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Acute confusional episodes in elderly orthopaedic patients: the patients' actions and speech.

Andersson, Edith LU ; Norberg, Astrid and Rahm Hallberg, Ingalill LU (2002) In International Journal of Nursing Studies 39(3). p.303-317
Abstract
The aim of this study was to illuminate the pattern of confusional episodes with regard to the content of elderly patients' actions and speech. Fifty-one (11.2%) out of 457 people admitted to an orthopaedic clinic developed acute confusional state. Non-participant direct observations and daily clinical bedside follow-up observations were made during the confusional episodes, focusing on the patients' speech, actions and reactions with reference to situation, the surroundings, and the nurses' actions, including their verbal communication with the patient. The texts were analysed using manifest and latent content analysis and revealed disturbances in motor activity, speech and mood. 'Struggling to understand and to gain control when in a... (More)
The aim of this study was to illuminate the pattern of confusional episodes with regard to the content of elderly patients' actions and speech. Fifty-one (11.2%) out of 457 people admitted to an orthopaedic clinic developed acute confusional state. Non-participant direct observations and daily clinical bedside follow-up observations were made during the confusional episodes, focusing on the patients' speech, actions and reactions with reference to situation, the surroundings, and the nurses' actions, including their verbal communication with the patient. The texts were analysed using manifest and latent content analysis and revealed disturbances in motor activity, speech and mood. 'Struggling to understand and to gain control when in a state of confusion and viewing oneself as being confused' was the main theme illuminated in the texts. In the struggle to achieve understanding and take control over themselves and what was currently taking place, the patients used a variety of strategies. They attempted to find clarity, to make a sensible story out of the present and to impute meaning to the present by using their life story. The findings indicated that the patients had a drive to achieve control when they were confused and that they were both aware and unaware of their state and tended to oscillate between being in a confused state and viewing their confusion from an outside perspective. The findings indicated that possibly the best approach is to support their inner drive to gain control. This means moving between confirmation of their emotional state and their perceptions and trying to introduce 'reality' when they realize their state of confusion. Thus the nurse--patient relationship perhaps needs to hold a balance between confirmation and introducing in reality. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Communication, Confusion : physiopathology, Nurse-Patient Relations, Male, Human, Female, Support Non-U.S. Gov't, Orthopedics, Speech, Behavior, Aged, Aged 80 and over, Acute Disease
in
International Journal of Nursing Studies
volume
39
issue
3
pages
303 - 317
publisher
Elsevier
external identifiers
  • wos:000174742800008
  • pmid:11864654
  • scopus:0036512873
ISSN
1873-491X
DOI
10.1016/S0020-7489(01)00022-0
language
English
LU publication?
yes
id
aa327cc6-efd5-420c-b211-e0ceb6a73abd (old id 106754)
date added to LUP
2007-07-23 13:14:09
date last changed
2017-01-01 05:02:48
@article{aa327cc6-efd5-420c-b211-e0ceb6a73abd,
  abstract     = {The aim of this study was to illuminate the pattern of confusional episodes with regard to the content of elderly patients' actions and speech. Fifty-one (11.2%) out of 457 people admitted to an orthopaedic clinic developed acute confusional state. Non-participant direct observations and daily clinical bedside follow-up observations were made during the confusional episodes, focusing on the patients' speech, actions and reactions with reference to situation, the surroundings, and the nurses' actions, including their verbal communication with the patient. The texts were analysed using manifest and latent content analysis and revealed disturbances in motor activity, speech and mood. 'Struggling to understand and to gain control when in a state of confusion and viewing oneself as being confused' was the main theme illuminated in the texts. In the struggle to achieve understanding and take control over themselves and what was currently taking place, the patients used a variety of strategies. They attempted to find clarity, to make a sensible story out of the present and to impute meaning to the present by using their life story. The findings indicated that the patients had a drive to achieve control when they were confused and that they were both aware and unaware of their state and tended to oscillate between being in a confused state and viewing their confusion from an outside perspective. The findings indicated that possibly the best approach is to support their inner drive to gain control. This means moving between confirmation of their emotional state and their perceptions and trying to introduce 'reality' when they realize their state of confusion. Thus the nurse--patient relationship perhaps needs to hold a balance between confirmation and introducing in reality.},
  author       = {Andersson, Edith and Norberg, Astrid and Rahm Hallberg, Ingalill},
  issn         = {1873-491X},
  keyword      = {Communication,Confusion : physiopathology,Nurse-Patient Relations,Male,Human,Female,Support Non-U.S. Gov't,Orthopedics,Speech,Behavior,Aged,Aged 80 and over,Acute Disease},
  language     = {eng},
  number       = {3},
  pages        = {303--317},
  publisher    = {Elsevier},
  series       = {International Journal of Nursing Studies},
  title        = {Acute confusional episodes in elderly orthopaedic patients: the patients' actions and speech.},
  url          = {http://dx.doi.org/10.1016/S0020-7489(01)00022-0},
  volume       = {39},
  year         = {2002},
}