Nurses' perception of the phenomenon confusion in elderly hospitalized patients

The purpose of this descriptive study was to identify nurses' perception of signs, symptoms, assessment and reversibility of confusion in elderly hospitalized patients. The convenience sample consisted of 10 registered nurses working in an acute care setting. Data were collected using an open-ended interview guide and analyzed via qualitative analysis. The results showed that all of the subjects found behaviours indicative of disorientation, memory impairment, altered awareness of own situation and safety needs, aggressive behaviour, and altered ability to interact were components of confusion. Altered awareness of own situation, disorientation and altered ability to interact were found to be critical indicators of confusion. No consistent means to assess the presence and level of confusion was identified. The assessment of causes of confusion was primarily physical in nature with some psycho-social factors included. Confusion was considered reversible if it had an acute onset and a physiological cause. Replication of the study is recommended using a larger sample of nurses in a variety of settings, to more clearly define and delineate categories of mental functioning and develop assessment tools.