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Delirium: behavioural changes before and during the prodromal phase
Gill Sörensen Duppils1, Karin Wikblad
1Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden. gsd@du.se
Journal of Clinical Nursing
|June 11, 2004
Summary
Recognizing behavioral changes before delirium onset is crucial for early intervention in older adults. Prompt attention to these prodromal symptoms can help prevent delirium and improve patient well-being.
Area of Science:
- Geriatric Medicine
- Psychiatry
- Clinical Psychology
Background:
- Delirium is a significant cause of morbidity and functional decline in elderly individuals.
- Early symptoms, known as the prodromal phase, can appear before all diagnostic criteria are met.
Purpose of the Study:
- To identify and describe behavioral changes occurring before and during the prodromal phase of delirium.
- To understand the temporal relationship between behavioral shifts and the onset of delirium.
Main Methods:
- A prospective, descriptive observational study involving 103 hip surgery patients aged 80 years and older.
- Behavioral observations (37 items) were conducted from admission up to delirium onset or 48 hours postoperatively, comparing against an initial baseline observation.
Main Results:
- 62% of patients who developed delirium (D group) showed pre-onset behavioral changes, compared to 48% in the non-delirium group (R group).
- The D group exhibited more numerous and distinct behavioral changes, including anxiety, disorientation, and urgent calls for attention.
- Behavioral changes intensified in the six hours preceding delirium onset.
Conclusions:
- Awareness of the prodromal phase and individual behavioral changes is essential for preventing delirium in older patients.
- Early identification of these subtle shifts can aid in timely interventions, improving patient outcomes and well-being.