Delirium y Enfermería en adultos y adultos mayores. Revisión de la literatura

Autores/as

DOI:

https://doi.org/10.51326/ec.8.5745749

Palabras clave:

delirium, factores desencadenantes, conocimientos, enfermería, adulto

Resumen

Introducción: Delirium o síndrome confusional es un trastorno neurocognitivo con diferente sintomatología orientada a las alteraciones cognitivas de la conciencia y de la atención. Las nuevas investigaciones son escasas, por lo que aparece la necesidad de la realización del presente estudio, una actualización de conocimientos sobre un síndrome relevante desde el enfoque del gremio de la enfermería.

Objetivo general: Realizar una recopilación de conocimientos científicos sobre el delirium aplicado en personas adultas y mayores desde la perspectiva enfermera, buscando estudiar específicamente los factores desencadenantes y el nivel de conocimiento en los profesionales enfermeros.

Metodología: Estudio de revisión bibliográfica de la literatura científica actual (últimos 5 años), y dividido en tres etapas. La búsqueda de literatura se aproximó desde los meses de diciembre de 2023 a febrero de 2024. Las bases de datos utilizadas fueron Web of Science, ProQuest, Scopus y Cochrane Library Plus, con términos como “Delirium AND Aged”, entre otros.

Resultados: Se seleccionaron 14 artículos de alta relevancia. Los resultados evidencian que respecto al nivel de conocimientos de las enfermeras sobre el delirium, este es insuficiente en la mayoría de los estudios. En los factores desencadenantes, se encontraron gran variedad según el estudio, donde la edad avanzada se recalca repetidamente.

Conclusión: Las competencias y conocimientos de los equipos de enfermería son escasos y se encuentran en niveles moderados o bajos, necesitando de un refuerzo educativo específico. Entre los factores desencadenantes destacan la edad avanzada, la demencia, enfermedades sistémicas y disfunciones orgánicas, entre muchos otros.

Descargas

Los datos de descargas todavía no están disponibles.

Citas

Wilson JE, Mart MF, Cunningham C, Shehabi Y, Girard TD, MacLullich AMJ, et al. Delirium. Nat Rev Dis Primers. 2020;6(1):90. https://doi.org/10.1038/s41572-020-00223-4

American Psychiatric Association, Editor. Diagnostic and Statistical Manual of Mental Disorders. 5ª ed. Aarlington (Virginia): American Psychiatric Association; 2013. https://psychiatryonline.org/doi/book/10.1176/appi.books.9780890425596

Hemeda, A. Delirium: a common preventable medical disorder in elderly patients. Egypt J Intern Med 31, 403–407 (2019). https://doi.org/10.4103/ejim.ejim_55_19

Bellelli G, Brathwaite JS, Mazzola P. Delirium: A Marker of Vulnerability in Older People. Front Aging Neurosci. 2021;13:626127. https://doi.org/10.3389/fnagi.2021.626127

Jaqua EE, Nguyen VTN, Chin E. Delirium in Older Persons: Prevention, Evaluation, and Management. Am Fam Physician. 2023 Sep;108(3):278-287. Disponible en: https://www.aafp.org/pubs/afp/issues/2023/0900/delirium-older-persons.html [Consultado 10-02-2024]

Seiler A, Schubert M, Hertler C, Schettle M, Blum D, Guckenberger M, et al. Predisposing and precipitating risk factors for delirium in palliative care patients. Palliat Support Care. 2020;18(4):437-46. https://doi.org/10.1017/s1478951519000919

Babine RL, Hyrkäs KE, Scott C, Wierman HR. Individuals Who Developed Delirium While Enrolled in the Hospital Elder Life Program: An Exploratory Study. J Gerontol Nurs. 2023 May;49(5):19-29. https://doi.org/10.3928/00989134-20230414-02

