Mukaetova-Ladinska Elizabeta B, Cosker Glynis, Chan Mahathir, Coppock Michael, Scully Ann, Kim Seon-Young, Kim Sung-Wan, McNally Richard J Q, Teodorczuk Andrew
Institute of Neuroscience, Psychology and Behaviour, University of Leicester, Leicester LE1 7RH, UK.
The Evington Centre, Leicestershire Partnership NHS Trust, Leicester General Hospital, Gwendolen Rd, Leicester LE5 4QG, UK.
Geriatrics (Basel). 2018 Dec 31;4(1):6. doi: 10.3390/geriatrics4010006.
Older people with delirium occupy more than one third of acute medical beds and require increased medical attention, as care at present is suboptimal. In addition, since delirium is undetected, it should form a target for teaching in wards. Moreover, as people with delirium are largely dependent on daily interactions and care by inpatients professional staff, it is important to address stigmatisation of these vulnerable patients. This is especially important as previous studies have shown that negative staff attitudes towards these patients undermine good care. This single center cross-sectional study was designed to determine the extent of institutional stigma among health professionals involved in the care of people with delirium. For this, professional staff working on medical wards and in communities were approached to fill in a questionnaire containing the adapted Delirium Stigma Scale and the EuroQol five dimensions (EQ-5D-5L) questionnaire. Additional demographic information concerning their education and professional and personal experience with delirium was also collected. The characteristics associated with stigma were determined from the sample. The findings of our study provide an insight into the high level of stigmatisation of delirium patients among professionals (mean 11.66/18 points). This was not related to professionals' own experiences of delirium, their educational and professional backgrounds, or them having received formal delirium education. However, working closely with people with delirium seems to have a positive impact on the de-stigmatisation of this population among health professionals. Our findings that attitudes are not influenced by formal delirium teaching need to be incorporated into the design of interprofessional educational interventions. Accordingly, we advocate more direct patient-oriented and care delivered teaching interventions.
患有谵妄的老年人占据了超过三分之一的急性内科病床，且需要更多医疗护理，因为目前的护理并不理想。此外，由于谵妄未被及时发现，它应成为病房教学的一个目标。而且，由于谵妄患者在很大程度上依赖住院专业人员的日常互动和护理，消除对这些脆弱患者的污名化很重要。这一点尤为重要，因为先前的研究表明，医护人员对这些患者的负面态度会破坏良好的护理。这项单中心横断面研究旨在确定参与谵妄患者护理的医护人员中机构污名化的程度。为此，研究人员联系了在内科病房和社区工作的专业人员，让他们填写一份包含改编后的谵妄污名量表和欧洲五维健康量表（EQ-5D-5L）问卷的调查问卷。还收集了有关他们的教育背景以及与谵妄相关的专业和个人经历的其他人口统计学信息。从样本中确定与污名化相关的特征。我们的研究结果揭示了专业人员中对谵妄患者的高度污名化现象（平均11.66/18分）。这与专业人员自身的谵妄经历、他们的教育和专业背景，或他们是否接受过正式的谵妄教育无关。然而，与谵妄患者密切合作似乎对医护人员消除对这一群体的污名化有积极影响。我们的研究结果表明态度不受正式谵妄教学的影响，这一结果需要纳入跨专业教育干预的设计中。因此，我们提倡更多直接以患者为导向和提供护理的教学干预措施。
