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The meaning of acute confusional state from the perspective of elderly patients.

Andersson, Edith LU ; Rahm Hallberg, Ingalill LU ; Norberg, Astrid and Edberg, Anna-Karin LU (2002) In International Journal of Geriatric Psychiatry 17(7). p.652-663
Abstract
OBJECTIVES: The aim of this study was to illuminate lived experience of having been in an acute confusional state (ACS) as narrated by elderly patients in orthopaedic care. METHOD: Qualitative study with phenomenological hermeneutic method for analysing the data based on narrative interviews. Fifty patients (67-96 years of age) who developed ACS during hospitalisation and in all cases the ACS ceased during their stay on the ward were interviewed once lucid again regarding the course of the event, their experiences, memories and interpretation of what had happened during the ACS. RESULTS: The meaning of the patients' lived experiences of being and having been confused was interpreted as 'Being trapped in incomprehensible experiences and a... (More)
OBJECTIVES: The aim of this study was to illuminate lived experience of having been in an acute confusional state (ACS) as narrated by elderly patients in orthopaedic care. METHOD: Qualitative study with phenomenological hermeneutic method for analysing the data based on narrative interviews. Fifty patients (67-96 years of age) who developed ACS during hospitalisation and in all cases the ACS ceased during their stay on the ward were interviewed once lucid again regarding the course of the event, their experiences, memories and interpretation of what had happened during the ACS. RESULTS: The meaning of the patients' lived experiences of being and having been confused was interpreted as 'Being trapped in incomprehensible experiences and a turmoil of past and present and here and there', comprising the themes trying to get a grip on the experience of the confusion, encountering past, present and the realm of the imagination as reality during the period of confusion and confronting the idea of having been confused. Contradictory to earlier research the patients remembered and could tell in great detail about their ACS. While confused, the confusional state means that impressions of all kinds invade the mind of the person and are experienced as reality, making him/her a victim of these impressions rather than the one who controls what comes into his/her mind. While in the middle of these experiences the person simultaneously senses that the impressions are unreal, thus indicating that he/she is in some sort of borderland between understanding and not understanding. The things that come into the mind of the person can either be frightening or neutral or enjoyable scenarios that seem to be mainly familiar but can also be unknown. These scenarios seem to be a mixture of past and present, of events and people while they seem to float from location to location. CONCLUSIONS: The findings indicates that what takes place during the ACS is not nonsense but probably a mix of the patient's life history, their present situation and above all a form of communication concerning their emotional state and inner experiences in this new situation. The findings also indicated that one possible approach to the patients is to confirm and support the patients in narrating their experiences both during the confusion and also after the ACS had ceased. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
80 and over, Confusion : nursing, Confusion : psychology, Female, Hospitalization, Male, Human, Recall, Support, Non-U.S. Gov't, Acute Disease, Aged, Aged : psychology
in
International Journal of Geriatric Psychiatry
volume
17
issue
7
pages
652 - 663
publisher
John Wiley and Sons Ltd
external identifiers
  • pmid:12112164
  • wos:000176887000010
  • scopus:0036063165
ISSN
1099-1166
DOI
10.1002/gps.682
language
English
LU publication?
yes
id
d0c1733f-2bd9-4d9b-b788-08ce8a90f9bf (old id 109213)
date added to LUP
2007-07-23 13:11:37
date last changed
2017-02-19 03:29:36
@article{d0c1733f-2bd9-4d9b-b788-08ce8a90f9bf,
  abstract     = {OBJECTIVES: The aim of this study was to illuminate lived experience of having been in an acute confusional state (ACS) as narrated by elderly patients in orthopaedic care. METHOD: Qualitative study with phenomenological hermeneutic method for analysing the data based on narrative interviews. Fifty patients (67-96 years of age) who developed ACS during hospitalisation and in all cases the ACS ceased during their stay on the ward were interviewed once lucid again regarding the course of the event, their experiences, memories and interpretation of what had happened during the ACS. RESULTS: The meaning of the patients' lived experiences of being and having been confused was interpreted as 'Being trapped in incomprehensible experiences and a turmoil of past and present and here and there', comprising the themes trying to get a grip on the experience of the confusion, encountering past, present and the realm of the imagination as reality during the period of confusion and confronting the idea of having been confused. Contradictory to earlier research the patients remembered and could tell in great detail about their ACS. While confused, the confusional state means that impressions of all kinds invade the mind of the person and are experienced as reality, making him/her a victim of these impressions rather than the one who controls what comes into his/her mind. While in the middle of these experiences the person simultaneously senses that the impressions are unreal, thus indicating that he/she is in some sort of borderland between understanding and not understanding. The things that come into the mind of the person can either be frightening or neutral or enjoyable scenarios that seem to be mainly familiar but can also be unknown. These scenarios seem to be a mixture of past and present, of events and people while they seem to float from location to location. CONCLUSIONS: The findings indicates that what takes place during the ACS is not nonsense but probably a mix of the patient's life history, their present situation and above all a form of communication concerning their emotional state and inner experiences in this new situation. The findings also indicated that one possible approach to the patients is to confirm and support the patients in narrating their experiences both during the confusion and also after the ACS had ceased.},
  author       = {Andersson, Edith and Rahm Hallberg, Ingalill and Norberg, Astrid and Edberg, Anna-Karin},
  issn         = {1099-1166},
  keyword      = {80 and over,Confusion : nursing,Confusion : psychology,Female,Hospitalization,Male,Human,Recall,Support,Non-U.S. Gov't,Acute Disease,Aged,Aged : psychology},
  language     = {eng},
  number       = {7},
  pages        = {652--663},
  publisher    = {John Wiley and Sons Ltd},
  series       = {International Journal of Geriatric Psychiatry},
  title        = {The meaning of acute confusional state from the perspective of elderly patients.},
  url          = {http://dx.doi.org/10.1002/gps.682},
  volume       = {17},
  year         = {2002},
}