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谵妄:对医疗保健专业人员的知识、信念和实践的调查

Delirium: A Survey of Healthcare Professionals' Knowledge, Beliefs, and Practices.

作者信息

Sinvani Liron, Kozikowski Andrzej, Pekmezaris Renee, Akerman Meredith, Wolf-Klein Gisele

机构信息

Division of Hospital Medicine, Department of Medicine, Northwell Health, Manhasset, New York.

Department of Medicine, Northwell Health, Manhasset, New York.

出版信息

J Am Geriatr Soc. 2016 Dec;64(12):e297-e303. doi: 10.1111/jgs.14544. Epub 2016 Nov 23.

Abstract

OBJECTIVES

To evaluate knowledge, beliefs, and practices regarding delirium of physicians, nurse practitioners (NPs), and registered nurses (RNs).

DESIGN

Anonymous cross-sectional paper survey.

SETTING

New York metropolitan area tertiary care hospital.

PARTICIPANTS

RNs, NPs, and physicians (N = 164).

MEASUREMENTS

The survey assessed knowledge, beliefs, and practices regarding delirium and prior delirium or geriatric training.

RESULTS

Of the 200 surveys distributed, 164 were completed (82% response rate). Of these, 61.7% were RNs, 13.6% were NPs, and 20.7% were physicians. Mean participant age was 36.3. The majority (80.1%) were female; 56.5% were white, 18.1% Asian, 8.7% Hispanic, 8.0% black, and 8.7% other. Of the seven potential barriers to delirium screening assessed, the three most frequently reported were lack of conceptual understanding of delirium (48.0%), similarity of delirium and dementia (41.4%), and the fluctuating nature of delirium (38.1%). Physicians were more likely than NPs and RNs to report being confident in identifying delirium (P = .002) and to score higher on the delirium knowledge assessment (P < .001). Participants who received geriatrics training were significantly more likely than those who did not to be confident in identifying delirium (P = .005) and to score higher on overall delirium knowledge assessment (P = .003).

CONCLUSION

Geriatric training is associated with more confidence in delirium screening and higher delirium knowledge scores. There is an urgent need to broaden the approach to delirium education of nurses and physicians caring for hospitalized older adults using comprehensive multidisciplinary geriatric educational models.

摘要

目的

评估内科医生、执业护士(NP)和注册护士(RN)关于谵妄的知识、信念和实践。

设计

匿名横断面纸质调查。

地点

纽约大都市地区三级护理医院。

参与者

注册护士、执业护士和内科医生(N = 164)。

测量

该调查评估了关于谵妄以及既往谵妄或老年医学培训的知识、信念和实践。

结果

在分发的200份调查问卷中,164份被完成(回复率82%)。其中,61.7%是注册护士,13.6%是执业护士,20.7%是内科医生。参与者的平均年龄为36.3岁。大多数(80.1%)为女性;56.5%为白人,18.1%为亚洲人,8.7%为西班牙裔,8.0%为黑人,8.7%为其他种族。在评估的谵妄筛查的七个潜在障碍中,报告最频繁的三个是对谵妄缺乏概念理解(48.0%)、谵妄与痴呆的相似性(41.4%)以及谵妄的波动性质(38.1%)。内科医生比执业护士和注册护士更有可能报告对识别谵妄有信心(P = .002),并且在谵妄知识评估中得分更高(P < .001)。接受过老年医学培训的参与者比未接受过培训的参与者更有可能对识别谵妄有信心(P = .005),并且在总体谵妄知识评估中得分更高(P = .003)。

结论

老年医学培训与对谵妄筛查更有信心以及更高的谵妄知识得分相关。迫切需要采用综合多学科老年医学教育模式,拓宽对照顾住院老年人的护士和医生进行谵妄教育的方法。

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