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Assessment of Dependence in Activities of Daily Living Among Older Patients in an Acute Care Unit

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Using simulated family presence to decrease agitation in older hospitalized delirious patients: A randomized

Christine M Waszynski¹, Kerry A Milner², Ilene Staff³

¹Department of Geriatric Medicine and Department of Nursing, Hartford Hospital, 80 Seymour Street, Hartford, CT 06012, USA.

International Journal of Nursing Studies

|November 4, 2017

Summary

This summary is machine-generated.

Simulated family presence via video messages significantly reduced agitation in hospitalized delirious patients. This nonpharmacological approach shows promise for managing agitation in acute care settings.

Keywords:

Agitation Hospitalized patient Hyperactive delirium Mixed delirium Nature video Nonpharmacological intervention Simulated family presence Video messages

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Area of Science:

Gerontology
Psychiatry
Clinical Nursing

Background:

Delirium, particularly hyperactive or mixed types, frequently causes agitation in hospitalized patients.
Effective nonpharmacological interventions are needed to manage agitation in delirious patients.
Simulated family presence has previously reduced agitation in dementia patients in nursing homes.

Purpose of the Study:

To assess the impact of pre-recorded family video messages on agitation levels in hospitalized patients with delirium.
To compare the effectiveness of simulated family presence with nature videos and usual care.

Main Methods:

A single-site randomized controlled trial was conducted with 111 hospitalized delirious patients.
Participants were assigned to view a family video, a nature video, or receive usual care.
Agitation was measured using the Agitated Behavior Scale at multiple time points.

Main Results:

Both video interventions significantly reduced agitation scores compared to usual care (p<0.001).
The family video group showed a greater reduction in agitation (94%) during the intervention compared to nature video (70%) and usual care (30%).
A significant reduction in agitation persisted for the family video group compared to usual care immediately post-intervention (60% vs 35.1%, p=0.001).

Conclusions:

Family video messaging offers preliminary support as a nonpharmacological intervention to decrease agitation in hospitalized delirious patients.
Further research is needed to confirm efficacy in younger patients and as part of multi-component interventions.