Incidence and Related Factors of Acute Confusion among the Medical Hospitalized Elderly

內科住院老年人急性混亂發生率及相關因素之探討

吳麗芬(Li-Fen Wu)

《榮總護理》 19卷3期 (2002/09) Pp. 306-316

https://doi.org/10.6142/VGHN.19.3.306

摘要

“急性混亂”又名譫妄，是一項老年住院病人容易發生但常被忽略的臨床症狀，此症狀若未能即時被發現，便經常導致病人死亡、延長住院天數及增加護理的工作量。本研究的目的在瞭解內科住院老年人急性混亂的發生率及相關因素。研究以急性混亂行爲量表爲工具，進行24小時連續性監測，並分別由三班護理人員記錄監利結果。結果發現，某醫學中心12個內科及綜合科病房中，共有671位病人，其中經過篩檢合乎收案條件的85位個案中有16位在住院期間發生急性混亂，發生率爲18.8%；發生的時間由住院當天起，最多爲住院後第二天，在住院第七天後沒有新的個案發生。多數個案在夜間10時至午夜2時的急性混亂症狀最明顯。研究中同時發現，視力不清楚及個案聽力差時，產生混亂的機率較高；血液檢查無單項檢驗結果與混亂有直接關係；發生急性混亂個案與未發生者間的行爲有很明顯的差異。本研究的結果有助於增加護理人員對急性混亂高危險群認知的敏感度，使其能及早正確診斷出急性混亂，並做正確且適當之預防或護理處置。

關鍵字

內科住院老年人 ； 急性混亂 ； 發生率 ； 相關因素

並列摘要

”Acute confusion,” alias delirium, is a clinical phenomenon commonly found among hospitalized elders. If not corrected in time, it will increase mortality, prolong the number of days of hospitalization, and increase nursing workload. The goals of this study were to understand the incidence and related factors of acute confusion among the medical hospitalized elderly. By using the Acute Confusion Behavior Scale as an instrument, three-shift nurses performed a 24-hour continuingly monitoring and recording. It showed that there were 671 patients in twelve medical and general wards. Among them, 16 patients were with acute confusion in hospitalization in 85 patients who were qualified after screening. The incidence of acute confusion was 18.8%. The onset of acute confusion was from the first hospitalized day to the following day and there were no new findings of acute confusion after the seventh day of hospitalization. The features of acute confusion were much more obvious at midnight from 10 p.m. to 2 a.m. Participants with hearing and visual impairment had greater incidence of acute confusion. The laboratory findings did not associate with acute confusion. Acutely confused patients had really different behaviors compared to non-confused patients. Our study is helpful to elevate nurses' sensibility to detect high-risk group with acute confusion which will enable them to recognize acute confusion as soon as possible and intervene correctly for prevention or treatment of acute confusion.

並列關鍵字

medical hospitalized elders ； acute confusion ； incidence ； related factors