Development and validation of the content of a manual for the prevention and non-pharmacological management of delirium in the hospital environment
DOI:
https://doi.org/10.11606/issn.2238-6149.v34i1-3e229344Keywords:
Delirium, hospitalization, Occupational TherapyAbstract
Delirium is a neuropsychiatric syndrome characterized by an altered level of consciousness with decreased or increased psychomotor activity, called hypoactive and hyperactive delirium, respectively. It is a prevalent condition in hospitalized elderly people, and the multidisciplinary health team is responsible for implementing measures for its prevention and management. The aim is to validate the content of a manual for the prevention and non-pharmacological management of delirium in the hospital environment. This is a qualitative study in two stages: content development and validation by occupational therapists. It was prepared based on an integrative review conducted by Caetano et al.¹. Aiming to update this review, a new bibliographic search was carried out, finding 166 articles. 13 articles were selected, but no new strategies were identified in relation to those already identified by the aforementioned author. Content validation was carried out using the Delphi technique. In the first round, experts contributed criticisms and suggestions on general aspects of the manual. In the second round, they judged each topic according to the criteria “content” and “clarity of statement”. In the third and final round, they exclusively evaluated the relevance of images. The process of preparing the manual and judging it by experts gave the manual content validity as a useful tool for occupational therapists.
Downloads
References
Wacker P, Nunes PV, Forlenza OV. Delirium: uma perspectiva histórica. Arch Clin Psychiatry. 2005;32(3):97-103. https://doi.org/10.1590/S0101-60832005000300001.
Prayce R, Quaresma F, Neto IG. Delirium: O 7º Parâmetro Vital? Acta Med Port. 201831;31(1):51-58. https://doi.org/10.20344/amp.9670.
American Psychiatric Association – APA. Manual diagnóstico e estatístico de transtornos mentais: DSM-5. 5ed. Porto Alegre: Artmed; 2014.
Sousa CMP. Delirium no Idoso: artigo de revisão [Tese]. Coimbra: Universidade de Coimbra, Faculdade de Medicina; 2015. https://estudogeral.sib.uc.pt/bitstream/10316/37396/1/Delirium%20no%20idoso.pdf>
Lôbo RR, Silva Filho SRB, Lima NKC, Ferriolli E, Moriguti JC. Delirium. Medicina. 2010;43(3):249-57. https://doi.org/10.11606/issn.2176-7262.v43i3p249-257
Rosen T, Connors S, Clark S, Halpern A, Stern ME, DeWald J, Lachs MS, Flomenbaum N. Assessment and Management of Delirium in Older Adults in the Emergency Department: Literature Review to Inform Development of a Novel Clinical Protocol. Adv Emerg Nurs J. 2015;37(3):183-96. https://doi.org/10.1097/TME.0000000000000066.
Marcantonio ER. Delirium in Hospitalized Older Adults. Clinical Practice. NEJM. 2017;377(15):1456-66. https://doi.org/10.1056/NEJMcp1605501
Caetano GM, Niyama BT, Almeida MHM, Batista MPP, Ratier APP. Intervenção não farmacológica no manejo de delirium: uma revisão bibliográfica integrativa. Cadernos Brasileiros de Terapia Ocupacional. 2021;29:e2909. https://doi.org/10.1590/2526-8910.ctoAR2198
American Occupational Therapy Association – AOTA. Estrutura da prática da Terapia Ocupacional: domínio e processo. Rev Terap. 2015;26(Esp):1-49. https://doi.org/10.11606/issn.2238-6149.v26iespp1-49
Santos CAV, Carlo MMRPD. Hospital como campo de práticas: revisão integrativa da literatura e a terapia ocupacional. Cad Ter Ocup UFSCar. 2013;21(1):99-107. https://doi.org/10.4322/cto.2013.014
Chagas FP. Intervenções da terapia ocupacional em pacientes hospitalizados com delirium: uma revisão integrativa [trabalho de conclusão de curso]. Brasília, DF: (Universidade de Brasília, Graduação em Terapia Ocupacional; 2018. https://bdm.unb.br/handle/10483/20706.
Williams PL, Webb C. The Delphi technique: a methodological discussion. J Adv Nurs. 1994;19(1):180-6. https://doi.org/10.1111/j.1365-2648.1994.tb01066.x.
Marques JBV, Freitas D. Método DELPHI: caracterização e potencialidades na pesquisa em educação. Pro-Posições. 2018;29(2):389-415. https://doi.org/10.1590/1980-6248-2015-0140.
