Mixed-Methods Approach to Understanding Nurses' Clinical Reasoning in Recognizing Delirium in Hospitalized Older Adults

被引：23

作者：

Rice, Karen L. ^{[1
]}

Bennett, Marsha J. ^{[3
]}

Clesi, Tara ^{[2
]}

Linville, Lisa ^{[4
]}

机构：

[1] Ctr Nursing Res, New Orleans, LA USA

[2] Ochsner Hlth Syst, New Orleans, LA 70121 USA

[3] Louisiana State Univ, Hlth Sci Ctr, Sch Nursing, New Orleans, LA USA

[4] Loyola Univ, New Orleans, LA 70118 USA

来源：

JOURNAL OF CONTINUING EDUCATION IN NURSING | 2014年 / 45卷 / 03期

关键词：

MEDICAL INPATIENTS; ELDERLY-PATIENTS; RECOGNITION; CONFUSION; DEMENTIA; CARE; SYMPTOMS; PEOPLE; RISK;

D O I：

10.3928/00220124-20140219-02

中图分类号：

R47 [护理学];

学科分类号：

1011 ;

摘要：

A mixed-methods study was conducted to enhance understanding of nurses' clinical reasoning in recognizing delirium in the hospitalized older adult. Paired nurse and researcher ratings of the confusion assessment method in 103 medical-surgical patients were analyzed to determine the rate of agreement in detecting delirium and to identify a purposive sample of nurses to be interviewed about the patients with delirium who were under their care. Nurses' clinical reasoning in recognizing and underrecognizing delirium was investigated using semistructured interviews. The incidence of delirium was 13%, with poor agreement (95% CI [0.05, 0.64], p < 0.05) between the researchers and the nurses in detecting delirium. Sixteen nurses were interviewed and transcripts were analyzed with grounded theory. Confusion was the primary causal factor for recognizing symptoms of delirium. The findings explicated a framework that forms the basis for generating testable assumptions to improve nurses' recognition of delirium.

引用

页码：136 / 148

页数：13

共 40 条

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