The delirium experience: Delirium recall and delirium-related distress in hospitalized patients with cancer, their spouses/caregivers, and their nurses Journal Article


Authors: Breitbart, W.; Gibson, C.; Tremblay, A.
Article Title: The delirium experience: Delirium recall and delirium-related distress in hospitalized patients with cancer, their spouses/caregivers, and their nurses
Abstract: We conducted a systematic examination of the experience of delirium in a sample of 154 hospitalized patients with cancer. Patients all met DSM-IV criteria for delirium and were rated with the Memorial Delirium Assessment Scale as a measure of delirium severity, phenomenology, and resolution. Of the 154 patients assessed, 101 had complete resolution of their delirium and were administered the Delirium Experience Questionnaire (DEQ - a face-valid measure that assesses delirium recall and distress related to the delirium episode). Spouse/caregivers and primary nurses were also administered the DEQ to assess distress related to caring for a delirious patient. Fifty-four (53.5%) patients recalled their delirium experience. Logistic- regression analysis demonstrated that short-term memory impairment (odds ratio [OR] = 38.4), delirium severity (OR = 11.3), and the presence of perceptual disturbances (OR = 6.9) were significant predictors of delirium recall. Mean delirium -related distress levels (on a 0-4 numerical rating scale of the DEQ) were 3.2 for patients who recalled delirium, 3.75 for spouses/caregivers, and 3.09 for nurses. Logistic-regression analysis demonstrated that the presence of delusions (OR = 7.9) was the most significant predictor of patient distress. Patients with "hypoactive " delirium were just as distressed as patients with "hyperactive" delirium. Karnofsky Performance Status (OR = 9.1) was the most significant predictor of spouse/caregiver distress. Delirium severity (OR =5.2) and the presence of perceptual disturbances (OR =3.6) were the most significant predictors of nurse distress. In conclusion, a majority of patients with delirium recall their delirium as highly distressing. Delirium is also a highly distressing experience for spouses/ caregivers and nurses who are caring for delirious patients. Prompt recognition and treatment of delirium is critically important to reduce suffering and distress.
Keywords: adult; controlled study; aged; middle aged; major clinical study; cancer patient; prospective studies; neoplasms; logistic models; delirium; risk factors; questionnaires; early diagnosis; psychiatric status rating scales; hospital patient; rating scale; chi-square distribution; caregiver; mental stress; stress, psychological; recall; mental recall; caregivers; spouses; inpatients; nurse; spouse; memorial delirium assessment scale; nurses; humans; human; male; female; article
Journal Title: Psychosomatics
Volume: 43
Issue: 3
ISSN: 0033-3182
Publisher: Elsevier Science, Inc.  
Date Published: 2002-05-01
Start Page: 183
End Page: 194
Language: English
DOI: 10.1176/appi.psy.43.3.183
PUBMED: 12075033
PROVIDER: scopus
DOI/URL:
Notes: Export Date: 14 November 2014 -- Source: Scopus
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MSK Authors
  1. William S Breitbart
    344 Breitbart
  2. Christopher A Gibson
    12 Gibson