Penn State College of Nursing, State College, PA, USA.
Int J Older People Nurs. 2020 Dec;15(4):e12321. doi: 10.1111/opn.12321. Epub 2020 May 6.
To enhance understanding of how family caregivers perceive the experience of caring for an older adult with delirium across care settings and to identify the challenges in recognising and managing delirium to inform future research and best practices.
A systematic literature review was conducted in five databases per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria. Primary or secondary peer-reviewed articles published between 1987 and October 2018 describing the experiences of family caregivers caring for older adults with delirium or delirium superimposed on dementia were included in the review. Mixed Method Appraisal Tool (MMAT) was used to evaluate the methodological quality. A thematic synthesis of results was conducted to extract relevant data as per the aims of the study.
Eighteen articles met the eligibility criteria, which were reviewed and analysed in regard to purpose, sample, research design, variables and results. Seven themes emerged in the process. The current challenges and gaps in our knowledge of this phenomenon have also been highlighted, which should be helpful to inform best practices, and finally, an agenda for future research is proposed.
Family caregivers are an important partner in the detection and management of delirium. The impact of caring for an older adult with delirium on the family caregivers should not be overlooked. This paper highlights the dearth of research on family caregiver's experience of caring for older adults with delirium and even less in the context of delirium superimposed on dementia. More research is required to further understand the family caregiver's experience and their challenges in order to support them in their caregiving role and to determine their needs and preferences of being involved in the plan of care.
These findings suggest that family caregivers are a valuable resource in the recognition and management of delirium and should be included as care partners in the health care team, while also catering to their health and well-being in the process.
增进对家庭照顾者在不同照护环境下照顾患有谵妄的老年患者的体验的理解,并确定识别和管理谵妄的挑战,以为未来的研究和最佳实践提供信息。
根据系统评价和荟萃分析的首选报告项目标准,在五个数据库中进行了系统文献综述。纳入了描述家庭照顾者照顾患有谵妄或谵妄叠加痴呆的老年患者的经验的主要或次要同行评议的文章,这些文章发表于 1987 年至 2018 年 10 月之间。混合方法评估工具(MMAT)用于评估方法学质量。根据研究目的,对结果进行了主题综合分析,以提取相关数据。
符合资格标准的 18 篇文章进行了审查和分析,内容涉及目的、样本、研究设计、变量和结果。在这个过程中出现了七个主题。还强调了我们对这种现象的认识的当前挑战和差距,这应该有助于为最佳实践提供信息,并最终提出未来研究的议程。
家庭照顾者是发现和管理谵妄的重要伙伴。照顾患有谵妄的老年患者对家庭照顾者的影响不应被忽视。本文强调了关于家庭照顾者照顾患有谵妄的老年患者的经验的研究不足,甚至在谵妄叠加痴呆的情况下更少。需要更多的研究来进一步了解家庭照顾者的经验及其在照顾角色中的挑战,以便为他们提供支持,并确定他们参与护理计划的需求和偏好。
这些发现表明,家庭照顾者是识别和管理谵妄的有价值的资源,应将他们作为医疗保健团队中的照顾伙伴纳入其中,同时在这个过程中也要照顾到他们的健康和福祉。