The experience of delirium in palliative care settings for patients, family, clinicians and volunteers: A qualitative systematic review and thematic synthesis

Author:

Featherstone Imogen1ORCID,Hosie Annmarie23ORCID,Siddiqi Najma14,Grassau Pamela567,Bush Shirley H6789,Taylor Johanna1ORCID,Sheldon Trevor10,Johnson Miriam J11ORCID

Affiliation:

1. Department of Health Sciences, University of York, York, UK

2. School of Nursing, The University of Notre Dame Australia, Sydney, NSW, Australia

3. The Cunningham Centre for Palliative Care, St Vincent’s Health Network, Sydney, NSW, Australia

4. Hull York Medical School, University of York, York, UK

5. School of Social Work, Carleton University, Ottawa, ON, Canada

6. Department of Medicine, Division of Palliative Care, University of Ottawa, Ottawa, ON, Canada

7. Bruyere Research Institute, Ottawa, ON, Canada

8. Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada

9. Department of Palliative Care, Bruyere Continuing Care, Ottawa, ON, Canada

10. Institute of Population Health Sciences, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK

11. Wolfson Palliative Care Research Centre, Hull York Medical School, University of Hull, Hull, UK

Abstract

Background: Delirium is common in palliative care settings and is distressing for patients, their families and clinicians. To develop effective interventions, we need first to understand current delirium care in this setting. Aim: To understand patient, family, clinicians’ and volunteers’ experience of delirium and its care in palliative care contexts. Design: Qualitative systematic review and thematic synthesis (PROSPERO 2018 CRD42018102417). Data sources: The following databases were searched: CINAHL, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, Embase, MEDLINE and PsycINFO (2000–2020) for qualitative studies exploring experiences of delirium or its care in specialist palliative care services. Study selection and quality appraisal were independently conducted by two reviewers. Results: A total of 21 papers describing 16 studies were included. In quality appraisal, trustworthiness (rigour of methods used) was assessed as high ( n = 5), medium ( n = 8) or low ( n = 3). Three major themes were identified: interpretations of delirium and their influence on care; clinicians’ responses to the suffering of patients with delirium and the roles of the family in delirium care. Nursing staff and other clinicians had limited understanding of delirium as a medical condition with potentially modifiable causes. Practice focused on alleviating patient suffering through person-centred approaches, which could be challenging with delirious patients, and medication use. Treatment decisions were also influenced by the distress of family and clinicians and resource limitations. Family played vital roles in delirium care. Conclusions: Increased understanding of non-pharmacological approaches to delirium prevention and management, as well as support for clinicians and families, are important to enable patients’ multi-dimensional needs to be met.

Funder

National Institute for Health Research Doctoral Fellowship

Publisher

SAGE Publications

Subject

Anesthesiology and Pain Medicine,General Medicine

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3