An investigation of the management of delirium in intensive care BY health care workers

In the intensive care unit, factors arising from the patients or the unit can cause changes in the psychological and mental state of patients. Health workers in intensive care units play an important part in the diagnosis and prevention of delirium. The aim of this study was to investigate the knowledge, attitudes and practice regarding the management of delirium by nurses and doctors working in intensive care. The research was performed between November 2014 and February 2015 at Dokuz Eylül University Hospital, Ege University Medical Faculty Hospital and Katip Çelebi University Atatürk Teaching and Research Hospital in the province of Izmir, Turkey. The research sample consisted of 175 health workers employed in the intensive care units of these hospitals, who consented to take part in the study. Two questionnaires were used to collect data, one devised by the researchers on sociodemographic characteristics and one developed according to the literature and in consultation with experts on knowledge, attitudes and practice regarding delirium and consisting of four sections and 47 questions. Of these, nine were on sociodemographic characteristics, 19 were on knowledge about delirium, ten concerned attitudes and nine concerned practice. Evaluation of the data obtained was performed by computer using the program Statistical Package for Social Science (SPSS). Data was expressed numerically and as percentages and means, and Kolmogrov Smirnov, Shapiro-Wilk, Mann Whitney U and Kruskal Wallis tests, and Cronbach's α and Spearman rank correlation analyses were used. It was found that the mean age of the health workers participating in the study was 30.81±3.88 years, 66.9% had received training on delirium; their knowledge level score was 12.6, their attitude score was 39.6 and their practice score was 23.6. The knowledge level of 75.4% of the participants was "good". It was found that knowledge levels increased with years of working. When a comparison was made between mean scores on knowledge of delirium and attitudes and practice according to whether the health workers had received training on delirium, a significant difference was found only in mean knowledge scores according to whether they had received training. Knowledge scores were found to be higher in those who had received training. When the scores on knowledge, attitude and practice of professional groups were compared in pairs, statistical significance was found in the differences between the knowledge and practice scores of intensive care nurses and junior doctors, the attitude scores of intensive care nurses and specialist doctors, and the attitude and practice scores of junior doctors and specialists. Examining their status on recognising delirium, 151 (86.3%) stated that they had not made a diagnosis of delirium. According to the results of the study, a very small proportion had made a diagnosis of delirium. The results of the study showed that as the knowledge scores of intensive care health workers increased their practice scores increased, and as their practice scores increased, their attitude scores also increased. Therefore it is recommended that in-service training should be given in hospitals for the diagnosis of delirium in intensive care patients, and standards should be developed for the diagnosis of delirium. Keywords: delirium, health worker, knowledge, attitude, behaviour, delirium diagnosis