An examination of psychological distress associated with delirium in hospitalized older adults, their families, and nurses: an integrative review

OBJECTIVES: This integrative review examined, synthesized, and appraised the empirical literature examining the psychological distress associated with delirium among hospitalized adults aged 65 and older, their families, and nurses. METHODS: PubMed, CINAHL, and PsycINFO databases were searched for the key terms of 'delirium', 'psychological stress', 'psychological distress', and 'aged.' Included studies were quantitative designs, conducted in hospital inpatient settings, and involved patients aged 65 and over who experienced delirium while hospitalized, as well as care partners or nurses caring for patients when delirium-related distress was measured. RESULTS: Six observational studies were included, spanning a variety of inpatient hospital settings in European countries. Delirium-related distress was consistently reported in all studies at each of the participant levels (patient, caregiver, and nurse) and was most measured using the Delirium Experience Questionnaire (DEQ). Distress levels ranged from a 'fair amount' to a 'severe' amount of delirium-related distress at each of the participant levels. To date, no intervention studies have been published to address delirium-related distress specifically. CONCLUSION: A paucity of research exists on delirium-related distress in hospitalized older adults. Delirium-related distress is a clinically important but often overlooked symptom and warrants targeted interventions integrated into a clinical pathway for delirium care.