Fernandes Filipa, Santos Mariana, Anacleto Ana Margarida, Jerónimo Cátia, Ferreira Óscar, Baixinho Cristina Lavareda
Hospital de Vila Franca de Xira, 2600-009 Vila Franca de Xira, Portugal.
Hospital de Santa Maria, 1649-035 Lisboa, Portugal.
Healthcare (Basel). 2024 Jun 1;12(11):1134. doi: 10.3390/healthcare12111134.
Delirium is an acute neuropsychiatric syndrome of multifactorial etiology with a high incidence in people admitted to intensive care units. In addition to reversible impairment of cognitive processes, it may be associated with changes in thinking and perception. If, in the past, it was considered an expected complication of severe disease, nowadays, delirium is associated with a poor short-term and long-term prognosis. Knowing that its prevention and early identification can reduce morbidity, mortality, and health costs, it is vital to investigate nursing interventions focused on delirium in critically ill patients. This study aimed to identify nursing interventions in the prevention and management of delirium in critically ill adults. The method used to answer the research question was a scoping review. The literature search was performed in the Medline (via PubMed), CINAHL (via EBSCOhost), Scopus, Web of Science, and JBI databases. The final sample included 15 articles. Several categories of non-pharmacological interventions were identified, addressing the modifiable risk factors that contribute to the development of delirium, and for which nurses have a privileged position in their minimization. No drug agent can, by itself, prevent or treat delirium. However, psychoactive drugs are justified to control hyperactive behaviors through cautious use. Early diagnosis, prevention, or treatment can reduce symptoms and improve the individual's quality of life. Therefore, nursing professionals must ensure harmonious coordination between non-pharmacological and pharmacological strategies.
谵妄是一种病因多因素的急性神经精神综合征,在入住重症监护病房的患者中发病率很高。除了认知过程的可逆性损害外,它还可能与思维和感知的变化有关。如果说过去谵妄被认为是严重疾病的一种预期并发症,那么如今,谵妄与短期和长期预后不良相关。鉴于其预防和早期识别可降低发病率、死亡率和医疗成本,研究针对重症患者谵妄的护理干预措施至关重要。本研究旨在确定重症成年患者谵妄预防和管理中的护理干预措施。用于回答研究问题的方法是范围综述。文献检索在Medline(通过PubMed)、CINAHL(通过EBSCOhost)、Scopus、Web of Science和JBI数据库中进行。最终样本包括15篇文章。确定了几类非药物干预措施,针对导致谵妄发生的可改变风险因素,而护士在将这些因素降至最低方面具有得天独厚的地位。没有任何一种药物本身能够预防或治疗谵妄。然而,通过谨慎使用精神活性药物来控制多动行为是合理的。早期诊断、预防或治疗可减轻症状并改善个体的生活质量。因此,护理专业人员必须确保非药物和药物策略之间的和谐协调。