대한간호학회지 (Journal of Korean Academy of Nursing)

한국간호과학회 (Korean Society of Nursing Science)
권호 표지

일 종합병원 간호사들의 섬망에 대한 인식 및 교육요구에 관한 기초조사

A Preliminary Survey of Nurses' Understanding of Delirium and Their Need for Delirium Education - In a University Hospital -

  • 발행 : 2006.12.31
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초록

Purpose: The purpose of this survey was to investigate clinical nurses' understanding of delirium and their educational need of delirious patient care. Method: A survey questionnaire regarding nurses' general perception and understanding of delirium, experience with delirious patients and educational need was developed and conducted with 179 clinical nurses in a university hospital in Seoul. Data was analyzed using descriptive statistics. Results: Nurses thought that delirium was one of the most important nursing problems and they considered it to be more treatable than to be preventable. However, the majority of nurses were ilot confident in caring for delirious patients. Nurses reported that delirium happened most often after surgery, and that possible contributing factors could be changes in physical environment and anxiety/stress, as well as medication and long-term isolation. Thirteen nursing interventions were identified but half of the nurses utilized only one or two of the thirteen. The most frequently used intervention was reorienting the patient followed by medication and emotional support, presenting family, and close observation. 99.5% of nurses addressed the importance of professional education on delirium care, especially in the area of intervention and management. Conclusion: The results support the strong need for development of a multi-component educational program on delirium care.

