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Original Article

Effects of Nursing Intervention Program on Reducing Acute Confusion in Hospitalized Older Adults

Korean Journal of Adult Nursing 2014;26(1):89-97.
Published online: February 28, 2014

1Sunlin Hospital, Pohang, Korea.

2College of Nursing, Keiymyung University, Daegu, Korea.

Corresponding author: Shin, Yeonghee. College of Nursing, Keiymyung University, 1095 Dalgubeol-daero, Dalseo-gu, Daegu 704-701, Korea. Tel: +82-53-580-3926, Fax: +82-53-580-3916, yshin@kmu.ac.kr
• Received: August 9, 2013   • Revised: September 29, 2013   • Accepted: February 2, 2014

© 2014 Korean Society of Adult Nursing

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  • Purpose
    During hospitalization, confusion occurs in 15~20% of older adults and persists in 5~10% of them. This study was designed to investigate effects of a five-day nursing intervention program designed to reduce confusion in hospitalized older adults. Subjects were inpatients over the age of 60 years old and were admitted in a surgical care unit.
  • Methods
    Data were collected from 111 patients. Subjects divided into one of two groups, 58 patients of the control group which received the usual nursing care; and 53 patients of the intervention group which received the usual nursing care plus nursing intervention program for reducing acute confusion. The Delirium Observation Screening Scale (DOS) and the Korean Mini-Mental Screening Examination (MMSE-K) were utilized.
  • Results
    1) Acute delirium was significantly reduced in the intervention group compared to the control group (χ2=4.22, p=.034) as well as the duration of the delirious state was significantly shortened (F=56.62, p<.001). Cognitive function of the intervention group was improved (F=21.14, p<.001).
  • Conclusion
    The nursing intervention program reduced the incidence and duration of acute delirium of the elderly inpatients, as well as it helps them keep better cognitive function than the control group.

This study was a partial fulfillment for the requirement of the master of science in nursing for the first author.

  • 1. Balas MC, Rice M, Chaperon C, Smith H, Fuchs B. Management of delirium in critically ill older adults. Crit Care Nurse. 2012;32(4):Retrieved May 3, 2013, from http://ccn.aacnjournals.org
  • 2. Beresin EV. Delirium in the elderly. J Geriatr Psychiatry Neurol. 1988;1:127-143.
  • 3. Cole MG, McCusker JJ. Treatment of delirium in older medical inpatients: a challenge for geriatric specialists. J Am Geriatr Soc. 2002;50(12):2101-2103.
  • 4. Cole MG, Primeau FJ, Bailey RF, Bonnycastle MJ, masciarelli F, Engelsmann , et al. Systematic intervention for elderly inpatients with delirium: a randomized trial. CMAJ. 1994;151(7):965-970.
  • 5. Elie M, Rousseau F, Cole M, Primeau F, McCusker J, Bellayance F. Prevalence and detection of delirium in elderly emergency department patients. CMAJ. 2000;163(8):977-981.
  • 6. Ely EW, Siegel MD, Iouye SK. Delirium in the intensive care unit: An under-recognized syndrome of organ dysfunction. Semin Respir Crit Care Med. 2001;22(2):115-126.
  • 7. Engelberger S, Zürcher M, Schuld J, Viehl CT, Kettelhack C. Postoperative course after emergency colorectal surgery for secondary peritonitis in the elderly is often complicated by delirium. Int Surg. 2012;97(2):129-134.
  • 8. Folstein MF, Folstein SE, McHugh PR. "Mini-mental." state A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12(3):189-198.
  • 9. Francis J, Martin D, Kapoor WN. A prospective study of delirium in hospitalized elderly. JAMA. 1990;263(8):1097-1101.
  • 10. Hwang SW, Kang SW, Kang YG, Choi SG, Lee J, Kim MJ, et al. Risk factors of delirium in elderly inpatients. J Korean Acad Fam Med. 2002;23(1):112-121.
  • 11. Inouye SK. Delirium in hospitalized older patients. Clin Geriatr Med. 1998;14(4):745-764.
  • 12. Inouye SK. Delirium in hospitalized older patients: Recognition and risk factor. J Geriatr Psychiatry Neurol. 1998;11(3):118-125.
  • 13. Inouye SK, Borgadus ST, Charpentier PA, Leo-Summers L, Acapora D, Holford TR, et al. A multicomponent interventions to prevent delirium in hospitalized older patients. N Engl J Med. 1999;340:669-676.
  • 14. Justic M. Does "ICU psychosis" really exist? Crit Care Nurse. 2000;20(3):28-37.
  • 15. Kim HY, Park MS, Lee HJ. The effects of delirium prevention education on hospitalized elders at high risk for delirium. J Korean Gerontol Nurs. 2007;9(1):60-67.
  • 16. Kwon YC, Park JH. A research for standardization of Korean Mini Mental State Examination for elderly. J Korean Neuropsychiatr Assoc. 1989;28(1):125-131.
  • 17. Lipowski ZJ. Update on delirium. Psychiatr Clin North Am. 1992;15(2):335-346.
  • 18. Marcantonio ER, Goldman L, Orav EJ, Cook EF, Lee TH. The association of intraoperative factor with development of postoperative delirium. Am J Med. 1998;105(5):380-384.
  • 19. McNicoll L, Pisani MA, Zhang Y, Ely EW, Siegel MD, Inouye SK. Delirium in the intensive care unit: Occurrence and clinical course in older patients. J Am Geriatr Soc. 2003;51(5):591-598.
  • 20. Rizzo JA, Bogardus ST Jr, Leo-Summers L, Williams CS, Acampora D, Inouye SK. Multicomponent targeted intervention to prevent delirium in hospitalized older patients: What is the economic value? Med Care. 2001;39(7):740-752.
  • 21. Schuurmans MJ, Donders RT, Duursma SA. Delirium case finding: Pilot testing of a new screening scale for nurses. J Am Geriatr Soc. 2002;50:suppl A8. S3.
  • 22. Schuurmans MJ, Shortridge-Bagget LM, Duursma SA. The Delirium Observation Screening Scale: A screening instrument for delirium. Res Theory Nurs Pract. 2003;17:31-50.
  • 23. Wanich CK, Sullivan-Max EM, Gottlieb GL, Johnson JC. Functional status outcomes of a nursing intervention in hospitalized elderly. Image J Nurs Sch. 1992;24(3):201-207.
  • 24. Yoo MY. Related factor of delirium occurrence in the intensive care unit patients. Ajou University; 2007. Unpublished master's thesis.
Table 1
General Characteristics of Study Subjects (N=111)
kjan-26-89-i001.jpg

