssal 6, Campus Lugnet, Högskolan Dalarna, Falun, 13:00
Available from: 2003-11-18 Created: 2003-11-18Bibliographically approved

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Wikblad, Karin
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