Schwarber Andrea, Hasemann Wolfgang, Stillhard Urs, Schoop Barbara, Senn Beate
1 Entwicklung und Qualitätsmanagement Pflege, Kantonsspital St. Gallen.
2 Institut für Angewandte Pflegewissenschaften, Fachhochschule St. Gallen.
Pflege. 2017 Jul;30(4):199-208. doi: 10.1024/1012-5302/a000564.
Background: Deliria have a massive effect on patients, from increased duration of hospitalization to higher mortality. Risk factors such as age, deprivation of substances, immobility as well as stress are known among others. Particularly in vulnerable persons minor factors can lead to a delirium. European studies report a prevalence rate between 17 % and 22 %, but can’t be compared to the Swiss hospital system. No national delirium prevalence data in acute hospitals is known. Aim: On the one hand to measure the delirium prevalence in an acute hospital, to elaborate patient characteristics of delirium patients based on group comparison and to test sensitivity and specifity of the applied instruments, on the other hand to get information about the practicality of the study execution. Method: Delirium point prevalence measurement has been conducted in a prospective cross-sectional study. On one determined day data of patients have been collected by nurses in an acute hospital. Results: A prevalence point rate of 14 % (6 / 43) based on CAM has been identified. Significant differences were found between the groups in respect of age, discipline, number of ICD diagnoses, care dependency and in all the three delirium instruments. Delirium patients were not only longer hospitalized but had almost twice as many ICD diagnosed, were high-maintenance patients and mostly didn’t claim to be in pain. Conclusion: This is the first prevalence study in a Swiss acute hospital. The utilized instruments are reliable and the study execution is practicable and could be conducted with a larger sample. Most known risk factors were confirmed.
谵妄对患者有巨大影响，从住院时间延长到死亡率升高。已知的风险因素包括年龄、物质剥夺、活动不便以及压力等。特别是在易受影响的人群中，一些微小因素也可能导致谵妄。欧洲的研究报告患病率在17%至22%之间，但无法与瑞士医院系统进行比较。目前尚无急性医院全国性谵妄患病率数据。目的：一方面测量急性医院中的谵妄患病率，通过组间比较阐述谵妄患者的特征，并测试所应用工具的敏感性和特异性，另一方面获取有关研究实施可行性的信息。方法：在一项前瞻性横断面研究中进行谵妄现患率测量。在一家急性医院，护士在确定的一天收集患者数据。结果：基于CAM确定的现患率为14%（6/43）。在年龄、科室、国际疾病分类诊断数量、护理依赖程度以及所有三种谵妄评估工具方面，各组之间存在显著差异。谵妄患者不仅住院时间更长，国际疾病分类诊断数量几乎是其他患者的两倍，护理需求高，且大多声称无痛。结论：这是瑞士急性医院的首次患病率研究。所使用的工具可靠，研究实施可行，且可采用更大样本进行。大多数已知风险因素得到了证实。
