Delirium-related distress in the ICU: A qualitative meta-synthesis of patient and family perspectives and experiences.
Leanne M Boehm, Abigail C Jones, Abeer A Selim and 5 others
PMID 34343884WHAT IT FOUND
ICU patients described fear, anger and disorientation during delirium, then shame and guilt after it.
Nurses' presence, eye contact, explanations and forgiveness helped them feel safe. Families wanted early clear information and ways to help.
Key findings
01Fear was the most reported emotion during delirium (14/35 patient quotes), and after delirium patients described shame, embarrassment and guilt.
02Patients said nurses' presence, eye contact, explanations and forgiveness helped them feel safe during delirium.
03Family members said clear explanations about delirium helped make sense of it, and they valued being included in care through familiar items and orientation.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only published quotes were analyzed, not the full range obtained in original studies. Only English-language studies were included, and most were from Western countries. Only five studies confirmed patient delirium with a structured assessment. Reviewer agreement for screening was low, although included studies were agreed by consensus. The review describes experiences and possible relieving factors; it does not test whether any intervention reduces distress.
The easy way to misread this
Do not read this as evidence that nurse presence, explanations or family involvement reduce delirium distress. The review reports patient and family experiences, not tested interventions.