Registered nurses' experiences of caring for patients with hypoactive delirium after cardiac surgery - A qualitative study.

Autor: Hallberg Kristensen A; Department of Cardiology, Heart and Vascular Center, Karolinska University Hospital, SE-171 76 Stockholm, Sweden., Nymark C; Department of Cardiology, Heart and Vascular Center, Karolinska University Hospital, SE-171 76 Stockholm, Sweden; Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Alfred Nobels Allé 23, SE-141 52 Huddinge, Sweden., Stenman M; Perioperative Medicine and Intensive Care Function, Heart and Vascular Center, Karolinska University Hospital, SE-171 76 Stockholm, Sweden; Department of Molecular Medicine and Surgery, Karolinska Institute, L1:00, Anna Steckséns gata 53, SE-171 76 Stockholm, Sweden., Falk A; Perioperative Medicine and Intensive Care Function, Heart and Vascular Center, Karolinska University Hospital, SE-171 76 Stockholm, Sweden; Department of Molecular Medicine and Surgery, Karolinska Institute, L1:00, Anna Steckséns gata 53, SE-171 76 Stockholm, Sweden. Electronic address: anna.falk.2@ki.se.
Jazyk: angličtina
Zdroj: Intensive & critical care nursing [Intensive Crit Care Nurs] 2024 Oct; Vol. 84, pp. 103757. Date of Electronic Publication: 2024 Jun 28.
DOI: 10.1016/j.iccn.2024.103757
Abstrakt: Objectives: Delirium is a common post-cardiac surgery complication that presents as acute changes in mental abilities with confused thinking and a lack of awareness of the surroundings. Delirium symptoms present in hyperactive- and hypoactive forms. Hypoactive delirium is often overlooked. Although nursing interventions are important in preventing and treating hypoactive delirium, studies focusing on nurses' experiences of hypoactive delirium are scarce. This study describes registered nurses' experiences of caring for patients with hypoactive delirium after cardiac surgery.
Research Methodology/design: This was a qualitative descriptive study with an inductive approach. Data was collected through focus group interviews with 12 registered nurses with experience in caring for cardiac surgery patients with hypoactive delirium. The study complied with the Consolidated Criteria for Reporting Qualitative Research.
Setting: A cardiac surgery department at a Swedish University Hospital.
Findings: The analysis resulted in one main category; "Navigating the complexities of care when caring for patients with hypoactive delirium" and three sub-categories: "Challenges, "Nursing interventions" and "Promoting a team approach".
Conclusion: Delirium assessment and nursing interventions are perceived as essential yet demanding. when caring for patients with hypoactive delirium. Nursing interventions like maintaining the circadian rhythm and offering emotional support need to be prioritised by the nurses, in line with the autonomy of the registered nurse's profession. Moreover, the team around the patient is crucial for detecting and treating hypoactive delirium, and it is important to involve other professionals as well as the patient's relatives. Future research is needed to develop assessment instruments that more accurately capture hypoactive delirium in the postoperative setting.
Implications for Clinical Practice: Despite the use of screening tools, nurses still experience challenges in detecting the symptoms of hypoactive delirium, indicating a need for more clinically effective screening tools for hypoactive delirium. Nursing interventions are emphasised in the care of patients with hypoactive delirium.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)
Databáze: MEDLINE
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