Chow Susan Ka Yee, Chan Soi Chu
Discipline of Nursing & Healthcare, Hong Kong Nang Yan College of Higher Education, Hong Kong SAR, China.
Faculty of Medicine, Macau University of Science and Technology, Macao SAR, China.
Int J Environ Res Public Health. 2024 Nov 27;21(12):1582. doi: 10.3390/ijerph21121582.
Delirium can occur at any age, although the incidence is higher in older patients and after surgery. Although delirium is an acute, potentially reversible, cognitive disorder, there is evidence that it is associated with increased healthcare costs and imposes a significant burden on patients, families, hospitals, and public resources. The aim of this study was to investigate and assess the knowledge, behaviours, and factors influencing assessments of delirium by hospital nurses so as to predict the factors associated with their current delirium management behaviours. A cross-sectional survey was conducted among 342 nurses in different hospitals in Macau. The questionnaires included items on the respondents' demographic information, knowledge of delirium care, nursing behaviours, and factors influencing nurses' assessment of delirium patients in their daily practice. The descriptive statistics showed that nurses were found to have a moderate level of knowledge about the management of delirium. The repeated measures ANOVA revealed that patient factors were the most significant, outweighing individual and organizational factors as barriers to assessing patients with delirium. The Pearson's correlation showed a moderate positive correlation between delirium care knowledge and delirium care behaviour (r = 0.339). With regard to factors influencing delirium care behaviours, multiple linear regression models showed that the significant predictors were years of work experience (β = 0.206, 95% CI: 1.125-3.158), the duration of delirium care courses (β = 0.103, 95% CI: 0.118-3.339), the knowledge of delirium care (β = 0.264, 95% CI: 0.474-1.019), and personal factors influencing nurses' delirium assessments (β = -0.239, 95% CI: -1.031--0.432). To enhance delirium management and achieve the optimal care of patients with delirium, formal education and training are crucial. Organizations should develop structured protocols and workflows that empower nurses. By integrating organizational strategies with individual efforts, clinical practices can be improved, resulting in optimal delirium care for patients.
谵妄可发生于任何年龄，尽管在老年患者及术后发病率更高。虽然谵妄是一种急性、潜在可逆的认知障碍，但有证据表明，它与医疗费用增加相关，并给患者、家庭、医院及公共资源带来沉重负担。本研究旨在调查和评估医院护士关于谵妄的知识、行为以及影响谵妄评估的因素，以便预测与其当前谵妄管理行为相关的因素。对澳门不同医院的342名护士进行了横断面调查。问卷包括受访者的人口统计学信息、谵妄护理知识、护理行为以及在日常工作中影响护士对谵妄患者评估的因素等项目。描述性统计显示，护士对谵妄管理的知识水平中等。重复测量方差分析表明，患者因素最为显著，超过个体和组织因素，成为评估谵妄患者的障碍。Pearson相关性分析显示，谵妄护理知识与谵妄护理行为之间存在中等程度的正相关（r = 0.339）。关于影响谵妄护理行为的因素，多元线性回归模型显示，显著预测因素为工作年限（β = 0.206，95%CI：1.125 - 3.158）、谵妄护理课程时长（β = 0.103，95%CI：0.118 - 3.339）、谵妄护理知识（β = 0.264，95%CI：0.474 - 1.019）以及影响护士谵妄评估的个人因素（β = -0.239，95%CI：-1.031 - -0.432）。为加强谵妄管理并实现对谵妄患者的最佳护理，正规教育和培训至关重要。各机构应制定结构化的方案和工作流程，赋予护士权力。通过将组织策略与个人努力相结合，可改善临床实践，从而为患者提供最佳的谵妄护理。
