Boyle D M, Abernathy G, Baker L, Wall A C
Inova Fairfax Cancer Center Gill Abernathy, USA.
Oncol Nurs Forum. 1998 Sep;25(8):1335-43.
PURPOSE/OBJECTIVES: To review the literature on confusion at the end of life, provide accurate definitional and defining characteristics of confusion, and outline nursing strategies for its resolution.
Published articles, computerized databases, book chapters, reference lists from chapters and journal articles.
As a major component of symptom distress in terminal care, confusion has not been defined clearly and therefore has not benefited from rigorous assessment and study as have other end-of-life symptoms.
Increased knowledge about confusion that occurs in patients with widely metastatic cancer will assist in accurate symptom identification, early recognition, and timely management to reduce cognitive symptom distress at the end of life. Improved symptom resolution also can benefit family coping during terminal care.
Oncology nurses can devise management protocols for confused patients that include screening criteria, pharmacologic interventions, environmental support, and prophylactic safety measures.
目的/目标：回顾关于临终时意识混乱的文献，提供意识混乱准确的定义和界定特征，并概述解决意识混乱的护理策略。
已发表的文章、计算机数据库、书籍章节、章节和期刊文章的参考文献列表。
作为临终护理中症状困扰的一个主要组成部分，意识混乱尚未得到明确界定，因此未像其他临终症状那样受益于严格的评估和研究。
增加对广泛转移性癌症患者出现的意识混乱的了解，将有助于准确识别症状、早期发现并及时处理，以减轻临终时的认知症状困扰。症状的更好解决也有利于临终护理期间患者家属的应对。
肿瘤护士可为意识混乱患者制定管理方案，包括筛查标准、药物干预、环境支持和预防性安全措施。
