Brooke Joanne
Reader of Complex Older Persons Care, Oxford Institute of Nursing, Midwifery and Allied Health Research, Oxford Brookes University, Oxford.
Br J Nurs. 2018 Apr 12;27(7):363-367. doi: 10.12968/bjon.2018.27.7.363.
Delirium is an acute clinical emergency that requires prompt clinical intervention. A predisposing factor for delirium is dementia, and delirium may highlight the vulnerability of a patient to developing dementia. However, delirium also occurs during an acute illness in patients diagnosed with dementia; this is classified as delirium superimposed on dementia. This complex interplay of both dementia syndromes and the condition of delirium has been extensively studied. However, delirium continues to be under-recognised in the acute setting, which impacts negatively on patient outcomes. Nurses are the health professionals best placed to recognise a change in a patient's cognitive symptoms, but nurses caring for the older person have suggested the identification of and differentiation between delirium, dementia and delirium superimposed on dementia remains very confusing. A need for further education with supportive guidelines and protocols is required to empower nurses caring for an older person to verbalise changes in patients' cognitive status in a reliable, robust and systematic manner.
谵妄是一种急性临床急症，需要及时进行临床干预。谵妄的一个诱发因素是痴呆症，谵妄可能凸显患者患痴呆症的易感性。然而，谵妄也会在被诊断患有痴呆症的患者急性疾病期间出现；这被归类为叠加在痴呆症上的谵妄。痴呆综合征和谵妄状况之间这种复杂的相互作用已得到广泛研究。然而，谵妄在急性环境中仍未得到充分认识，这对患者的预后产生了负面影响。护士是最有能力识别患者认知症状变化的健康专业人员，但照顾老年人的护士表示，识别谵妄、痴呆症以及叠加在痴呆症上的谵妄并加以区分仍然非常困难。需要通过支持性指南和规程进行进一步教育，以使照顾老年人的护士能够以可靠、有力和系统的方式表达患者认知状态的变化。
