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http://dx.doi.org/10.15207/JKCS.2021.12.10.353

Risk Factors, Symptoms, and Intervention Analysis of Delirium Subtypes in Hospitalized Patients  

Ryu, Ahyun (College of Nursing, Chungnam National University)
Kang, Young-Ok (Chungnam National University Hospital)
Song, Rhayun (College of Nursing, Chungnam National University)
Publication Information
Journal of the Korea Convergence Society / v.12, no.10, 2021 , pp. 353-363 More about this Journal
Abstract
This study aimed to investigate subtypes, risk factors, symptoms and the interventions to inpatients with delirium. The data of 108 inpatients who had the diagnosis of delirium during their hospital stay were collected from Electronic Medical Record at a university hospital and were analyzed by SPSS for Windows V. 26.0 program. As a results, Patients had a high proportion of elderly, male, orthopedic, and with fractures or amputations. The subtypes of delirium were hyperactive (51.9%), hypoactive (6.5%), and mixed (41.7%). Among the risk factors, depression and use of psychotropic agent were more common in those with hypoactive delirium. Among delirium interventions, behavioral symptom management and aggressive behavioral intervention were mainly implemented for those with hyperactive or mixed types, and emotional support was mainly implemented for those with hypoactive or mixed types. The delirium related intervention was more likely given immediately when the patients showed aggressive behaviors. Therefore, intervention strategies and protocol development are required for early detection of delirium in inpatients.
Keywords
Inpatient; Delirium; Risk factor; Symptom; Intervention;
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1 Y. K. Chun & J. Y. Park. (2017). Risk Factors of Delirium Among the Patients at a Surgical Intensive Care Unit. Journal of Korean critical care nursing, 10(3), 31-40.
2 J. Y. Kim & E. J. Lee. (2016). Factors affecting nursing performance of delirium for general hospital clinical nurses. Journal of Korean Clinical Nursing Research, 22(2), 183-193. DOI : 10.22650/JKCNR.2016.22.2.183.   DOI
3 H. K. Kim, M. J. Lee, I. S. Kwon & J. L. Kim. (2018). Validation of the Korean version of the delirium motor subtype scale. Psychiatry Investigation, 15(1), 6-12. DOI : 10.4306/pi.2018.15.1.6   DOI
4 B. Liptzin & S. E. Levkoff. (1992). An empirical study of delirium subtypes, The British Journal of Psychiatry, 161(6), 843-845. DOI : 10.1192/bjp.161.6.843   DOI
5 Y. H. Kim et al. (2010). Phenomenology of Delirium in Cancer Patients and Its Association with Sedative-Hypnotics. Korean Journal of Psychopharmacology, 21(3), 150-155.
6 S. H. Paik, S. H. Min, J. S. Ahn, K. C. Park & M. H. Kim. (2015). Symptomatic and Clinical Profiles Across Motoric Subtypes in Delirium. Korean Journal of Psychosomatic Medicine, 23(2), 79-85.
7 S. J. Choi & Y. A. Cho. (2014). Prevalence and related risk factors of delirium in intensive care units as detected by the CAM-ICU. Journal of Korean Clinical Nursing Research, 20(3), 406-416. DOI : 10.22650/JKCNR.2014.20.3.406.   DOI
8 H. M. Kim, K. M. Kim, S. Y. Jang & S. W. Lee. (2020). Factors Affecting the Onset of Hyperactive Delirium in Terminally Ill Cancer Patients in Hospice Care. Journal of the Korean Society of Biological Therapies in Psychiatry, 26(3), 251-258. DOI : 10.22802/jksbtp.2020.26.3.251   DOI
9 M. S. Kim, J. J. Yoon, H. J. Chun & Y. O. Kim. (2018). The Incidence and Related Risk Factors of Delirium in the Older Inpatients with Neurological Disorders in a Tertiary Hospital. Korean Journal of Adult Nursing, 30(3), 255-265. DOI : 10.7475/kjan.2018.30.3.255   DOI
10 K. E. Jang. (2008). ICU nurses's knowledge and nursing activities for ICU syndrome. Master's thesis. Yonsei University, Seoul.
11 American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5th ed.), Washington, DC American Psychiatric Association Publishing. DOI : 10.1176/appi.books.9780890425596.893619   DOI
12 J. H. Bae, W. S. Kang, J. W. Paik & J. W. Kim. (2012). Changing trends in the occurrence and management of delirium for 5 years in a university hospital. Korean Journal of Psychosomatic Medicine, 20(2), 112-119.
13 J. S. Kang & H. J. Song. (2019). Factors Affecting the Performance of Nursing in Delirium Care. Journal of Korean Critical Care Nursing, 12(1), 13-21. DOI : 10.34250/jkccn.2019.12.1.13   DOI
14 K. H. Kwak, B. S. Do, S. Y. Park, S & S. B. Lee. (2011). Risk factors for delirium in elderly patients visiting an emergency department. Journal of The Korean Society of Emergency Medicine, 22(5), 489-493.
