Post-stroke delirium risk factors,signs and symptoms of onset and outcomes as perceived by expert nurses: A focus group study |
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Institution: | 2. Department of Diagnostics and Public Health, University of Verona, Italy;3. Department of Medical Science, University of Udine, Viale Ungheria 20, 33100 Udine, Italy;2. Department of Neurosurgery, Henry Ford Hospital, Detroit MI, USA;3. Department of Radiology, Henry Ford Hospital, Detroit, MI, USA;2. Post-Graduate Program in Cardiology and Cardiovascular Sciences, Medical School, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil;3. Neurology Division, Hospital de Clínicas de Porto Alegre, Brazil;2. Department of Neurology, Tongzhou People''s Hospital, Nantong, China;3. New Era Stroke Care and Research Institute, The PLA Rocket Force Characteristic Medical Center, Xinjiekou Outer Street No 16, Beijing, China;2. Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Shuaifuyuan 1#, Dongchengqu, Beijing 100730, China;2. Medical University of South Carolina, United States;3. University of Ibadan, Nigeria;4. University of California San Francisco, United States;2. PGY-4, Neurology Cleveland Clinic Florida;3. Department of Neurology Cleveland Clinic Florida;4. Department of Pulmonary and Critical Care Medicine Cleveland Clinic Florida |
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Abstract: | BackgroundHigher rates of delirium have been reported among patients with acute stroke. However, poorly modifiable risk factors have been documented to date while sign and symptoms capable of early detecting its onset and outcomes in this specific population have been largely neglected. The aim of this study was to emerge nurses’ clinical knowledge and experiences regarding post-stroke delirium (a) risk factors, (b) signs and symptoms of delirium onset, and (c) outcomes.MethodA qualitative study based upon focus groups have been performed on 2019 and here reported according to the COnsolidated criteria for REporting Qualitative research. A purposeful sample of 28 nurses was invited to participate in focus groups at two Italian hospitals, and 20 participated. A semi-structured question guide was developed; all focus groups were audio recorded and then transcribed verbatim. Two researchers independently analysed, coded and categorised the findings according to the main research question. A member checking with ten nurses was also performed to ensure rigour.ResultsFour risk factors emerged (a) at the individual level; (b) associated with previous (e.g., dementia) and the current clinical condition (stroke), (c) associated with the nursing care delivered, and (d) associated with the hospital environment. In their daily practice, nurses suspect the onset of delirium when some motor, verbal or multidimensional signs and symptoms occur. The delirium episodes affect outcomes at the individual, family, and at the system levels.ConclusionsIn a field of research in need of study, we have involved expert nurses who shared their tacit knowledge to gain insights regarding risk factors, early signs and symptoms of delirium and its outcomes to address future directions of this research field. |
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