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对哥伦比亚精神科医生和精神科住院医师关于他们在谵妄方面的预防和治疗实践的调查。

Survey of psychiatrists and psychiatry residents in Colombia about their preventive and therapeutic practices in delirium.

作者信息

Franco José G, Oviedo Lugo Gabriel Fernando, Patarroyo Rodriguez Liliana, Bernal Miranda Jaime, Molano Juan Carlos, Rojas Moreno Monica, Cardeño Carlos, Velasquez Tirado Juan David

机构信息

Escuela de Ciencias de la Salud, Facultad de Medicina, Grupo de Investigación en Psiquiatría de Enlace (GIPE), Universidad Pontificia Bolivariana, Medellín, Colombia.

Hospital Universitario San Ignacio, Centro de Memoria y Cognición Intellectus, Bogotá, Colombia; Facultad de Medicina, Departamento de Psiquiatría y Salud Mental, Grupo de Investigación: Perspectivas en ciclo vital, salud mental y psiquiatría, Pontificia Universidad Javeriana, Bogotá, Colombia.

出版信息

Rev Colomb Psiquiatr (Engl Ed). 2020 May 28. doi: 10.1016/j.rcp.2020.02.003.

Abstract

OBJECTIVE

To describe pharmacological and non-pharmacological practices for delirium, carried out by psychiatry residents and psychiatrists in Colombia.

METHODS

An anonymous survey was conducted based on the consensus of experts of the Liaison Psychiatry Committee of the Asociación Colombiana de Psiquiatría [Colombian Psychiatric Association] and on the literature review. It was sent by email to the association members.

RESULTS

101 clinicians participated. Non-pharmacological preventive measures such as psychoeducation, correction of sensory problems or sleep hygiene are performed by 70% or more. Only about 1 in 10 participants are part of an institutional multi-component prevention programme. The preventive prescription of drugs was less than 20%. Regarding non-pharmacological treatment, more than 75% recommend correction of sensory difficulties, control of stimuli and reorientation. None of the participants indicated that the care at their centres is organised to enhance non-pharmacological treatment. 17.8% do not use medication in the treatment of delirium. Those who use it prefer haloperidol or quetiapine, particularly in hyperactive or mixed motor subtypes.

CONCLUSIONS

The practices of the respondents coincide with those of other experts around the world. In general, non-pharmacological actions are individual initiatives, which demonstrates the need in Colombian health institutions to commit to addressing delirium, in particular when its prevalence and consequences are indicators of quality of care.

摘要

目的

描述哥伦比亚精神科住院医师和精神科医生针对谵妄所采取的药物和非药物治疗措施。

方法

基于哥伦比亚精神科协会联络精神医学委员会专家的共识并结合文献综述开展了一项匿名调查。通过电子邮件将其发送给协会成员。

结果

101名临床医生参与了调查。70% 或更多的人采取了非药物预防措施,如心理教育、纠正感觉问题或睡眠卫生。只有约十分之一的参与者属于机构多成分预防项目。药物预防性处方不到20%。关于非药物治疗,超过75% 的人推荐纠正感觉障碍、控制刺激和重新定向。没有参与者表示其所在中心的护理工作是为加强非药物治疗而组织的。17.8% 的人在谵妄治疗中不使用药物。使用药物的人更喜欢使用氟哌啶醇或喹硫平,尤其是在多动或混合运动亚型中。

结论

受访者的做法与世界其他专家的做法一致。总体而言,非药物措施是个人行为,这表明哥伦比亚医疗机构需要致力于解决谵妄问题,特别是当其患病率和后果是护理质量指标时。

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