Symptom communication during critical illness: The impact of age, delirium, and delirium presentation

DOI

10.3928/00989134-20130530-03

Document Type

Journal Article

Publication Date

1-1-2013

Publication Title

Journal of Gerontological Nursing

Volume

39

Issue

8

First Page

28

Last Page

38

ISSN

989134

Abstract

Symptom communication is integral to quality patient care. Communication between patients and nurses in the intensive care unit (ICU) is complicated by oral or endotracheal intubation and fluctuating neurocognitive status or delirium. We report the (a) prevalence of delirium and its subtypes in non-vocal, mechanically ventilated, critically ill patients; (b) impact of age on delirium; and (c) influence of delirium and age on symptom communication. Videorecorded interactions between patients (N = 89) and nurses (N = 30) were analyzed for evidence of patient symptom communication at four time points across 2 consecutive days. Delirium was measured at enrollment and following sessions. Delirium prevalence was 23.6% at enrollment and 28.7% across sessions. Participants age >60 were more likely to be delirious on enrollment and during observational sessions. Delirium was associated with self-report of pain, drowsiness, and feeling cold. Patients were significantly less likely to initiate symptom communication when delirious. Symptom identification should be carefully undertaken in older adults with or without delirium. © SLACK Incorporated.

Open Access

Green Accepted

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