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

Published online by Cambridge University Press:  20 December 2012

Andrew Teodorczuk ,
Elizabeta Mukaetova-Ladinska ,
Sally Corbett  and
Mark Welfare
Andrew Teodorczuk*
Affiliation:
Institute for Ageing and Health, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, United Kingdom
Elizabeta Mukaetova-Ladinska
Affiliation:
Institute for Ageing and Health, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, United Kingdom
Sally Corbett
Affiliation:
Education Centre, Northumbria Healthcare NHS Foundation Trust, North Tyneside Hospital, North Shields, England, United Kingdom
Mark Welfare
Affiliation:
Education Centre, Northumbria Healthcare NHS Foundation Trust, North Tyneside Hospital, North Shields, England, United Kingdom
*
Correspondence should be addressed to: Dr Andrew Teodorczuk, Institute for Ageing and Health, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne NE4 6BE, United Kingdom. Phone: +44 191 246 8658; Fax: +44 191 293 8617. Email: Andrew.Teodorczuk@ncl.ac.uk.
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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.

Keywords

deliriumeducationtrainingteachingliaison
Type
Research Article
Information
International Psychogeriatrics , Volume 25 , Issue 4 , April 2013 , pp. 645 - 655
Copyright
Copyright © International Psychogeriatric Association 2012

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