Department of Emergency Medicine, Beaumont Health System, Royal Oak, MI; Department of Emergency Medicine, The Warren Alpert Medical School of Brown University, Providence, RI.
Oakland University William Beaumont School of Medicine, Rochester, MI.
R I Med J (2013). 2023 May 1;106(4):35-39.
Hospital-associated delirium is common in older adults, especially those with dementia, and is associated with high morbidity and mortality. We performed a feasibility study in the emergency department (ED) to examine the effect of light and/or music on the incidence of hospital- associated delirium. Patients aged ≥ 65 who presented to the ED and tested positive for cognitive impairment were enrolled in the study (n = 133). Patients were randomized to one of four treatment arms: music, light, music and light, and usual care. They received the intervention during their ED stay. In the control group, 7/32 patients developed delirium, while in the music-only group, 2/33 patients developed delirium (RR 0.27, 95% CI 0.06-1.23), and in the light-only group (RR 0.41, 95% CI 0.12-1.46), 3/33 patients developed delirium. In the music + light group, 8/35 patients developed delirium (RR 1.04, 95% CI 0.42--2.55). Providing music therapy and bright light therapy to ED patients was shown to be feasible. Although this small pilot study did not reach statistical significance, there was a trend towards less delirium in the music-only and light-only groups. This study lays the groundwork for future investigation into the efficacy of these interventions.
医院相关性谵妄在老年人中很常见，尤其是那些患有痴呆症的患者，并且与高发病率和死亡率相关。我们在急诊科进行了一项可行性研究，以研究光线和/或音乐对医院相关性谵妄发生率的影响。年龄≥65 岁且认知障碍检测呈阳性的急诊科患者纳入研究（n=133）。患者被随机分为四组治疗组：音乐组、光照组、音乐和光照联合组以及常规护理组。他们在急诊科住院期间接受干预。在对照组中，32 名患者中有 7 名发生谵妄，而在仅音乐组中，33 名患者中有 2 名发生谵妄（RR 0.27，95%CI 0.06-1.23），在仅光照组中（RR 0.41，95%CI 0.12-1.46），33 名患者中有 3 名发生谵妄。在音乐+光照组中，35 名患者中有 8 名发生谵妄（RR 1.04，95%CI 0.42-2.55）。为急诊科患者提供音乐疗法和明亮光照疗法是可行的。尽管这项小型试点研究没有达到统计学意义，但仅音乐组和仅光照组的谵妄发生率呈下降趋势。这项研究为进一步研究这些干预措施的疗效奠定了基础。
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