Exp.=experimental group; Cont.=control group.

Table 2
Chi-square Test for the Occurrence of Acute Confusion between Two Groups (N=111)
kjan-26-89-i002.jpg

Exp.=experimental group; Cont.=control group.

Table 3
Odd ratio on the Occurrence of Acute Confusion in the Control Group Compared to Experimental Group by Logistic Regression Analysis (N=111)
kjan-26-89-i003.jpg

Reference: Experimental group.

Table 4
Comparison of the Duration of Acute Confusion between Two Groups (N=111)
kjan-26-89-i004.jpg
Table 5
Comparison of Cognitive Function of the Two Groups by the Repeated Measures ANOVA (N=111)
kjan-26-89-i005.jpg

Figure & Data

References

    Citations

    Citations to this article as recorded by  
    • Non-pharmacological interventions for preventing delirium in hospitalised non-ICU patients
      Jennifer K Burton, Louise E Craig, Shun Qi Yong, Najma Siddiqi, Elizabeth A Teale, Rebecca Woodhouse, Amanda J Barugh, Alison M Shepherd, Alan Brunton, Suzanne C Freeman, Alex J Sutton, Terry J Quinn
      Cochrane Database of Systematic Reviews.2021;[Epub]     CrossRef
    • A Systematic Review of Non-pharmacological Interventions for Delirium Prevention in Elderly Inpatients
      Sang Bin You, Ju Hee Lee
      Journal of Korean Academy of Fundamentals of Nursing.2021; 28(2): 249.     CrossRef
    • Effects of A Multicomponent Intervention Program for Preventing Delirium in Geriatric Patients in the Intensive Care Unit
      Ju Hee Hwang, Min Young Kim
      Korean Journal of Adult Nursing.2021; 33(6): 565.     CrossRef
    • Non-pharmacological interventions for preventing delirium in hospitalised non-ICU patients
      Jennifer K Burton, Louise Craig, Shun Qi Yong, Najma Siddiqi, Elizabeth A Teale, Rebecca Woodhouse, Amanda J Barugh, Alison M Shepherd, Alan Brunton, Suzanne C Freeman, Alex J Sutton, Terry J Quinn
      Cochrane Database of Systematic Reviews.2021;[Epub]     CrossRef

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    Effects of Nursing Intervention Program on Reducing Acute Confusion in Hospitalized Older Adults
    Korean J Adult Nurs. 2014;26(1):89-97.   Published online February 28, 2014
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    Korean J Adult Nurs. 2014;26(1):89-97.   Published online February 28, 2014
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    Effects of Nursing Intervention Program on Reducing Acute Confusion in Hospitalized Older Adults
    Effects of Nursing Intervention Program on Reducing Acute Confusion in Hospitalized Older Adults

    General Characteristics of Study Subjects (N=111)

    Exp.=experimental group; Cont.=control group.

    Chi-square Test for the Occurrence of Acute Confusion between Two Groups (N=111)

    Exp.=experimental group; Cont.=control group.

    Odd ratio on the Occurrence of Acute Confusion in the Control Group Compared to Experimental Group by Logistic Regression Analysis (N=111)

    Reference: Experimental group.

    Comparison of the Duration of Acute Confusion between Two Groups (N=111)

    Comparison of Cognitive Function of the Two Groups by the Repeated Measures ANOVA (N=111)

    Table 1 General Characteristics of Study Subjects (N=111)

    Exp.=experimental group; Cont.=control group.

    Table 2 Chi-square Test for the Occurrence of Acute Confusion between Two Groups (N=111)

    Exp.=experimental group; Cont.=control group.

    Table 3 Odd ratio on the Occurrence of Acute Confusion in the Control Group Compared to Experimental Group by Logistic Regression Analysis (N=111)

    Reference: Experimental group.

    Table 4 Comparison of the Duration of Acute Confusion between Two Groups (N=111)

    Table 5 Comparison of Cognitive Function of the Two Groups by the Repeated Measures ANOVA (N=111)

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