Delirium: the lived experience

Delirium is one of the most serious and prevalent cognitive disorders occurring in the older person post-surgery. Delirium is a potentially preventable and reversible cause of post-operative functional disability, morbidity and mortality. As well as the significant impact for the person, delirium also results in increased health care costs and poses a substantial challenge for clinicians. Medical and nursing textbooks concentrate on diagnosis, reduction of the modifiable risk factors and treatments. Nursing research has examined documentation, nursing skills and lack of education on how to nurse the delirious patient. However, little research has focused on the patient's experience of incomprehension and various feelings of discomfort during an acute episode of delirium. The importance of researching the patient's experience of delirium provides health care staff insight into the experience, enables understanding and acknowledgement, and supports improving evidence-based care to meet the needs expressed by the delirious patient. The aim of this study was to explore the lived experience of delirium in the acute inpatient orthopaedic population with the anticipation that increased understanding and knowledge of this lived experience will support the development of evidence-based nursing care management of the delirious patient. This study examines the experiences of eleven patients who described their experiences of delirium in semi-structured interviews. The interviews were transcribed verbatim, and analysed using the techniques of qualitative description (Sandelowski 2000) and the grounded theory coding process described by Glaser and Strauss (1967). The findings of this study provide an insight into the incomprehensible emotional pain suffered by patients while they were delirious and the disparate feelings of remorse, guilt and shame they experienced after the episode of delirium. It is hoped that the findings of this study will contribute to the care of the delirious patient post-surgery. Following this study, it is apparent that more research is required into the long-term impact of the experience of delirium.