Medidas no farmacológicas para el tratamiento del síndrome confusional agudo en la unidad de cuidados intensivos

• Autores: José Miguel Cachón Pérez , Cristina Álvarez López, Domingo Palacios Ceña
• Localización: Enfermería intensiva, ISSN 1130-2399, Vol. 25, Nº. 2, 2014, págs. 38-45
• Idioma: español
• DOI: 10.1016/j.enfi.2013.11.004
• Enlaces
  • Texto completo
• Dialnet Métricas: 2 Citas
• Resumen

  • El delirium tiene una elevada incidencia en las unidades de cuidados intensivos y se encuentra infradiagnosticado e infratratado.

    Objetivo Describir las experiencias de las enfermeras de la UCI de adultos en la identificación y aplicación de las medidas no farmacológicas para la prevención y tratamiento del delirium.

    Método Estudio cualitativo fenomenológico, mediante grupos de discusión. Criterio de inclusión: enfermeras de UCI con un año o más de experiencia. Muestreo: por propósito y técnica de bola de nieve. Recogida de datos: grupos de discusión que se transcribieron para su análisis. Se realizó análisis temático de los textos.

    Resultados Cuatro temas identificados: a) la estructura física y social de la UCI; b) la implicación de la familia; c) la necesidad de formación de los profesionales sanitarios; y d) favorecer el ciclo sueño-vigilia.

    Conclusiones Controlar el medio ambiente de la UCI para hacerlo más amigable, modificar la rutina de trabajo para favorecer el descanso, implementar acciones de formación y flexibilizar el horario de visitas.

