Moura Maria Leonor, Martins Sónia, Correia Raquel, Pinho Elika, Paulo Cristiana, Silva Maria João, Teixeira Ana, Fontes Liliana, Lopes Luís, Paiva José Artur, Azevedo Luís Filipe, Fernandes Lia
Faculdade de Medicina, Universidade do Porto, Porto, Portugal.
Centro de Investigação em Tecnologias e Serviços de Saúde, Rede de Investigação em Saúde (CINTESIS@RISE), Departamento de Neurociências Clínicas e Saúde Mental, Faculdade de Medicina, Universidade do Porto, Porto, Portugal.
Porto Biomed J. 2022 Dec 1;7(6):e196. doi: 10.1097/j.pbj.0000000000000196. eCollection 2022 Nov-Dec.
Delirium is a very common neuropsychiatric disorder in the elderly, with a significant physical and psychological burden. Much is still unknown about its psychological effects. This study aims to identify the proportion of patients who recall delirium and to analyze the distress caused by it. In addition, this study aims to analyze the association between delirium recall and related distress and global psychological distress regarding hospitalization. This is a prospective study with elderly hospitalized patients in level-2 units of intensive care medicine department of a university hospital. Exclusion criteria were a Glasgow Coma Scale total ≤11, brain injury, blindness, deafness, or inability to communicate. Delirium was daily assessed with the Confusion Assessment Method. Delirium recall and related distress in patients were measured using the Delirium Experience Questionnaire. Global psychological distress was assessed with the Kessler Psychological Distress Scale. From 105 patients, 38 (36.2%) developed delirium. Most patients did not remember the delirium episode (64.7%). Among those who remembered (35.3%), most described delirium as a distressing experience (75%). Delirium recall was associated with high global psychological distress ( = .029) Distress related to delirium is high, namely in patients who recall the episode. Global psychological distress during hospitalization is associated with delirium recall. This study highlights the need to assess the experience of delirium in these patients, as well as the importance of providing support and psychological interventions to minimize the associated distress.
谵妄是老年人中一种非常常见的神经精神障碍,会带来重大的身心负担。关于其心理影响,仍有许多未知之处。本研究旨在确定能回忆起谵妄的患者比例,并分析谵妄所造成的痛苦。此外,本研究旨在分析谵妄回忆与相关痛苦以及住院期间整体心理痛苦之间的关联。这是一项针对某大学医院重症医学科二级病房老年住院患者的前瞻性研究。排除标准为格拉斯哥昏迷量表总分≤11、脑损伤、失明、失聪或无法交流。每天使用意识模糊评估法对谵妄进行评估。使用谵妄体验问卷测量患者的谵妄回忆及相关痛苦。使用凯斯勒心理痛苦量表评估整体心理痛苦。在105名患者中,38名(36.2%)出现了谵妄。大多数患者不记得谵妄发作(64.7%)。在那些记得的患者中(35.3%),大多数将谵妄描述为一种痛苦的经历(75%)。谵妄回忆与较高的整体心理痛苦相关( = 0.029)。与谵妄相关的痛苦程度较高,即在能回忆起发作的患者中。住院期间的整体心理痛苦与谵妄回忆相关。本研究强调了评估这些患者谵妄经历的必要性,以及提供支持和心理干预以尽量减少相关痛苦的重要性。