Revorêdo LS, Maia RS, Torres GV, Maia EMC. O uso da técnica delphi em saúde: uma revisão integrativa de estudos brasileiros. Arq Cienc Saúde. 2015;22(2):16-21. https://doi.org/10.17696/2318-3691.22.2.2015.136
Vasconcellos KMAV, Almeida MHM. Percepção de egressos sobre estágios de terapia ocupacional em geriatria e gerontologia. Rev Terap Ocup. 2013;24(1):48-56. https://doi.org/10.11606/issn.2238-6149.v24i1p48-56.
Ferreira JSSP, Sacco ICN, Siqueira AA, Almeida MHM, Sartor CD. Rehabilitation technology for self-care: Customised foot and ankle exercise software for people with diabetes. PLoS One. 2019;14(6):e0218560. https://doi.org/10.1371/journal.pone.0218560.
Veríssimo JL, Sartor CD, Almeida MHM, Sacco ICN. Cartilha de exercícios para pés e tornozelos destinada a pessoas com Diabetes Mellitus. São Paulo: USP; 2021.
Almeida MHM, Caromano FA, Ribeiro SS, Batista MPP. Programa de orientação com ênfase em práticas de autocuidado para motoristas idosos. Rev Bras Geriatr Gerontol. 2016;19(2):303-11. https://doi.org/10.1590/1809-98232016019.140192.
Almeida MHM, Spínola AWP, Lancman S. Técnica Delphi: validação de um instrumento para uso do terapeuta ocupacional em gerontologia. Rev Terap Ocup. 2009;20(1):49-58. https://doi.org/10.11606/issn.2238-6149.v20i1p49-58
Silva MR, Montilha RCI. Contribuições da técnica Delphi para a validação de uma avaliação de Terapia Ocupacional em deficiência visual. Cad. Bras. Ter. Ocup. 2021;29:e2863.https://doi.org/10.1590/2526-8910.ctoAO2163
Faro ACM. Técnica Delphi na validação das intervenções de enfermagem. Rev esc enferm USP. 1997;31(2): 259-73. https://doi.org/10.1590/S0080-62341997000200008.
Rebelo CC, Oliveira H, Rocha MC. Abordagem do Delirium na Comunidade. Gazeta Med. 2021;8(4):263-73. https://doi.org/10.29315/gm.v8i4.482
Cebrian MAR, Bermejo CL, Beltrán NLC, Apastegui RV, Pérez DC, Méndez JJA. Cuidados paliativos en Atención Primaria: abordaje del delirium y manejo de la vía subcutánea. Rev Clin Med Fam. 2021;14(1):18-25. https://scielo.isciii.es/scielo.php?script=sci_abstract&pid=S1699-695X2021000100018.
Louro LAV, Possari JF, Lima AFC. Pharmacological and non-pharmacological treatment of delirium in an oncological hospital service: an integrative review. Rev Bras Enferm. 2021;74(1):e20200200. https://doi.org/10.1590/0034-7167-2020-0200.
Gouveia BR, Jomar RT, Santos DCL, Valente TCO. Construção e Validação de um Protocolo de Cuidados para Pacientes Críticos com Câncer em Delirium. Rev Bras Cancerol. 2021;67(3):e051311. https://doi.org/10.32635/2176-9745.RBC.2021v67n3.1311
Garcez FB, Silva TJA, Castro REV, Inouye SK. Delirium in older adults. GGA. 20221;15:e0210032. https://doi.org/10.53886/GGA.E0210032
Almeida L, Martins S, Martins N, Fernandes L. Diagnóstico, intervenção precoce e prevenção do delirium no adulto: o que fazer na atenção primária à saúde? Rev Bras Med Fam Comunidade. 2021;16(43):2366. https://doi.org/10.5712/rbmfc16(43)236.
Stollings JL, Kotfis K, Chanques G, Pun BT, Pandharipande PP, Ely EW. Delirium in critical illness: clinical manifestations, outcomes, and management. Intensive Care Med. 2021;47(10):1089-1103. https://doi.org/10.1007/s00134-021-06503-1.
Nitchingham A, Caplan GA. Current Challenges in the Recognition and Management of Delirium Superimposed on Dementia. Neuropsychiatr Dis Treat. 2021;17:1341-52. https://doi.org/10.2147/NDT.S247957.
Mossie A, Regasa T, Neme D, Awoke Z, Zemedkun A, Hailu S. Evidence-Based Guideline on Management of Postoperative Delirium in Older People for Low Resource Setting: Systematic Review Article. Int J Gen Med. 2022;15:4053-65. https://doi.org/10.2147/IJGM.S349232.
