Verkliga upplevelser av overklighet – en systematisk litteraturöversikt om patienters upplevelser av delirium

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Sammanfattning: Introduction: Delirium is an acute cerebral dysfunction which is a common occurrence for intensive care patients. The condition has been known since the 1950s and brings dire consequences to the affected patients. However, in intensive care units today it is still not a priority and correctly diagnosing patients with delirium poses many difficulties. Aim: To describe patients’ experiences of delirium while being cared for in an intensive care unit. Methods: A systematic review was conducted to generate a deeper understanding of patients’ subjective experiences. The collected data was analysed and condensed into six themes. Results: The results showed that intensive care patients with delirium experience a bizarre reality characterised by hallucinations and delusions. They often face a perceived struggle for survival where the surrounding care environment and staff can constitute a threat. The patients can experience being transported through time and place as well as feeling like they are losing themselves and the control of both body and mind. The relationship with staff and close relatives vary for patients with delirium but the need for empathy and an affirmative approach is paramount. Fear is an overall central theme in patients with delirium and the experiences still affect the patients afterwards. Talking about the experiences is important to many to receive closure. Conclusion: Delirium is a complex condition that constitutes a great suffering for those affected. It needs to be further recognized and prioritised in the clinical day-to-day work. The critical care nurse who is in close contact with patients at all hours has an important responsibility in assessing patients in regards to delirium and mitigate the suffering for those who develop it. A way to do this is through a calm demeanour, with emphasis on empathy and communication.

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