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Ingalill Rahm Hallberg

Ingalill Rahm Hallberg

Professor emerita

Ingalill Rahm Hallberg

Acute confusional episodes in elderly orthopaedic patients: the patients' actions and speech.

Author

  • Edith Andersson
  • Astrid Norberg
  • Ingalill Rahm Hallberg

Summary, in English

The aim of this study was to illuminate the pattern of confusional episodes with regard to the content of elderly patients' actions and speech. Fifty-one (11.2%) out of 457 people admitted to an orthopaedic clinic developed acute confusional state. Non-participant direct observations and daily clinical bedside follow-up observations were made during the confusional episodes, focusing on the patients' speech, actions and reactions with reference to situation, the surroundings, and the nurses' actions, including their verbal communication with the patient. The texts were analysed using manifest and latent content analysis and revealed disturbances in motor activity, speech and mood. 'Struggling to understand and to gain control when in a state of confusion and viewing oneself as being confused' was the main theme illuminated in the texts. In the struggle to achieve understanding and take control over themselves and what was currently taking place, the patients used a variety of strategies. They attempted to find clarity, to make a sensible story out of the present and to impute meaning to the present by using their life story. The findings indicated that the patients had a drive to achieve control when they were confused and that they were both aware and unaware of their state and tended to oscillate between being in a confused state and viewing their confusion from an outside perspective. The findings indicated that possibly the best approach is to support their inner drive to gain control. This means moving between confirmation of their emotional state and their perceptions and trying to introduce 'reality' when they realize their state of confusion. Thus the nurse--patient relationship perhaps needs to hold a balance between confirmation and introducing in reality.

Department/s

  • Department of Health Sciences

Publishing year

2002

Language

English

Pages

303-317

Publication/Series

International Journal of Nursing Studies

Volume

39

Issue

3

Document type

Journal article

Publisher

Elsevier

Topic

  • Nursing

Keywords

  • Communication
  • Confusion : physiopathology
  • Nurse-Patient Relations
  • Male
  • Human
  • Female
  • Support Non-U.S. Gov't
  • Orthopedics
  • Speech
  • Behavior
  • Aged
  • Aged 80 and over
  • Acute Disease

Status

Published

ISBN/ISSN/Other

  • ISSN: 1873-491X