Woodhouse R, Burton JK, Rana N, Pang YL, Lister JE, Siddiqi N. Interventions for preventing delirium in older people in institutional long-term care. Cochrane Database Syst Rev. 2019 Apr 23;4(4):CD009537. https://doi.org/10.1002/14651858.cd009537.pub3

Subdirección General de Información Sanitaria. Ministerio de Sanidad, Gobierno de España. Salud mental en datos: prevalencia de los problemas de salud y consumo de psicofármacos y fármacos relacionados a partir de registros clínicos de atención primaria. Madrid: Ministerio de Sanidad; 2021. Disponible en: https://www.sanidad.gob.es/estadEstudios/estadisticas/estadisticas/estMinisterio/SIAP/Salud_mental_datos.pdf [Consultado 10-02-2024]

Lafarga-Molina L, Oriol Casanovas-Marsal, González de la Cuesta D. Estudio cuasi-experimental sobre intervenciones enfermeras en la valoración, manejo y prevención del síndrome confusional agudo. Rev Esp Salud Pública. 2023;97: e202310092. Disponible en: https://ojs.sanidad.gob.es/index.php/resp/article/view/172/297 [Consultado 11-02-2024]

Urfer Dettwiler P, Zúñiga F, Bachnick S, Gehri B, de Jonghe JFM, Hasemann W. Detecting delirium in nursing home residents using the Informant Assessment of Geriatric Delirium (I-AGeD): a validation pilot study. Eur Geriatr Med. 2022;13(4):917-31. https://doi.org/10.1007/s41999-022-00612-w

Miranda F, Gonzalez F, Plana MN, Zamora J, Quinn TJ, Seron P. Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) for the diagnosis of delirium in adults in critical care settings. Cochrane Database Syst Rev. 2023;11(11):CD013126. https://doi.org/10.1002/14651858.cd013126.pub2

Parra Santiago A, Barragán Martínez D, Tejeiro Martínez J. Protocolo diagnóstico y terapéutico del síndrome confusional agudo. Medicine. 2019;12(74):4371-5. https://doi.org/10.1016/j.med.2019.03.016

Li Y, Ma J, Jin Y, Li N, Zheng R, Mu W, et al. Benzodiazepines for treatment of patients with delirium excluding those who are cared for in an intensive care unit. Cochrane Database Syst Rev. 2020;2(2):CD012670. https://doi.org/10.1002/14651858.cd012670.pub2

Wang J, Niu S, Wu Y. Effect of the clinical decision assessment system on clinical outcomes of delirium in hospitalized older adults: study protocol for a pair-matched, parallel, cluster randomized controlled superiority trial. Trials. 2023;24(1):581. https://doi.org/10.1186/s13063-023-07607-3

Finucane AM, Jones L, Leurent B, Sampson EL, Stone P, Tookman A, et al. Drug therapy for delirium in terminally ill adults. Cochrane Database Syst Rev. 2020;1(1):CD004770. https://doi.org/10.1002/14651858.cd004770.pub3

Burry L, Hutton B, Williamson DR, Mehta S, Adhikari NK, Cheng W, et al. Pharmacological interventions for the treatment of delirium in critically ill adults. Cochrane Database Syst Rev. 2019;9(9):CD011749. https://doi.org/10.1002/14651858.cd011749.pub2

Rodríguez Cruz VE, Torres Palacios LP, Cali Adriano MP, Villafuerte Lozada EM, Eugenio Quingatuña, Ballesteros Reyes EP, et al. Avances en el manejo del delirium en los pacientes geriátricos. Arch Venez Farmacol Ter. 2020;39(1):1-4. https://doi.org/10.5281/zenodo.4058882

Burton JK, Craig LE, Yong SQ, Siddiqi N, Teale EA, Woodhouse R, et al. Non-pharmacological interventions for preventing delirium in hospitalised non-ICU patients. Cochrane Database Syst Rev. 2021;7(7):CD013307. https://doi.org/10.1002/14651858.cd013307.pub2

