Patients' and nurses' experiences of delirium: a review of qualitative studies

Background: Knowledge of delirium accumulated over the past two decades has focused more on its characteristics, pathophysiology, incidence, aetiology and prognosis as well as interventions for preventing, detecting, evaluating or managing this syndrome and less so on how patients and nurses who care for them experience it. Aims: To present the state of knowledge derived from qualitative studies of the experiences of persons who suffered delirium and of nurses who cared for them to guide critical care practice. Results: Delirious patients experience incomprehension and various feelings of discomfort. Understanding, support, believing what they are experiencing, explanations, the presence of family/friends and the possibility of talking about the lived experience are interventions that might help them get through such episodes more easily. Nurses who tend to delirious patients fail to comprehend the utterances and behaviours of the persons cared for and experience various feelings of discomfort as well. Nevertheless, they intervene following different goals and intervention strategies that seem to vary as a function of their culture and values. Conclusion: Qualitative studies conducted on persons who suffered delirium and on nurses who cared for them have shed light on their lived experience and provide insight on how to improve critical care practice. Relevance to clinical practice: The findings suggest that nurses must acknowledge the lived experience of the persons cared for and they must seek out the meaning that patients ascribe to this experience to understand the situation and thus conduct interventions that meet the needs expressed.