Carin-Levy Gail, Nicol Kath, van Wijck Frederike, Mead Gillian, McVittie Chris
Queen Margaret University Edinburgh, Musselburgh, United Kingdom.
Glasgow Caledonian University, Glasgow, United Kingdom.
Qual Health Res. 2021 Jan;31(1):137-147. doi: 10.1177/1049732320959295. Epub 2020 Sep 24.
Delirium is associated with increased mortality, morbidity, and length of hospital stay. In the acute stroke setting, delirium identification is challenging due to the complexity of cognitive screening in this patient group. The aim of this study was to explore how members of interprofessional stroke-unit teams identified and responded to a potential delirium in a patient. Online focus groups and interviews utilizing case vignettes were conducted with 15 participants: nurses, occupational therapists, speech and language therapists, and physiotherapists working in acute stroke services. Participants' understandings of delirium varied, most participants did not identify the symptoms of a possible hypoactive delirium, and nearly all participants discussed delirium symptoms in tentative terms. Aspects of interprofessional working were discussed through the expression of distinct roles around delirium identification. Although participants demonstrated an ethos of person-focused care, there are ongoing challenges involved in early identification and management of delirium in stroke survivors.
谵妄与死亡率、发病率的增加以及住院时间的延长有关。在急性中风的情况下，由于该患者群体认知筛查的复杂性，谵妄的识别具有挑战性。本研究的目的是探讨跨专业中风单元团队的成员如何识别并应对患者潜在的谵妄。对15名参与者进行了在线焦点小组讨论和利用病例 vignettes 的访谈，这些参与者包括在急性中风服务部门工作的护士、职业治疗师、言语和语言治疗师以及物理治疗师。参与者对谵妄的理解各不相同，大多数参与者没有识别出可能的安静型谵妄的症状，几乎所有参与者都以试探性的方式讨论了谵妄症状。通过围绕谵妄识别表达不同的角色，讨论了跨专业工作的各个方面。尽管参与者表现出以人为本的护理理念，但中风幸存者谵妄的早期识别和管理仍存在持续挑战。