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참고문헌

  1. American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders. 4th ed. Washington, DC : American Psychiatric Association
  2. Arnold, E. (2005). Sorting out the 3 D's : delirium, dementia, depression : learn how to sift through overlapping signs and symptoms so you can help improve an older patient's quality of life. Holist Nurs Pract, 19(3), 99-104 https://doi.org/10.1097/00004650-200505000-00004
  3. Blacher, R. S. (1997). The psychological and psychiatric consequences of the ICU stay. Eur J Anaesthesiol Suppl, 14(15), 45-47 https://doi.org/10.1097/00003643-199705001-00009
  4. Briggs, D. (1991). Preventing ICU psychosis. Nurs Times, 87, 30-31
  5. Cameron, D., Thomas, R., Mulvihill, M., & Bronheim, H. (1987). Delirium : A test of the diagnostic and statistical manual III criteria on medical inpatients. J Am Geriatr Soc, 35, 1007-1010 https://doi.org/10.1111/j.1532-5415.1987.tb04004.x
  6. Cho, N. (1985). Study of factors influencing post cardiotomy delirium. Unpublished master's thesis. Seoul National University, Seoul
  7. D'Arcy, Y. (2006). Managing postop pain in a patient who's delirious. Nursing, 36(6), 17
  8. Ely, E., Shintani, A., Truman, B., Speroff, T., Gordon, S., Harrell, F., et al. (2004). Delirium as a predictor of mortality in mechanically ventilated patients in the intensive care unit. JAMA, 291, 1753-1762 https://doi.org/10.1001/jama.291.14.1753
  9. Francis, J., & Kapoor, W. (1990). Delirium in hospitalized elderly. J Gen Intern Med, 5, 65-69 https://doi.org/10.1007/BF02602312
  10. Francis, J. (2005). Prevention and treatment of delirium and confusional state. Retrieved Mar 30, 2006, From Up to date Web site : http://www.utol.com/utd
  11. Gandhi, G., Nuttall, G., Abel, M., Mullany, C., Schaff, H., Williams, B., et al. (2005). Intraoperative hyperglycemia and perioperative outcomes in cardiac surgery patients. Mayo Clin Proc, 80(7), 862-866 https://doi.org/10.4065/80.7.862
  12. Granberg, A., Malmros, C., Bergbom, I., & Lundberg, D. (2002). Intensive care unit syndrome/delirium is associated with anemia, drug therapy and duration of ventilation treatment. Acta Anaesthesiol Scand, 46(6), 726-731 https://doi.org/10.1034/j.1399-6576.2002.460616.x
  13. Inouye, S., Bogardus, S., Charpentier, P., Leo-Summers, L., Acampora, D., Holford, T., et al. (1999). A multicomponent intervention to prevent delirium in hospitalized older patients. N Engl J Med, 340(9), 669- 676 https://doi.org/10.1056/NEJM199903043400901
  14. Inouye, S., Foreman, M., Mion, L., Katz, K., & Cooney, L. (2001). Nurses' recognition of delirium and its symptoms : comparison of nurse and researcher ratings. Arch Int Med, 161(20), 2467-2473 https://doi.org/10.1001/archinte.161.20.2467
  15. Justice, M. (2000). Does 'ICU psychosis' really exist? Critical Care Nurse, 20(3), 28-37
  16. Lin. S., Liu, C., Wang, C., Lin, H., Huang, C., Huang, P., et al. (2004). The impact of delirium on the survival of mechanically ventilated patients. Crit Care Med, 32, 2254-2259 https://doi.org/10.1097/01.CCM.0000145587.16421.BB
  17. Lynch, E. P., Lazor, M. A., Gellis, J. E., Orav, J., Goldman, L., & Marcantonio, E. R. (1998). The impact of postoperative pain on the development of postoperative delirium. Anesth Analg, 86(4), 781-785 https://doi.org/10.1097/00000539-199804000-00019
  18. Manepalli, J., Grossberg, G., & Mueller, C. (1990). Prevalence of delirium and urinary tract infection in a psychogeriatric unit. J Geriatr Psychiatry Neurol., 3(4), 198-202 https://doi.org/10.1177/089198879000300404
  19. Marshall, M., & Soucy, M. (2003). Delirium in the intensive care unit. Crit Care Nurs Q, 26(3), 172-178 https://doi.org/10.1097/00002727-200307000-00002
  20. McCartney, J., & Boland, R. (1994). Anxiety and delirium in the intensive care unit. Crit Care Clin, 10, 673-680 https://doi.org/10.1016/S0749-0704(18)30099-X
  21. Milbrandt, E., Deppen, S., Harrison, P., Shintani, A., Speroff, T., Stiles, R., et al. (2004). Costs associated with delirium in mechanically ventilated patients. Crit Care Med, 32, 955-962 https://doi.org/10.1097/01.CCM.0000119429.16055.92
  22. Milisen, K., Lemiengre, J., & Foreman B. (2005). Multicomponent intervention strategies for managing deliriumin hospitalized older people : Systematic review. J Adv Nurs, 52(1), 79-90 https://doi.org/10.1111/j.1365-2648.2005.03557.x
  23. Pun, B. T., Gordon, S. M., Peterson, J. F., Shintani, A. K., Jackson, J. C., Foss, J., et al. (2005). Large-scale implementation of sedation and delirium monitoring in the intensive care unit : A report from two medical centers. Crit Care Med, 33(6), 1199-1205 https://doi.org/10.1097/01.CCM.0000166867.78320.AC
  24. Ritchie, J., Steiner, W., & Abrahamowicz, M. (1996). Incidence of and risk factors for delirium among psychiatric inpatients. Psychiatr Serv, 47, 727-30 https://doi.org/10.1176/ps.47.7.727
  25. Rockwood, J. (1989). Acute confusion in elderly medical patients. J Am Geriatr Soc, 37, 150-4 https://doi.org/10.1111/j.1532-5415.1989.tb05874.x
  26. Shin, Y. (1986). Exploratory study on symptoms of Postcardiotomy delirium. Unpublished master's thesis. Yonsei University, Seoul
  27. Smith, L. W., & Dimsdale, J. E. (1989). Postcardiotomy delirium : Conclusions after 25 years- Am J Psychiatry, 146, 452-8 https://doi.org/10.1176/ajp.146.4.452
  28. Walker, S., McGeer, A., Simor, A., Armstrong-Evans, M., & Loeb, M. (2000). Why are antibiotics prescribed for asymptomatic bacteriuria in institutionalized elderly people? CMAJ, 163(3), 273-277
  29. Whang, S., Kang, S., Kang, Y., Choi, S., Lee, J., Kim, M., et al. (2002). Risk factors of delirium in elderly inpatients. J Korean Acad Fam Med, 23(1), 112-121
  30. Wise, M. G. (1987). Delirium, In R. E. Hales & S. C. Yudofsky, S. C. (Eds.), American psychiatric press textbook of neuropsychiatry(pp. 89-105). Washington, D. C. : American Psychiatric Press