Delirium recall – an integrative review

AIMS AND OBJECTIVES: The aim of this article is to review and synthesise the empirical literature on patient recall of delirium episodes and to provide a direction for future research. BACKGROUND: Delirium is a common and costly condition seen in hospitalised and institutionalised patients. Much of the existing literature focuses on delirium detection, risk factors, aetiologies and treatment. Few studies describe the patient experience of delirium recall. DESIGN: A literature search was conducted using the databases of the National Library of Medicine (PubMed/MEDLINE/OVID), the Cumulative Index of Nursing and Allied Health Literature and the American Psychological Association (PsycINFO). Articles were restricted to the English language and from the years 1980-2014. METHODS: An integrative review of 12 selected studies on delirium recall was performed. RESULTS: The majority of participants recalled their delirious episodes and during these episodes experienced both perceptual disturbances and psychological distress. Common themes from the qualitative data included incomprehensible experiences, strong emotional feelings and fear. CONCLUSION: Delirium recall is common, is distressing and warrants further investigation. Future studies should employ standardised delirium detection tools and a systematic examination of factors that may predict delirium recall. RELEVANCE TO CLINICAL PRACTICE: Understanding delirium recall may help nurses mitigate the psychological morbidity and distress associated with the phenomenon and generate new theories to improve care.