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Feasibility of Cognitive Training in Critically Ill Patients: A Pilot Study
Annelies Wassenaar1, Paul Rood1, Danielle Boelen1
1Annelies Wassenaar and Paul Rood are PhD students, Department of Intensive Care Medicine, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands. Danielle Boelen is a clinical neuropsychologist, Department of Medical Psychology, Radboud Expert Center for Psychology and Medicine, Radboud University Medical Center, and Klimmendaal Rehabilitation Centre, Arnhem, the Netherlands. Lisette Schoonhoven is professor of nursing, IQ Healthcare, Radboud Institute for Health Sciences, Radboud University Medical Center, and Faculty of Health Sciences, University of Southampton, Southampton, United Kingdom. Peter Pickkers is a professor of experimental intensive care medicine, and Mark van den Boogaard is an assistant professor, Department of Intensive Care Medicine, Radboud Institute for Health Sciences, Radboud University Medical Center.
Background:
Delirium occurs frequently in the intensive care unit and is associated with detrimental consequences. Cognitive training is a promising, nonpharmacologic, preventive intervention, but it is unknown whether cognitive training is feasible for patients in intensive care units.
Objectives:
To examine the feasibility for both nurses and patients of using cognitive training exercises for intensive care unit patients.
Methods:
A pilot study of a set of cognitive training exercises in a large, academic intensive care unit. Feasibility of the exercises, operationalized as practicability and burden for the patient and the nurse, was tested in multiple rounds and evaluated using Likert scales and open-ended questions, patients' vital signs, and time investment.
Results:
In total, 75 patients were included. During the first round, 11 exercises were separately tested by nursing researchers in 44 cooperative patients (50% with delirium). Four exercises were evaluated as burdensome and were excluded. Vital signs did not alter during execution. In a second round, the remaining exercises were tested in 31 patients (52% with delirium) by their attending nurse. All exercises were rated as practicable and not burdensome by the patients and the nurses. Total time investment per exercise was a median 4.5 (interquartile range, 3.0-5.0) minutes.
Conclusion:
Cognitive training exercises used in this study were feasible for intensive care unit patients (including cooperative patients with delirium) and their nurses. More research is needed to determine the clinical effect of the exercises on delirium outcome.
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