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家庭和医护人员对谵妄的认知。

Family and healthcare staff's perception of delirium.

机构信息

Research Unit of Medicine of Ageing, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.

Division of Geriatric and Intensive Care Medicine, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy.

出版信息

Eur Geriatr Med. 2020 Feb;11(1):95-103. doi: 10.1007/s41999-019-00284-z. Epub 2020 Jan 1.

Abstract

PURPOSE

To review the available literature regarding delirium experiences of family caregivers and healthcare staff, to discuss how caregivers and staff perception can increase delirium detection and to summarize how to address the needs of family caregivers and healthcare providers in delirium care.

METHODS

"State of the science" paper.

RESULTS

High levels of caregiver stress are associated with delirium, although sources and features of burden differ according to background health status of patients, i.e. older subjects, with or without dementia, or terminal neoplastic disease. Family observation of cognitive changes is key for delirium detection, especially when dementia coexists, and is included in available delirium detection instruments. Healthcare staff experiences a high level of burden associated with delirium care, but often does not recognize delirium according to literature. An interprofessional healthcare staff education can improve attitudes towards delirium and increase delirium awareness, although intervention studies are still limited. Flexible visiting time is important to reduce family burden, although it needs appropriate staff training and work organization to avoid the risk of increased nurse burn-out.

CONCLUSION

Delirium is a stressful event not only for patients but also for family caregivers and healthcare staff, especially nurses. Recording the observations of family members and healthcare staff can help in delirium detection. Staff education is crucial to reduce the burden of professional and family caregivers.

摘要

目的

回顾有关家庭护理者和医护人员谵妄体验的现有文献,讨论护理者和医护人员的感知如何提高谵妄检测率,并总结如何满足谵妄护理中家庭护理者和医护人员的需求。

方法

“科学现状”论文。

结果

caregiver 压力与谵妄高度相关,尽管压力源和特征因患者的背景健康状况而异,例如年龄较大的患者、伴有或不伴有痴呆症、或终末期肿瘤疾病的患者。家庭对认知变化的观察是谵妄检测的关键,尤其是当痴呆症并存时,并且包含在现有的谵妄检测工具中。医护人员在照顾谵妄患者时会感到很大的负担,但根据文献,他们往往无法识别出谵妄。医护人员的跨专业教育可以改善对谵妄的态度,提高对谵妄的认识,尽管干预研究仍然有限。灵活的探视时间对于减轻家庭负担很重要,尽管这需要适当的员工培训和工作组织,以避免增加护士倦怠的风险。

结论

谵妄不仅对患者,而且对家庭护理者和医护人员(尤其是护士)来说都是一种压力事件。记录家庭成员和医护人员的观察结果有助于谵妄的检测。员工教育对于减轻专业护理者和家庭护理者的负担至关重要。

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