Experience of nurses in identifying delirium among cancer patients: A qualitative study

Authors

  • Nurul Huda Department of Nursing, Universitas Riau, Riau City, Indonesia https://orcid.org/0000-0002-6981-7196
  • Hellena Deli Department of Nursing, Universitas Riau, Riau City, Indonesia
  • Sri Wahyuni Department of Nursing, Universitas Riau, Riau City, Indonesia
  • Erwin Department of Nursing, Universitas Riau, Riau City, Indonesia
  • Satriya Pranata Department of Nursing, Universitas Muhammadiyah Semarang, Semarang, Indonesia https://orcid.org/0000-0002-2026-8931
  • Sri Wahyuni Department of Nursing, Universitas Yayasan Pendidikan Imam Bonjol Majalengka, Majalengka, Indonesia https://orcid.org/0000-0002-7450-9841

DOI:

https://doi.org/10.3329/bsmmuj.v18i1.75386

Keywords:

delirium, assessment, nursing, cancer

Abstract

Background: Information about how nurses screen for delirium in cancer patients can provide insights into improving recognition. This study aimed to investigate the experiences of nurses while identifying delirium in cancer patients.

Methods: The study's design was qualitative, using thematic analysis. Data were gathered via a focus group discussion with ten nurses from two oncological wards of Nursing and Health Research Universitas Riau, Pekan Baru Riau, Indonesia. The focus group discussion lasted roughly 90 minutes. Participants provided feedback on their experiences with assessment in delirium through semi-structured and open-ended questions. Data collection occurred in September 2023 at two oncology wards. Data analysis in this phenomenological research used the Collaizzi method to describe the meaning of an experience identified through the important themes of a phenomenon consisting of seven stages.

Results: Categories, subcategories and themes were constructed. Experiences of nurses in identifying delirium among cancer patients were identified i) delirium, agitation and confusion are almost similar  (the term delirium is not well known, and the type of delirium is not familiar); ii) tools for assessing delirium are needed (the tool does not exist and is unknown, used clinical experiences supported by laboratory testing); and iii) nurses can play an important role in identifying delirium (important role in assessing delirium, advising to prevent delirium among healthcare professionals).

Conclusion: Nurses who work in oncology wards need to know more about delirium screening since they play an important role in early detection and treatment. Therefore, appropriate knowledge and measurement tools are required to identify delirium earlier among cancer patients.

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References

Faeder M, Hale E, Hedayati D, Israel A, Moschenross D, Peterson M, Peterson R, Piechowicz M, Punzi J, Gopalan P. Preventing and treating delirium in clinical settings for older adults. Ther Adv Psychopharmacol. 2023 Sep 8;13:20451253231198462. DOI: https://doi.org/10.1177/20451253231198462

Sadeghirad B, Dodsworth BT, Schmutz Gelsomino N, Goettel N, Spence J, Buchan TA, Crandon HN, Baneshi MR, Pol RA, Brattinga B, Park UJ, Terashima M, Banning LBD, Van Leeuwen BL, Neerland BE, Chuan A, Martinez FT, Van Vugt JLA, Rampersaud YR, Hatakeyama S, Di Stasio E, Milisen K, Van Grootven B, van der Laan L, Thomson Mangnall L, Goodlin SJ, Lungeanu D, Denhaerynck K, Dhakharia V, Sampson EL, Zywiel MG, Falco L, Nguyen AV, Moss SJ, Krewulak KD, Jaworska N, Plotnikoff K, Kotteduwa-Jayawarden S, Sandarage R, Busse JW, Mbuagbaw L. Perioperative Factors Associated With Postoperative Delirium in Patients Undergoing Noncardiac Surgery: An Individual Patient Data Meta-Analysis. JAMA Netw Open. 2023 Oct 2;6(10):e2337239. DOI: https://doi.org/10.1001/jamanetworkopen.2023.37239

Tomczyk K, Jurasz K, Chojnacka N, Klarycki J, Podgórska D, Cymer R, Rzeska E, Sanecki M. Hospital Hallucinosis - where to look for the cause of the delirious syndrome in a geriatric patient and what management to implement. J Educ Heal Sport. 2024;53:102-125. DOI: https://doi.org/10.12775/jehs.2024.53.008

Martínez-Arnau FM, Buigues C, Pérez-Ros P. Incidence of delirium in older people with cancer: Systematic review and meta-analysis. Eur J Oncol Nurs. 2023 Dec;67:102457. DOI: https://doi.org/10.1016/j.ejon.2023.102457

Poulin TG, Jaworska N, Stelfox HT, Fiest KM, Moss SJ. Clinical practice guideline recommendations for diagnosis and management of anxiety and depression in hospitalized adults with delirium: a systematic review. Syst Rev. 2023 Sep 25;12(1):174. DOI: https://doi.org/10.1186/s13643-023-02339-6

Featherstone I, Siddiqi N, Jones L, Coppo E, Sheldon T, Hosie A, Wolkowski A, Bush SH, Taylor J, Teodorczuk A, Johnson MJ. 'It's tough. It is hard': A qualitative interview study of staff and volunteers caring for hospice in-patients with delirium. Palliat Med. 2023 Jul;37(7):993-1005. DOI: https://doi.org/10.1177/02692163231170655

Zhou W, Zheng Q, Huang M, Zhang C, Zhang H, Yang L, Wu T, Gan X. Knowledge, attitude, and practice toward delirium and subtype assessment among Chinese clinical nurses and determinant factors: A multicentre cross-section study. Front Psychiatry. 2023 Feb 1;13:1017283. DOI: https://doi.org/10.3389/fpsyt.2022.1017283