Liang S, Chau JPC, Lo SHS, Zhao J, Liu W. Non-pharmacological delirium prevention practices among critical care nurses: a qualitative study. BMC Nurs. 2022 Aug 25;21(1):235. https://doi.org/10.1186/s12912-022-01019-5

Fernández Herranz J, García-Espona Pancorbo A, Castuera Gil AI, Miguens Blanco I. Síndrome confusional agudo. Medicine. 2023;13(90):5317-25. https://doi.org/10.1016/j.med.2023.11.002

Lynn M, Goulden B, Parmar M, Knopp P, Yeung M, Giles I, et al. Play attention! Therapeutic aspects to play in delirium prevention and management. Wellcome Open Res. 2020;5:277. https://doi.org/10.12688/wellcomeopenres.16199.1

Sánchez Artero MJ, Nadales Rojas MI, Nava García P, Nieves Carnicer M. Protocolo diagnóstico y tratamiento del síndrome confusional agudo. Medicine. 2023;13(85):5046-50. https://doi.org/10.1016/j.med.2023.08.016

Fong TG, Inouye SK. The inter-relationship between delirium and dementia: the importance of delirium prevention. Nat Rev Neurol. 2022;18(10):579-96. https://doi.org/10.1038/s41582-022-00698-7

Sillner AY, Berish D, Mailhot T, Sweeder L, Fick DM, Kolanowski AM. Delirium superimposed on dementia in post-acute care: Nurse documentation of symptoms and interventions. Geriatr Nurs. 2023;49:122-6. https://doi.org/10.1016/j.gerinurse.2022.11.015

Henao Castaño ÁM, Baquero Lizarazo AC, González Pabón N, Burgos Tulcán GF, Lozano González L. Enfermería en la monitorización del delirium en cuidado intensivo adulto: una revisión de alcance. Investig Enferm Imagen Desarro. 2020;22. https://doi.org/10.11144/Javeriana.ie22.emdc

Bento MSPM, Marques RMD, Sousa PP. Delirium: intervenciones de enfermería en el adulto hospitalizado – una revisión bibliográfica. Enferm Glob. 2018;17(4):640-88. Disponible en: https://revistas.um.es/eglobal/article/view/eglobal.17.4.302971/250291 [Consultado 15-02-2024]

Bloomer MJ, Woszczeiko C, Hutchinson AM. Older age, delirium, dementia, frailty, and critical care: Care priorities. Intensive Crit Care Nurs. 2022;73:103297. https://doi.org/10.1016/j.iccn.2022.103297

Kinalski SS, Beuter M, Benetti ERR, Leite MT, Venturini L, Brandão MAG. Nursing microtheory in the prevention of delirium in older adult in the intensive care unit. Rev. Latino-Am. Enfermagem. 2023;31:e4071. https://doi.org/10.1590/1518-8345.6707.4071

Elsevier. NNNConsult. Amsterdam: Elsevier; 2024. Disponible en: https://www.nnnconsult.com/nanda/pat [Consultado 25-10-2024]

Goldberg TE, Chen C, Wang Y, Jung E, Swanson A, Ing C, García PS, et al. Association of Delirium With Long-term Cognitive Decline: A Meta-analysis. JAMA Neurol. 2020;77(11):1373-81. https://doi.org/10.1001/jamaneurol.2020.2273

Livingston G, Huntley J, Sommerlad A, Ames D, Ballard C, Banerjee S, et al. Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. Lancet. 2020;396(10248):413-46. https://doi.org/10.1016/s0140-6736(20)30367-6

Grey T, Fleming R, Goodenough BJ, Xidous D, Möhler R, O´Neill D. Hospital design for older people with cognitive impairment including dementia and delirium: supporting inpatients and accompanying persons. Cochrane Database Syst Rev. 2019;11:CD013482. https://doi.org/10.1002/14651858.CD013482

