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Reconceptualizing models of delirium education: findings of a Grounded Theory study

Lookup NU author(s): Dr Andrew Teodorczuk, Dr Elizabeta Mukaetova-Ladinska, Dr Mark Welfare

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Abstract

Background: Effectiveness of educational interventions targeted at improving delirium care is limited by implementation barriers. Studying factors which shape learning needs can overcome these knowledge transfer barriers. This in-depth qualitative study explores learning needs of hospital staff relating to care needs of the confused older patients. Methods: Fifteen research participants from across the healthcare spectrum working within an acute care setting were interviewed. Five focus groups were undertaken with patients, carers, and mental health specialists. A Grounded Theory methodology was adopted and data were analyzed thematically in parallel to collection until theoretical saturation was reached. Results: Eight categories of practice gap emerged: ownership of the confused patient, negative attitudes, lack of understanding of how frightened the patient is in hospital, carer partnerships, person-centered care, communication, recognition of cognitive impairment and specific clinical needs (e. g. capacity assessments). Conceptually, the learning needs were found to be hierarchically related. Moreover, a vicious circle relating to the core learning needs of ownership, attitudes and patient's fear emerged. A patient with delirium may be frightened in an alien environment and then negatively labeled by staff who subsequently wish for their removal, thereby worsening the patient's fear. Discussion: These findings reconceptualize delirium education approaches suggesting a need to focus interventions on core level practice gaps. This fresh perspective on education, away from disease-based delirium knowledge toward work-based patient, team and practice knowledge, could lead to more effective educational strategies to improve delirium care.

Publication metadata

Author(s): Mukaetova-Ladinska E; Welfare M; Teodorczuk A; Corbett S

Publication type: Article

Publication status: Published

Journal: International Psychogeriatrics

Year: 2013

Volume: 25

Issue: 4

Pages: 645-655

Print publication date: 20/12/2012

ISSN (print): 1041-6102

ISSN (electronic): 1741-203X

Publisher: Cambridge University Press

URL: http://dx.doi.org/10.1017/S1041610212002074

DOI: 10.1017/S1041610212002074

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