TY - JOUR
T1 - Delirium superimposed on dementia
T2 - A quantitative and qualitative evaluation of patient experience
AU - Morandi, Alessandro
AU - Lucchi, Elena
AU - Turco, Renato
AU - Morghen, Sara
AU - Guerini, Fabio
AU - Santi, Rossana
AU - Gentile, Simona
AU - Meagher, David
AU - Voyer, Philippe
AU - Fick, Donna
AU - Schmitt, Eva M.
AU - Inouye, Sharon K.
AU - Trabucchi, Marco
AU - Bellelli, Giuseppe
N1 - Publisher Copyright:
© 2015 Elsevier Inc..
PY - 2015/10/1
Y1 - 2015/10/1
N2 - Objective: Delirium superimposed on dementia is common and is associated with adverse outcomes. Yet little is known about the patients' personal delirium experiences. We used quantitative and qualitative methods to assess the delirium superimposed on dementia experience among older patients. Methods: We conducted a prospective cohort study among patients with delirium superimposed on dementia who were admitted to a rehabilitation ward. Delirium was diagnosed using DSM-IV-TR criteria. Delirium severity and symptoms were evaluated with the Delirium-O-Meter (D-O-M). The experience of delirium was assessed after delirium resolution (T0) and one month later (T1) with a standardized questionnaire and a qualitative interview. Level of distress was measured with the Delirium Experience Questionnaire. Results: Of the 30 patients included in the study, 50% had mild dementia; 33% and 17% had moderate and severe dementia. Half of the patients had evidence of the full range of D-O-M delirium symptoms. We evaluated 30 patients at T0 and 20 at T1. At T0, half of the patients remembered being confused as part of the delirium episode, and reported an overall moderate level of related distress. Patients reported high distress related to memories of anxiety/fear, delusions, restlessness, hypokinesia, and impaired orientation. Qualitative interviews revealed six main aspects of patient delirium experiences: Emotions; Cognitive Impairment; Psychosis; Memories; Awareness of Change; and Physical Symptoms. Conclusions: The study provides novel information on the delirium experience in patients with dementia. These findings are the key for health care providers to improve the everyday care of this important group of frail older patients.
AB - Objective: Delirium superimposed on dementia is common and is associated with adverse outcomes. Yet little is known about the patients' personal delirium experiences. We used quantitative and qualitative methods to assess the delirium superimposed on dementia experience among older patients. Methods: We conducted a prospective cohort study among patients with delirium superimposed on dementia who were admitted to a rehabilitation ward. Delirium was diagnosed using DSM-IV-TR criteria. Delirium severity and symptoms were evaluated with the Delirium-O-Meter (D-O-M). The experience of delirium was assessed after delirium resolution (T0) and one month later (T1) with a standardized questionnaire and a qualitative interview. Level of distress was measured with the Delirium Experience Questionnaire. Results: Of the 30 patients included in the study, 50% had mild dementia; 33% and 17% had moderate and severe dementia. Half of the patients had evidence of the full range of D-O-M delirium symptoms. We evaluated 30 patients at T0 and 20 at T1. At T0, half of the patients remembered being confused as part of the delirium episode, and reported an overall moderate level of related distress. Patients reported high distress related to memories of anxiety/fear, delusions, restlessness, hypokinesia, and impaired orientation. Qualitative interviews revealed six main aspects of patient delirium experiences: Emotions; Cognitive Impairment; Psychosis; Memories; Awareness of Change; and Physical Symptoms. Conclusions: The study provides novel information on the delirium experience in patients with dementia. These findings are the key for health care providers to improve the everyday care of this important group of frail older patients.
KW - Delirium experience
KW - Delirium stress
KW - Delirium superimposed on dementia
UR - http://www.scopus.com/inward/record.url?scp=84941601256&partnerID=8YFLogxK
U2 - 10.1016/j.jpsychores.2015.07.010
DO - 10.1016/j.jpsychores.2015.07.010
M3 - Article
C2 - 26282373
AN - SCOPUS:84941601256
SN - 0022-3999
VL - 79
SP - 281
EP - 287
JO - Journal of Psychosomatic Research
JF - Journal of Psychosomatic Research
IS - 4
M1 - 9052
ER -