Martín-Santiago O, Alario-Ruiz C, Guerra-Valera G. Delirium and dementia retrospective cohort study. European Psychiatry. 2023;66(S1):S399–S399. Disponible en: https://www.cambridge.org/core/journals/european-psychiatry/article/delirium-and-dementia-retrospective-cohort-study/D72D27495E54DFEA597E9ECD24BE0924#article [Consultado 20-02-2024]

Steensma E, Zhou W, Ngo L, Gallagher J, Inouye S, Leslie D, et al. Ultra-brief Screeners for Detecting Delirium Superimposed on Dementia. J Am Med Dir Assoc. 2019 Nov;20(11):1391-6.e1. https://doi.org/10.1016/j.jamda.2019.05.011

Jose S, Cyriac MC, Dhandapani M. Nurses' Knowledge and Subjective Strain in Delirium Care: Impact of a Web-based Instructional Module on Nurses Competence. Indian J Crit Care Med. 2024;28(2):111-9. https://doi.org/10.5005/jp-journals-10071-24626

Lange S, Mȩdrzycka-Da Browska W, Tomaszek L, Wujtewicz M, Krupa S. Nurses' knowledge, barriers and practice in the care of patients with delirium in the intensive care unit in Poland-A cross-sectional study. Front Public Health. 2023;11:1119526. https://doi.org/10.3389/fpubh.2023.1119526

Zhou W, Zheng Q, Huang M, Zhang C, Zhang H, Yang L, Wu T, Gan X. Knowledge, attitude, and practice toward delirium and subtype assessment among Chinese clinical nurses and determinant factors: A multicentre cross-section study. Front Psychiatry. 2023 Feb 1;13:1017283. https://doi.org/10.3389/fpsyt.2022.1017283

Martínez-García M, Sánchez-López E, Fernández-Trinidad M. Managing delirium in acute inpatient units: A cross-sectional study of nursing teams' knowledge and perceived limitations. Nurs Open. 2023;10(4):2213-21. https://doi.org/10.1002/nop2.1471

Lee G, Roh YS. Knowledge, barriers, and training needs of nurses working in delirium care. Nurs Crit Care. 2023;28(5):637-44. https://doi.org/10.1111/nicc.12724

Ormonde C, Igwe EO, Nealon J, O'Shaughnessy P, Traynor V. Delirium education and post-anaesthetics care unit nurses' knowledge on recognising and managing delirium in older patients. Aging Clin Exp Res. 2023;35(5):995-1003. https://doi.org/10.1007/s40520-023-02390-2

Grover S, Mehra A, Sharma N, Sahoo S, Dua D. Knowledge and Attitude of Nurses Toward Delirium. Ann Indian Psychiatry. 2022;6(1):73-81. https://doi.org/10.4103/aip.aip_134_21

Marquetand J, Gehrke S, Bode L, Fuchs S, Hildenbrand F, Ernst J, et al. Delirium in trauma patients: a 1-year prospective cohort study of 2026 patients. Eur J Trauma Emerg Surg. 2022;48(2):1017-24. https://doi.org/10.1007/s00068-021-01603-5

Marquetand J, Bode L, Fuchs S, Ernst J, von Känel R, Boettger S. Predisposing and Precipitating Factors for Delirium in the Very Old (≥80 Years): A Prospective Cohort Study of 3,076 Patients. Gerontology. 2021;67(5):599-607. https://doi.org/10.1159/000514298

Marquetand J, Bode L, Fuchs S, Hildenbrand F, Ernst J, von Kaenel R, Boettger S. Risk Factors for Delirium Are Different in the Very Old: A Comparative One-Year Prospective Cohort Study of 5,831 Patients. Front Psychiatry. 2021;12:655087. https://doi.org/10.3389/fpsyt.2021.655087

Zipser CM, Deuel J, Ernst J, Schubert M, Weller M, von Känel R, et al. Predisposing and precipitating factors for delirium in neurology: a prospective cohort study of 1487 patients. J Neurol. 2019 Dec;266(12):3065-3075. https://doi.org/10.1007/s00415-019-09533-4