Gandhi I, Sharma R. Improving Delirium Assessment in Palliative Homecare: A quality improvement project at CanSupport. Indian J Palliat Care. 2023 Jan-Mar;29(1):70-74. DOI: https://doi.org/10.25259/IJPC_48_2022

Mion LC, Tan A, Brockman A, Tate JA, Vasilevskis EE, Pun BT, Rosas SR, Balas MC. An Exploration of Critical Care Professionals' Strategies to Enhance Daily Implementation of the Assess, Prevent, and Manage Pain; Both Spontaneous Awakening and Breathing Trials; Choice of Analgesia and Sedation; Delirium Assess, Prevent, and Manage; Early Mobility and Exercise; and Family Engagement and Empowerment: A Group Concept Mapping Study. Crit Care Explor. 2023 Mar 3;5(3):e0872. DOI: https://doi.org/10.1097/CCE.0000000000000872

Saviano A, Zanza C, Longhitano Y, Ojetti V, Franceschi F, Bellou A, Voza A, Ceresa IF, Savioli G. Current Trends for Delirium Screening within the Emergency Department. Medicina (Kaunas). 2023 Sep 8;59(9):1634. DOI: https://doi.org/10.3390/medicina59091634

Solberg LM, Duckworth LJ, Dunn EM, Dickinson T, Magoc T, Snigurska UA, Ser SE, Celso B, Bailey M, Bowen C, Radharkrishnan N, Patel CR, Lucero R, Bjarnadottir R . Use of a Data Repository to Identify Delirium as a Presenting Symptom of COVID-19 Infection in Hospitalized Adults: Cross-Sectional Cohort Pilot Study. JMIR Aging. 2023;6:e43185. DOI: https://doi.org/10.2196/43185

Llisterri-Sánchez P, Benlloch M, Pérez-Ros P. The Confusion Assessment Method Could Be More Accurate than the Memorial Delirium Assessment Scale for Diagnosing Delirium in Older Cancer Patients: An Exploratory Study. Curr Oncol. 2023 Sep 6;30(9):8245-8254. DOI: https://doi.org/10.3390/curroncol30090598

Aldwikat RK, Manias E, Holmes AC, Tomlinson E, Nicholson P. Associations of postoperative delirium with activities of daily living in older people after major surgery: A prospective cohort study. J Clin Nurs. 2023 Oct;32(19-20):7578-7588. DOI: https://doi.org/10.1111/jocn.16801

Polit DF, Beck CT. Essentials of nursing research: Appraising evidence for nursing practice. 8th ed. Philadelphia: Lippincott Williams and Wilkins. p. 585

Recchia A, Rizzi B, Favero A, Nobili A, Pasina L. Prevalence of Delirium in End-of-Life Palliative Care Patients: An Observational Study. Med Princ Pract. 2022;31(2):118-124. DOI: https://doi.org/10.1159/000521994

Bush SH, Lawlor PG, Ryan K, Centeno C, Lucchesi M, Kanji S, Siddiqi N, Morandi A, Davis DHJ, Laurent M, Schofield N, Barallat E, Ripamonti CI; ESMO Guidelines Committee. Delirium in adult cancer patients: ESMO Clinical Practice Guidelines. Ann Oncol. 2018 Oct 1;29(Suppl 4):iv143-iv165. DOI: https://doi.org/10.1093/annonc/mdy147

Boccardi V, Ercolani S, Serra R, Bubba V, Piccolo A, Scamosci M, Villa A, Ruggiero C, Mecocci P. Hypomagnesemia and incident delirium in hospitalized older persons. Aging Clin Exp Res. 2023 Apr;35(4):847-853. DOI: https://doi.org/10.1007/s40520-023-02357-3

Gagnon P, Allard P, Mâsse B, DeSerres M. Delirium in terminal cancer: a prospective study using daily screening, early diagnosis, and continuous monitoring. J Pain Symptom Manage. 2000 Jun;19(6):412-426. DOI: https://doi.org/10.1016/s0885-3924(00)00143-3

Horacek R, Krnacova B, Prasko J, Latalova K. Delirium as a complication of the surgical intensive care. Neuropsychiatr Dis Treat. 2016 Sep 22;12:2425-2434. DOI: https://doi.org/10.2147/NDT.S115800

Stevens E, Scott EME. Delirium Among Patients With Cancer in the Intensive Care Unit: Prognostic Sign or Opportunity for Intervention. JCO Oncol Pract. 2023 Jun;19(6):327-329. DOI: https://doi.org/10.1200/OP.23.00061

Khan BA, Guzman O, Campbell NL, Walroth T, Tricker JL, Hui SL, Perkins A, Zawahiri M, Buckley JD, Farber MO, Ely EW, Boustani MA. Comparison and agreement between the Richmond Agitation-Sedation Scale and the Riker Sedation-Agitation Scale in evaluating patients' eligibility for delirium assessment in the ICU. Chest. 2012 Jul;142(1):48-54. DOI: https://doi.org/10.1378/chest.11-2100

Published

2025-03-13

How to Cite

Huda, N., Deli, H., Wahyuni, S., Erwin, Pranata, S., & Wahyuni, S. (2025). Experience of nurses in identifying delirium among cancer patients: A qualitative study. Bangabandhu Sheikh Mujib Medical University Journal, 18(1), e75386. https://doi.org/10.3329/bsmmuj.v18i1.75386

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Research Article

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