15 K. D. Krewulak, H. T Stelfox, E. W. Ely & K. M. Fiest. (2020). Risk factors and outcomes among delirium subtypes in adult ICUs: a systematic review. Journal of critical care, 56, 257-264. DOI : 10.1016/j.jcrc.2020.01.017   DOI
16 D. J. Meagher, D. O'Hanlon, E. O'Mahony, P. R. Casey & P. T. Trzepacz. (2000). Relationship between symptoms and motoric subtype of delirium. The Journal of neuropsychiatry and clinical neurosciences, 12(1), 51-56. DOI : 10.1176/jnp.12.1.51   DOI
17 S. K. Inouye, M. D. Foreman, L. C. Mion, K. H. Katz & L. M. Cooney. (2001). Nurses' Recognition of Delirium and Its Symptoms Comparison of Nurse and Researcher Ratings. Archives of internal medicine, 161(20), 2467-2473. DOI : 10.1001/archinte.161.20.2467   DOI
18 S. Y. Park & J. M. Woo. (2012). Delirium of Elderly Patients in Emergency Room. Journal of the Korean Society of Biological Therapies in Psychiatry, 18(2), 104-100. DOI : 10.1016/s0924-977x(12)70601-6   DOI
19 J. Devlin et al. (2018). Clinical practice guidelines for the prevention and management of pain, agitation/sedation, delirium, immobility, and sleep disruption in adult patients in the ICU. Critical Care Medicine, 46(9), e825-e873. DOI : 10.1097/CCM.0000000000003299   DOI
20 H. J. Ko, C. H. Youn, S. E. Kim & H. M. Kim. (2014). Risk factors related to development of delirium in hospice patients. The Korean Journal of Hospice Palliative Care, 17(3), 170-178. DOI : 10.14475/kjhpc.2014.17.3.170.   DOI
21 M. H. Chung, S. O. Yun, J. H. Park, S. O. Chu, S. Y. Oh & M. Y. Kim. (2011) Predictors of Delirium in Patients after Orthopedic Surgery. Journal of Korean Clinical Nursing Research, 17(3), 443-454.
22 M. Marshall & M. Soucy. (2003). Delirium in the intensive care unit. Critical care nursing quarterly, 26(3), 172-178. DOI : 10.1097/00002727-200307000-00002   DOI
23 S. W. Lee, C. H. Cho, K. C. Bae, K. J. Lee, E. S. Son & S. H. Um. (2019). Incidence and Associated Factors of Delirium after Orthopedic Surgery. Journal of the Korean Orthopaedic Association, 54(2), 157-163. DOI : 10.4055/jkoa.2019.54.2.157   DOI
24 J. R. Kim & J. A. Ahn. (2020). Risk Factors for Delirium in Trauma Intensive Care Unit Patients. Korean Journal of Adult Nursing, 32(6), 623-631. DOI : 10.7475/kjan.2020.32.6.623   DOI
25 E. Y. Noh & Y. H. Park. (2019). Prevalence of Delirium and Risk Factors in Heart Surgery Patients in Intensive Care Unit: A Retrospective study. Korean Journal of Adult Nursing, 31(2), 146-155. DOI : 10.7475/kjan.2019.31.2.146   DOI
26 I. S. Jang & M. H. Kim. (2008). The Effect of the Environmental Nursing Intervention on ICU Delirium, Environmental Stress and Sleep in Patients Underwent Cardiac Surgical Procedures. Journal of Korean Clinical Nursing Research 14(2), 127-138.
27 E. Ely et al. (2004). Delirium as a predictor of mortality in mechanically ventilated patients in the intensive care unit. Jama, 291(14), 1753-1762. DOI : 10.1001/jama.291.14.1753   DOI
28 M. Y. Yu, J. W. Park, M. S. Hyun & Y. J. Lee. (2008). Factors related to delirium occurrence among the patients in the intensive care units. Journal of Korean Clinical Nursing Research, 14(1), 151-160.
29 Z. Lipowski. (1987). Delirium (acute confusional states). Jama, 258(13), 1789-1792. DOI : 10.1001/jama.1987.03400130103041   DOI
30 S. H. Park et al. (2020). Factors Related to Motor Subtypes of Delirium Patients in a Surgical Intensive Care Unit. Journal of Korean Clinical Nursing Research, 26(2), 207-216. DOI : 10.22650/JKCNR.2020.26.2.207   DOI
31 J. Y. Han et al. (2018). The Risk Evaluation of Delirium in Elderly Patients with Lower Extremity Fractures. Journal of Korean Geriatric Psychiatry, 22(2), 84-88. DOI : 10.47825/jkgp.2018.22.2.84.   DOI
32 T. H. An, Y. S. Ra, C. W. Han, H. S. Kim, K. S. Lee & H. L. Bae. (2015). Clinical Correlates of Subtype and Severity in Patients with Delirium. Journal of The Korean Neuropsychiatric Association, 54(4), 489-494. DOI : 10.4306/jknpa.2015.54.4.489   DOI
33 S. H. Kim et al. (2007). A Pilot Study of Postoperative Delirium in Spine Surgery. Journal of Korean Geriatric Psychiatry, 11(2), 98-103.
34 A. Morandi et al. (2017). Clinical features associated with delirium motor subtypes in older inpatients: results of a multicenter study. The American Journal of Geriatric Psychiatry, 25(10), 1064-1071. DOI : 10.1016/j.jagp.2017.05.003   DOI
35 J. Lee, H. J. Lee, S. Y. Kim & J. L. Kim. (2008). A Study for the Diagnosis, Severity and Subtypes of Delirium Using the Korean Version of Delirium Rating Scale-Revised-98(K-DRS-98). Journal of the Korean Society of Biological Therapies in Psychiatry, 14(1), 101-109.
36 A. Schreier. (2010). Nursing care, delirium, and pain management for the hospitalized older adult. Pain Management Nursing, 11(3), 177-185. DOI : 10.1016/j.pmn.2009.07.002.   DOI