Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Mar 14;59(2):327-337.
doi: 10.1093/geront/gnx153.

Perspectives on the Delirium Experience and Its Burden: Common Themes Among Older Patients, Their Family Caregivers, and Nurses

Eva M Schmitt  1 , Jacqueline Gallagher  2 , Asha Albuquerque  1 , Patricia Tabloski  3 , Hyo Jung Lee  4 , Lauren Gleason  5 , Lauren S Weiner  6 , Edward R Marcantonio  2   7 , Richard N Jones  8 , Sharon K Inouye  1   7 , Dena Schulman-Green  9
Affiliations

Perspectives on the Delirium Experience and Its Burden: Common Themes Among Older Patients, Their Family Caregivers, and Nurses

Eva M Schmitt et al. Gerontologist. .

Abstract

Background and objectives: While there are qualitative studies examining the delirium-related experiences of patients, family caregivers, and nurses separately, little is known about common aspects of delirium burden among all three groups. We describe common delirium burdens from the perspectives of patients, family caregivers, and nurses.

Research design and methods: We conducted semistructured qualitative interviews about delirium burden with 18 patients who had recently experienced a delirium episode, with 16 family caregivers, and with 15 nurses who routinely cared for patients with delirium. We recruited participants from a large, urban teaching hospital in Boston, Massachusetts. Interviews were recorded and transcribed. We used interpretive description as the approach to data analysis.

Results: We identified three common burden themes of the delirium experience: Symptom Burden (Disorientation, Hallucinations/Delusions, Impaired Communication, Memory Problems, Personality Changes, Sleep Disturbances); Emotional Burden (Anger/Frustration, Emotional Distress, Fear, Guilt, Helplessness); and Situational Burden (Loss of Control, Lack of Attention, Lack of Knowledge, Lack of Resources, Safety Concerns, Unpredictability, Unpreparedness). These burdens arise from different sources among patients, family caregivers, and nurses, with markedly differing perspectives on the burden experience.

Discussion and implications: Our findings advance the understanding of common burdens of the delirium experience for all groups and offer structure for instrument development and distinct interventions to address the burden of delirium as an individual or group experience. Our work reinforces that no one group experiences delirium in isolation. Delirium is a shared experience that will respond best to systemwide approaches to reduce associated burden.

Keywords: Burden; Confusion; Delirium; Hospitalization; Severity.

PubMed Disclaimer

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Adelman R. D., Tmanova L. L., Delgado D., Dion S., & Lachs M. S (2014). Caregiver burden: A clinical review. JAMA, 311, 1052–1060. doi:10.1001/jama.2014.304 - PubMed
    1. Adriaenssens J., De Gucht V., Van Der Doef M., & Maes S (2011). Exploring the burden of emergency care: Predictors of stress-health outcomes in emergency nurses. Journal of Advanced Nursing, 67, 1317–1328. doi:10.1111/j.1365-2648.2010.05599.x - PubMed
    1. Bélanger L., & Ducharme F (2011). Patients’ and nurses’ experiences of delirium: A review of qualitative studies. Nursing in Critical Care, 16, 303–315. doi:10.1111/j.1478-5153.2011.00454.x - PubMed
    1. Braithwaite V. (1992). Caregiving burden making the concept scientifically useful and policy relevant. Research on Aging, 14, 3–27. doi:10.1177/0164027592141001.
    1. Breitbart W., Gibson C., & Tremblay A (2002). The delirium experience: Delirium recall and delirium-related distress in hospitalized patients with cancer, their spouses/caregivers, and their nurses. Psychosomatics, 43, 183–194. doi:10.1176/appi.psy.43.3.183 - PubMed

Publication types