Ormseth CH, LaHue SC, Oldham MA, Josephson SA, Whitaker E, Douglas VC. Predisposing and Precipitating Factors Associated With Delirium: A Systematic Review. JAMA Netw Open. 2023;6(1):e2249950. https://doi.org/10.1001/jamanetworkopen.2022.49950

Carvalho LAC, Correia MDL, Ferreira RC, Botelho ML, Ribeiro E, Duran ECM. Accuracy of delirium risk factors in adult intensive care unit patients. Rev Esc Enferm USP. 2022;56:e20210222. https://doi.org/10.1590/1980-220x-reeusp-2021-0222

Jayaswal AK, Sampath H, Soohinda G, Dutta S. Delirium in medical intensive care units: Incidence, subtypes, risk factors, and outcome. Indian J Psychiatry. 2019;61(4):352-8. https://doi.org/10.4103/psychiatry.indianjpsychiatry_583_18

Papaioannou M, Papastavrou E, Kouta C, Tsangari H, Merkouris A. Investigating nurses' knowledge and attitudes about delirium in older persons: a cross-sectional study. BMC Nurs. 2023;22(1):10. https://doi.org/10.1186/s12912-022-01158-9

Yu M, Mi J, Zhang C, Chen H, Luo X. Knowledge, attitude and practice regarding hypoactive delirium among ICU nurses: A nationwide cross-sectional study. Nurse Educ Pract. 2023;72:103749. https://doi.org/10.1016/j.nepr.2023.103749

Baluku Murungi E, Niyonzima V, Atuhaire E, Nantume S, Beebwa E. Improving Nurses Knowledge and Practices of Delirium Assessment at Mbarara Regional Referral Hospital: A Quasi Experimental Study. Adv Med Educ Pract. 2023;14:313-22. https://doi.org/10.2147/amep.s398606

Ho MH, Chang HR, Liu MF, Chen KH, Shen Hsiao ST, Traynor V. Recognizing Intensive Care Unit Delirium: Are Critical Care Nurses Ready? J Nurs Res. 2022;30(3):e214. https://doi.org/10.1097/jnr.0000000000000487

Dylan F, Byrne G, Mudge AM. Delirium risk in non-surgical patients: systematic review of predictive tools. Arch Gerontol Geriatr. 2019;83:292-302. https://doi.org/10.1016/j.archger.2019.05.013

Zipser CM, Deuel J, Ernst J, Schubert M, von Känel R, Böttger S. The predisposing and precipitating risk factors for delirium in neurosurgery: a prospective cohort study of 949 patients. Acta Neurochir (Wien). 2019;161(7):1307-15. https://doi.org/10.1007/s00701-019-03927-z

Skretteberg WH, Holmefoss I, Krogseth M. Delirium During Acute Events in Nursing Home Patients. J Am Med Dir Assoc. 2022 Jan;23(1):146-9. https://doi.org/10.1016/j.jamda.2021.10.006

Junior MM, Kumar A, Kumar P, Gupta P. Assessment of Delirium as an Independent Predictor of Outcome among Critically Ill Patients in Intensive Care Unit: A Prospective Study. Indian J Crit Care Med. 2022;26(6):676-81. https://doi.org/10.5005/jp-journals-10071-23907

Berger E, Wils EJ, Vos P, van Santen S, Koets J, Slooter AJC, et al. Prevalence and management of delirium in intensive care units in the Netherlands: An observational multicentre study. Intensive Crit Care Nurs. 2020;61:102925. https://doi.org/10.1016/j.iccn.2020.

Descargas

Publicado

2025-06-18

Cómo citar

1.
Ruiz Rubio L. Delirium y Enfermería en adultos y adultos mayores. Revisión de la literatura. Enferm. cuid. [Internet]. 18 de junio de 2025 [citado 27 de junio de 2025];8. Disponible en: https://enfermeriacuidandote.com/article/view/7219

Número

Sección

Artículos