• Referencias bibliográficas
  • J.J. López-Ibor Aliño. DSM-IV-TR: manual diagnóstico y estadístico de los trastornos mentales texto revisado. 1.a ed., Elsevier Masson, (2007),
  • R. Boot. Delirium: A review of the nurses role in the intensive care unit. Intensive Crit Care Nurs, 12 (2012), pp. 185-189
  • N. Ayllon Garrido, M.J. Alvarez Gonzalez, M.P. Gonzalez Garcia. Delirium in intensive care. Incidence and risk factors. Enferm Intensiva,...
  • D.J. Meagher, M. Leonard, S. Donnelly, M. Conroy, D. Adamis, P.T. Trzepacz. A longitudinal study of motor subtypes in delirium: Relationship...
  • S.F. Jones, M.A. Pisani ICU delirium: An update. Curr Opin Crit Care, 18 (2012), pp. 146-151 http://dx.doi.org/10.1097/MCC.0b013e32835132b9
  • M.J. Dubois, N. Bergeron, M. Dumont, S. Dial, Y. Skrobik. Delirium in an intensive care unit: A study of risk factors. Intensive Care Med,...
  • E.B. Milbrandt, S. Deppen, P.L. Harrison, A.K. Shintani, T. Speroff, R.A. Stiles, et al. Costs associated with delirium in mechanically ventilated...
  • J.C. Jackson, S.M. Gordon, R.P. Hart, R.O. Hopkins, E.W. Ely. The association between delirium and cognitive decline: A review of the empirical...
  • E.W. Ely, A. Shintani, B. Truman, T. Speroff, S.M. Gordon, F.E. Harrell Jr., et al. Delirium as a predictor of mortality in mechanically ventilated...
  • S.M. Lin, C.Y. Liu, C.H. Wang, H.C. Lin, C.D. Huang, P.Y. Huang, et al. The impact of delirium on the survival of mechanically ventilated...
  • L. Belanger, F. Ducharme. Patients’ and nurses’ experiences of delirium: A review of qualitative studies. Nurs Crit Care, 16 (2011), pp. 303-315 http://dx.doi.org/10.1111/j.1478-5153.2011.00454.x
  • E.W. Ely, R.K. Stephens, J.C. Jackson, J.W. Thomason, B. Truman, S. Gordon, et al. Current opinions regarding the importance, diagnosis, and...
  • M.F. Lou, Y.T. Dai. Nurses’ experience of caring for delirious patients. J Nurs Res, 10 (2002), pp. 279-290
  • N. Nakkeeran, Qualitative RESEARCH Methodology: Epistemological foundation research procedures. Indian Soc Work, 67 (2006), pp. 104-118
  • R.S. Barbour. Making sense of focus groups. Medical Education, 39 (2005), pp. 742-750 http://dx.doi.org/10.1111/j.1365-2929.2005.02200.x
  • M. Bloor, J. Frankland, M. Thomas, K. Robson. Focus Groups in Social Research. Sage, (2001),
  • V. Braun, V. Clarke. Using thematic analysis in psychology. Qual Res Psychol, 3 (2006), pp. 77-101
  • P.J. Cunningham, L.E. Felland, P.B. Ginsburg, H.H. Pham. Qualitative methods: A crucial tool for understanding changes in health systems and...
  • Dew K. A health researcher's guide to qualitative methodologies. Aust N Z J Public Health. 2007; 31(5): 433-437.
  • M.J. Mayan. Una introducción a los métodos cualitativos: módulo de entrenamiento para estudiantes y profesionales. Qual Institute Press, (2001),
  • N. Nakkeeran. Knowledge, truth and social reality: An introductory note on qualitative research. Indian J Community Med, 35 (2010), pp. 379-381 http://dx.doi.org/10.4103/0970-0218.69249
  • K. Malterud. Qualitative research: Standard, challenges, and guidelines. Lancet, 358 (2001), pp. 483-488 http://dx.doi.org/10.1016/S0140-6736(01)05627-6
  • M.A. Willgerodt. Using focus groups to develop culturally relevant instruments. West J Nurs Res, 25 (2003), pp. 798-814
  • E.H. Bradley, L.A. Curry, K.J. Devers. Qualitative data analysis for health services research: Developing taxonomy themes, and theory. Health...
  • D.J. Cohen, B.F. Crabtree. Evaluative criteria for qualitative research in health care: Controversies and recommendations. Ann Fam Med, 6...
  • K. Dew. A health researcher's guide to qualitative methodologies. Aust N Z J Public Health, 31 (2007), pp. 433-437 http://dx.doi.org/10.1111/j.1753-6405.2007.00114.x
  • G.R. Williamson. Illustrating triangulation in mixed-methods nursing research. Nurse Researcher, 12 (2005), pp. 7-18
  • A. Tong, P. Sainsbury, J. Craig. Consolidated criteria for reporting qualitative research (COREQ): A 32-item checklist for interviews and...
  • A. Valentin, P. Ferdinande, ESICM Working Group on Quality Improvement. Recommendations on basic requirements for intensive care units: Structural...
  • I.J. Zaal, C.F. Spruyt, L.M. Peelen, M.M. van Eijk, R. Wientjes, M.M. Schneider, et al. Intensive care unit environment may affect the course...
  • T. Taguchi, M. Yano, Y. Kido. Influence of bright light therapy on postoperative patients: A pilot study. Intensive Crit Care Nurs, 23 (2007),...
  • M.F. Tracy, L. Chlan. Nonpharmacological interventions to manage common symptoms in patients receiving mechanical ventilation. Crit Care Nurse,...
  • R.F. Hu, X.Y. Jiang, Y.M. Zeng, X.Y. Chen, Y.H. Zhang. Effects of earplugs and eye masks on nocturnal sleep, melatonin and cortisol in a simulated...
  • K. Hofso, F.M. Coyer. Part 1. Chemical and physical restraints in the management of mechanically ventilated patients in the ICU: Contributing...
  • N. Pattison. Psychological implications of admission to critical care. Br J Nurs, 14 (2005), pp. 708-714 http://dx.doi.org/10.12968/bjon.2005.14.13.18452
  • M. Lundstrom, A. Edlund, S. Karlsson, B. Brannstrom, G. Bucht, Y. Gustafson. A multifactorial intervention program reduces the duration of...
  • A. Garcia Mozo, F. Sanchez Roldan, S.M. Amoros Cerda, F. Balaguer Albarracin, M. Diez Alcalde, M.T. Duran Torres, et al. Development of an...
  • M.I. Pardavila Belio, C.G. Vivar. Needs of the family in the intensive care units: A review of the literature. Enferm Intensiva, 23 (2012),...
  • A. Morandi, J.C. Jackson, E.W. Ely. Delirium in the intensive care unit. Int Rev Psychiatry, 21 (2009), pp. 43-58 http://dx.doi.org/10.1080/09540260802675296
  • B.T. Pun, E.W. Ely. The importance of diagnosing and managing ICU delirium. Chest, 132 (2007), pp. 624-636 http://dx.doi.org/10.1378/chest.06-1795
  • W.D. Schweickert, M.C. Pohlman, A.S. Pohlman, C. Nigos, A.J. Pawlik, C.L. Esbrook, et al. Early physical and occupational therapy in mechanically...
  • S.K. Inouye, D.I. Baker, P. Fugal, E.H. Bradley. HELP Dissemination Project. Dissemination of the hospital elder life program: Implementation,...
  • E. Tobar, C. Romero, T. Galleguillos, P. Fuentes, R. Cornejo, M.T. Lira, et al. Confusion assessment method for diagnosing delirium in ICU...
  • J.Y. Gabor, A.B. Cooper, S.A. Crombach, B. Lee, N. Kadikar, H.E. Bettger, et al. Contribution of the intensive care unit environment to sleep...
  • G. Mistraletti, E. Carloni, M. Cigada, E. Zambrelli, M. Taverna, G. Sabbatici, et al. Sleep and delirium in the intensive care unit. Minerva...