Duppils Gill Sörensen, Wikblad Karin
Department of Health and Social Sciences, Högskolan Dalarna, Falun, Sweden.
J Clin Nurs. 2007 May;16(5):810-8. doi: 10.1111/j.1365-2702.2006.01806.x.
The aim was to describe patients' experiences of being delirious.
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.
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.
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.
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.
描述患者谵妄发作时的体验。
谵妄是一种严重的精神障碍,在医院护理环境中经常有报告,尤其是在接受髋关节手术的老年患者中。它涉及意识障碍和认知改变,这种状态在短时间内发展,且一天中往往会波动。尽管谵妄状态常被描述为可怕,但事实上它的诊断和识别都很差。为了能够提供专业护理,了解更多患者对谵妄的体验至关重要。
访谈对象包括接受过髋关节相关手术且在住院期间经历过谵妄的患者。15名患者参与了访谈。其中,6人经历过夜间谵妄发作(日落综合征),9人在至少一天内经历过谵妄。访谈采用定性内容分析法进行分析。
谵妄的发作被体验为现实的突然改变,在某些情况下,可能与未满足的基本生理需求有关。谵妄体验就像戏剧性的场景,引发了强烈的恐惧、恐慌和愤怒情绪。这些体验还具有相反的特征;它们发生在医院,但同时又在其他地方;就像在做梦,但又清醒着。谵妄的结束伴随着不同的感受。
为了在谵妄阶段及康复后都能提供专业护理,有必要了解患者在谵妄阶段的想法和体验。