The delirium experience: what is the effect on patients, relatives and staff and what can be done to modify this?

Authors

  • Judith SL Partridge,

    Corresponding author
    1. Department of Ageing and Health, 9th Floor, North Wing, St Thomas' Hospital, London, UK
    • Division of Health and Social Care Research, Kings College London, London, UK
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  • Finbarr C Martin,

    1. Department of Ageing and Health, 9th Floor, North Wing, St Thomas' Hospital, London, UK
    2. Institute of Gerontology, Kings College London, London, UK
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  • Danielle Harari,

    1. Division of Health and Social Care Research, Kings College London, London, UK
    2. Department of Ageing and Health, 9th Floor, North Wing, St Thomas' Hospital, London, UK
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  • Jugdeep K Dhesi

    1. Department of Ageing and Health, 9th Floor, North Wing, St Thomas' Hospital, London, UK
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Correspondence to: J. Partridge, E-mail: judith.partridge@gstt.nhs.uk

Abstract

Background

Delirium is a common clinical syndrome with significant associated mortality, morbidity and financial cost. Less is understood about the experience of delirium for the patient, their family and staff involved in their care.

Objective

This synthesis draws on qualitative and quantitative literature examining different populations (patients, relatives and staff) in different clinical settings (intensive care units, surgery and hospice care) to provide a clinical summary of the delirium experience from the perspective of patients, relatives and staff.

Design

A literature search was conducted in Ovid, MEDLINE, Embase, PsychINFO, British Nursing Index and Archive and PubMed between 1980 and 2011 using the terms ‘delirium’ combined with ‘distress’, ‘recall’, ‘anxiety’, ‘depression’, ‘PTSD’, ‘experience’ and ‘patient education’. Articles were restricted to English language only.

Results

Evidence suggests that some patients recall delirium and that recollections are generally distressing. Distress may be greater in relatives witnessing delirium and is also reported in professional staff. This distress may result in longer-term psychological sequelae. Remedial action, such as explanatory information to patients and their families, may reduce distress and psychological morbidity.

Conclusions

A better understanding of the experience and psychological consequences of delirium will inform the development of appropriate methods of providing support and information to those at risk of delirium and their families or carers. Copyright © 2012 John Wiley & Sons, Ltd.

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