Delirium Experiences in ICU Patients: A Meta-Synthesis of Qualitative Studies.

Résumé

BACKGROUND: Delirium is common in the ICU, but little research has been undertaken to better understand the delirium experience from the patient's viewpoint.AIM: To summarise the current qualitative evidence on the experiences and perceptions of delirium in ICU patients.STUDY DESIGN: A meta-synthesis of qualitative studies was conducted in China National Knowledge Infrastructure (CNKI), Wanfang, VIP Database, China Biomedical Literature Database (CBLD), Cochrane Library, PubMed, Ovid MEDLINE, Web of Science, CINAHL, Scopus, FMRS and Embase from inception to August 2024. All studies that presented qualitative findings on the experiences, memories, subjective perceptions, feelings and needs of ICU delirium patients, based on participants' self-reports, were included. Publication year, location, sample size, delirium assessment methods, study design, data collection method and mode, phenomenon of interest, all qualitative themes identified and reported and participant quotes where appropriate.FINDINGS: Nine studies were included and 38 research findings were extracted and categorised into 10 new themes, resulting in three synthesised findings: (1) the multiple dilemmas faced by ICU delirium patients, (2) the cognitive differences and varying coping strategies in the ICU delirium experience (3) and the desire for support from both family and professional caregivers.CONCLUSIONS: Delirium manifests with heterogeneous short- and long-term consequences, adversely affecting patients' physical, psychological, social and spiritual well-being. The comprehensive burden of delirium in ICU patients is closely monitored by both family members and professional caregivers, who represent a potentially underutilised source of critical observational data.RELEVANCE TO CLINICAL PRACTICE: To enhance healthcare professionals' comprehension of the delirium experience in critically ill patients, with a particular focus on distinguishing between patients' subjective emotional states and their externally observable coping behaviours.