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“谵妄:本科培训的重要组成部分?”

"Delirium: An essential component in undergraduate training?".

机构信息

Ageing & Health, NHS Forth Valley, United Kingdom of Great Britain and Northern Ireland; Care, Erskine, United Kingdom of Great Britain and Northern Ireland.

出版信息

Nurse Educ Today. 2020 Feb;85:104211. doi: 10.1016/j.nedt.2019.104211. Epub 2019 Oct 19.

Abstract

Delirium is an acute medical emergency, the presenting features are significant disturbances in the person's cognition, both their attention and awareness. Delirium develops over a short period of time and predominantly relates to an underlying medical condition. It is significantly under-recognised in the older adults who present to acute medical services and in those living within a care home setting. Up to 30% of older adults who present via the Emergency Department may be experiencing signs and symptoms of delirium, with up to 33% of older adults within the care home setting also experiencing delirium. In both settings the delirium may go unrecognised and be incorrectly considered as a deterioration of an existing dementia. Nurses and care staff in the care home setting, spend more time with older adults than any member of the multi-disciplinary team e.g. GP, physiotherapist, district nurse etc. and as such, their knowledge and skills in the recognition and early intervention when delirium is present can have a significant impact on the outcome for the older adult. Using a Freedom of Information request (Freedom of Information (Scotland) Act, 2002), a legal process designed to elicit transparency and guarantee a response, the authors invited responses from Scottish universities, to enable a review of the current approach in the teaching of delirium to undergraduate nursing students. At the outset, the authors were interested to establish the extent to which delirium featured in the nursing undergraduate programme in Scotland. Having established that the approach to teaching was highly variable, this paper poses the question whether more structured focus should be given to the topic within the undergraduate nursing curriculum.

摘要

谵妄是一种急性医学急症,其表现特征为患者的认知功能显著紊乱,包括注意力和意识。谵妄在短时间内发展,主要与潜在的医学状况有关。它在急性医疗服务中就诊的老年患者以及在养老院环境中生活的患者中严重未被识别。高达 30%的通过急诊就诊的老年患者可能出现谵妄的迹象和症状,高达 33%的养老院环境中的老年患者也可能出现谵妄。在这两种情况下,谵妄可能未被识别,并被错误地认为是现有痴呆症的恶化。养老院环境中的护士和护理人员比多学科团队的任何成员(例如全科医生、物理治疗师、地区护士等)与老年患者相处的时间都更长,因此,他们在识别和早期干预谵妄时的知识和技能可以对老年患者的结局产生重大影响。作者通过信息自由请求(苏格兰信息自由(2002 年)法案,一种旨在提高透明度和保证回应的法律程序),邀请苏格兰各大学做出回应,以便对本科护理学生中教授谵妄的当前方法进行审查。起初,作者有兴趣了解在苏格兰,谵妄在护理本科课程中的程度。在确定教学方法差异很大之后,本文提出了一个问题,即在本科护理课程中,是否应该更结构化地关注这个主题。

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