Delirium Stigma Among Healthcare Staff.

Elizabeta Mukaetova-Ladinska,Ann Scully,Mahathir Chan,Glynis Cosker,Sung-Wan Kim,Seon-Young Kim,Michael Coppock,Andrew Teodorczuk,Richard Mcnally

doi:10.3390/geriatrics4010006

Abstract

Older people with delirium occupy more than one third of acute medical beds and require increased medical attention, as care at present is suboptimal. In addition, since delirium is undetected, it should form a target for teaching in wards. Moreover, as people with delirium are largely dependent on daily interactions and care by inpatients professional staff, it is important to address stigmatisation of these vulnerable patients. This is especially important as previous studies have shown that negative staff attitudes towards these patients undermine good care. This single center cross-sectional study was designed to determine the extent of institutional stigma among health professionals involved in the care of people with delirium. For this, professional staff working on medical wards and in communities were approached to fill in a questionnaire containing the adapted Delirium Stigma Scale and the EuroQol five dimensions (EQ-5D-5L) questionnaire. Additional demographic information concerning their education and professional and personal experience with delirium was also collected. The characteristics associated with stigma were determined from the sample. The findings of our study provide an insight into the high level of stigmatisation of delirium patients among professionals (mean 11.66/18 points). This was not related to professionals’ own experiences of delirium, their educational and professional backgrounds, or them having received formal delirium education. However, working closely with people with delirium seems to have a positive impact on the de-stigmatisation of this population among health professionals. Our findings that attitudes are not influenced by formal delirium teaching need to be incorporated into the design of interprofessional educational interventions. Accordingly, we advocate more direct patient-oriented and care delivered teaching interventions.

Highlights

Delirium patients represent more than one third of all older people admitted to acute medical beds
Working closely with people with delirium seems to have a positive impact on the de-stigmatisation of this population among health professionals
Whereas research advancement has largely concentrated on causes, detection and management of delirium [5,6] and educational interventions [7], there is scant work on potential stigma experienced by people with delirium by professionals involved in their care

Summary

Introduction

Delirium patients represent more than one third of all older people admitted to acute medical beds. Whereas research advancement has largely concentrated on causes, detection and management of delirium [5,6] and educational interventions [7], there is scant work on potential stigma experienced by people with delirium by professionals involved in their care. The latter is important since people with delirium are largely dependent on daily interactions with medical, nursing, and other affiliated professionals who care for them during an episode of acute confusion. Our previous qualitative research has determined that negative attitudes towards patients with delirium by hospital staff undermine care processes [7]

Methods

Results

Conclusion