Monaghan C, Martin G, Kerr J, Peters ML, Versloot J. Effectiveness of Interprofessional Consultation-Based Interventions for Delirium: A Scoping Review. J Appl Gerontol. 2022;41(3):881-91. https://doi.org/10.1177/07334648211018032.
Méndez-Martínez C, Fernández-Martínez MN, García- Suárez M, Martínez-Isasi S, Fernández-Fernández JA, Fernández-García D. Related Factors and Treatment of Postoperative Delirium in Old Adult Patients: An Integrative Review. Healthcare. 2021;9(9):1103.https://doi.org/10.3390/healthcare9091103
Lee Y, Lee J, Kim J, Jung Y. Non-Pharmacological Nursing Interventions for Prevention and Treatment of Delirium in Hospitalized Adult Patients: Systematic Review of Randomized Controlled Trials. Int J Environ Res Public Health. 2021;18(16):8853. https://doi.org/10.3390/ijerph18168853
Kim CM, van der Heide EM, van Rompay TJL, Verkerke GJ, Ludden GDS. Overview and Strategy Analysis of Technology-Based Nonpharmacological Interventions for In-Hospital Delirium Prevention and Reduction: Systematic Scoping Review. J Med Internet Res. 2021;23(8):e26079. https://doi.org/10.2196/26079
Barreto RG, Sousa WCM, Silva SMAF, Souza TA, Silva EC, Brito BS, Silvestre MCA. Recurso terapêutico ocupacional para tratamento de delirium em pacientes com covid-19. Rev Neurociências. 2020;28:1-19. https://doi.org/10.34024/rnc.2020.v28.11028
Maia EK, Dovigi P, Machado AM, Oda JY. A importância do diagnóstico precoce do delirium em pacientes idosos com covid-19. Res Soc Dev. 2022;11(10)1-11. https://doi.org/10.33448/rsd-v11i10.33297
Faria RS, Moreno RP. Delirium in intensive care: an under-diagnosed reality. Rev Bras Ter Intensiva. 2013;25(2):137-47. https://doi.org/10.5935/0103-507X.20130025.
Trettene AD, Fontes CM, Razera AP, Gomide MR. Impact of promoting self-care in nursing workload. Rev Esc Enferm USP. 2016;50(4):635-641. https://doi.org/10.1590/S0080-623420160000500014.
Faustino TN, Pedreira LC, Freitas YS, Silva RMO, Amaral JB. Prevention and monitoring of delirium in older adults: an educational intervention. Rev Bras Enferm. 2016;69(4):678-85. https://doi.org/10.1590/0034-7167.2016690416i.
Banh HL. (2012). Management of Delirium in Adult Critically ill Patients: An Overview. J Pharm Pharm Sci, 15(4):499-509. https://doi.org/10.18433/J3PK69
Souza TL, Azzolin KO, Fernandes VR. Cuidados multiprofissionais para pacientes em delirium em terapia intensiva: revisão integrativa. Rev Gaúcha Enferm. 2018;39:e2017-0157. https://doi.org/10.1590/1983-1447.2018.2017 0157
Finucane AM, Lugton J, Kennedy C, Spiller JA. The experiences of caregivers of patients with delirium, and their role in its management in palliative care settings: an integrative literature review. Psychooncology. 2017;26(3):291-300. https://doi.org/10.1002/pon.4140
Meagher DJ. Delirium: optimising management. BMJ. 2001;322(7279):144-9. https://doi.org/10.1136/bmj.322.7279.144
Alvarez E, Garrido M, González F, Guzmán E, Donoso T, Gallegos S, Vergara S, Aranda R, Prieto S, Briceño C, Tobar E, Alzamora C, Bolvarán C, Concha C, Valencia F, Villalobos F. Terapia ocupacional precoz e intensiva en la prevención del delirium en adultos mayores ingresados a unidades de paciente crítico. ensayo clínico randomizado: resultados preliminares. Revista Chilena De Terapia Ocupacional. 2012;12(1):44-59. https://doi.org/10.5354/0719-5346.2012.22051
Tobar E, Alvarez E, Garrido M. Cognitive stimulation and occupational therapy for delirium prevention. Rev Bras Ter Intensiva. 2017;29(2):248-52. https://doi.org/10.5935/0103-507X.20170034
Downloads
Published
Issue
Section
License
Copyright (c) 2024 Mariana Pedrosa, Marina Picazzio Perez Batista, Tamires Nicodemos Vasques, Maria Helena Helena Morgani de Almeida, Rosé Colom Toldrá

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.