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The meaning of acute confusional state from the perspective of elderly patients
Department of Nursing, University of Lund.
Department of Nursing, University of Lund.
Department of Nursing, Umeå University.
Department of Nursing, University of Lund.ORCID iD: 0000-0003-0161-4795
2002 (English)In: International Journal of Geriatric Psychiatry, ISSN 0885-6230, E-ISSN 1099-1166, Vol. 17, no 7, p. 652-63Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: The aim of this study was to illuminate lived experience of having been in an acute confusional state (ACS) as narrated by elderly patients in orthopaedic care.

METHOD: Qualitative study with phenomenological hermeneutic method for analysing the data based on narrative interviews. Fifty patients (67-96 years of age) who developed ACS during hospitalisation and in all cases the ACS ceased during their stay on the ward were interviewed once lucid again regarding the course of the event, their experiences, memories and interpretation of what had happened during the ACS.

RESULTS: The meaning of the patients' lived experiences of being and having been confused was interpreted as 'Being trapped in incomprehensible experiences and a turmoil of past and present and here and there', comprising the themes trying to get a grip on the experience of the confusion, encountering past, present and the realm of the imagination as reality during the period of confusion and confronting the idea of having been confused. Contradictory to earlier research the patients remembered and could tell in great detail about their ACS. While confused, the confusional state means that impressions of all kinds invade the mind of the person and are experienced as reality, making him/her a victim of these impressions rather than the one who controls what comes into his/her mind. While in the middle of these experiences the person simultaneously senses that the impressions are unreal, thus indicating that he/she is in some sort of borderland between understanding and not understanding. The things that come into the mind of the person can either be frightening or neutral or enjoyable scenarios that seem to be mainly familiar but can also be unknown. These scenarios seem to be a mixture of past and present, of events and people while they seem to float from location to location.

CONCLUSIONS: The findings indicates that what takes place during the ACS is not nonsense but probably a mix of the patient's life history, their present situation and above all a form of communication concerning their emotional state and inner experiences in this new situation. The findings also indicated that one possible approach to the patients is to confirm and support the patients in narrating their experiences both during the confusion and also after the ACS had ceased.

Place, publisher, year, edition, pages
2002. Vol. 17, no 7, p. 652-63
Keyword [en]
confusion, delirium, nursing care, elderly, memory
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:hkr:diva-8897DOI: 10.1002/gps.682PubMedID: 12112164OAI: oai:DiVA.org:hkr-8897DiVA: diva2:477101
Available from: 2012-01-12 Created: 2012-01-12 Last updated: 2017-12-08Bibliographically approved

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Edberg, Anna-Karin

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