The Ohio State University College of Nursing, Columbus, Ohio.
J Clin Nurs. 2019 Jun;28(11-12):2351-2360. doi: 10.1111/jocn.14776. Epub 2019 Feb 4.
To create a framework for future research through application and critique of the Life Course Health Development Model to the phenomenon of paediatric delirium.
Delirium in the paediatric intensive care unit is associated with increased duration of mechanical ventilation, length of stay and mortality. Nurses are uniquely positioned at the bedside to identify, prevent and treat delirium. An understanding of the potential long-term consequences of paediatric delirium is necessary to provide impetus for nursing research and practice change. The Life Course Health Development Model is a valuable tool when considering the multiple mechanisms and processes through which the experience of delirium could affect a child's life trajectory.
Critical review of the literature through application and critique of the Life Course Health Development Model in the context of paediatric delirium. Gaps in the current understanding of paediatric delirium, as well as future directions for research and practice, are discussed.
The seven core principles of the model are considered in the context of paediatric delirium. Each of the principles has the potential to further understanding of paediatric delirium and identify areas for future inquiry. This discussion leads to a critique of the ability of the model to lead future research and practice change.
The Life Course Health Development Model depicts a process in which the acute and severe stress of critical illness leads to maladaptive neurologic changes that contribute to the development of delirium and impair a child's life trajectory.
By emphasising the potential lifelong consequences for critically ill children who experience delirium, this application of the Life Course Health Development Model will stimulate discussion, research and practice change among paediatric clinicians and researchers.
通过将生命历程健康发展模型应用于儿科谵妄现象并进行批判，为未来的研究创建一个框架。
儿科重症监护病房的谵妄与机械通气时间延长、住院时间延长和死亡率增加有关。护士在床边处于独特的位置，可以识别、预防和治疗谵妄。为了推动护理研究和实践的变革，有必要了解儿科谵妄的潜在长期后果。在考虑谵妄体验可能影响儿童生活轨迹的多种机制和过程时，生命历程健康发展模型是一种有价值的工具。
通过在儿科谵妄背景下应用和批判生命历程健康发展模型，对文献进行批判性回顾。讨论了当前对儿科谵妄理解的差距以及未来的研究和实践方向。
在儿科谵妄的背景下考虑模型的七个核心原则。每个原则都有可能进一步了解儿科谵妄，并确定未来研究的领域。这一讨论导致了对模型引领未来研究和实践变革的能力的批判。
生命历程健康发展模型描绘了一个过程，即严重疾病的急性和严重压力导致适应性神经变化，导致谵妄的发展，并损害儿童的生活轨迹。
通过强调经历谵妄的重病儿童可能产生的终身后果，该生命历程健康发展模型的应用将刺激儿科临床医生和研究人员之间的讨论、研究和实践变革。
