Impact of Delirium and recall on the level or distress in patients with advanced cancer and their family caregivers

Eduardo Bruera, Shirley H. Bush, Jie Willey, Timotheos Paraskevopoulos, Zhijun Li, J. Lynn Palmer, Marlene Z Cohen, Debra Sivesind, Ahmed Elsayem

Research output: Contribution to journalArticle

141 Citations (Scopus)

Abstract

Background: Delirium has been the most frequent neuropsychiatry complication in patients with advanced cancer. This exploratory study aimed to determine the proportion of patients who were able to recall their experience of delirium and the level of distress experienced by patients, family caregivers, and healthcare professionals. METHODS: Patients with advanced cancer who had completely recovered from an acute delirium episode, had Memorial Delirium Assessment Scale score <13, and had a family caregiver present during the delirium were studied. Patients were given the Delirium Experience Questionnaire. Patients' and family caregivers' demographics, and the frequency and distress associated with different delirium symptoms were also collected. Bedside nurses and palliative care specialists reported the frequency of recalled delirium symptoms and their distress score. RESULTS: A total of 99 patient/family caregiver dyads participated in the study. The main identified causes for delirium were opioids. infection. brain metastases. hypercalcemia, and dehydration. There were 73 patients (74%) who remembered the episode of being delirious. with 59 of 73 patients (81%) reporting the experience as distressing (median distress level of 3). The median overall delirium distress score was higher in family caregivers (median. 3; 25%-75% quar-tile, 2-4) than in patients (median, 2; 25%-75% quartile, 0-3) (P =.0004). Bedside nurses and palliative care specialists expressed low median overall delirium distress scores (median, 0; 25%-75% quartile 0-1). CONCLUSIONS: The majority of patients with advanced cancer recalled their experience of delirium, causing moderate to severe distress in both patients and family caregivers. Appropriate interventions to reduce this distress are needed.

Original languageEnglish (US)
Pages (from-to)2004-2012
Number of pages9
JournalCancer
Volume115
Issue number9
DOIs
StatePublished - May 1 2009

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Delirium
Caregivers
Neoplasms
Palliative Care
Nurses
Neuropsychiatry
Hypercalcemia
Dehydration
Opioid Analgesics
Demography

Keywords

  • Confusion
  • Delirium
  • Neoplasms
  • Palliative care

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Bruera, E., Bush, S. H., Willey, J., Paraskevopoulos, T., Li, Z., Palmer, J. L., ... Elsayem, A. (2009). Impact of Delirium and recall on the level or distress in patients with advanced cancer and their family caregivers. Cancer, 115(9), 2004-2012. https://doi.org/10.1002/cncr.24215

Impact of Delirium and recall on the level or distress in patients with advanced cancer and their family caregivers. / Bruera, Eduardo; Bush, Shirley H.; Willey, Jie; Paraskevopoulos, Timotheos; Li, Zhijun; Palmer, J. Lynn; Cohen, Marlene Z; Sivesind, Debra; Elsayem, Ahmed.

In: Cancer, Vol. 115, No. 9, 01.05.2009, p. 2004-2012.

Research output: Contribution to journalArticle

Bruera, E, Bush, SH, Willey, J, Paraskevopoulos, T, Li, Z, Palmer, JL, Cohen, MZ, Sivesind, D & Elsayem, A 2009, 'Impact of Delirium and recall on the level or distress in patients with advanced cancer and their family caregivers', Cancer, vol. 115, no. 9, pp. 2004-2012. https://doi.org/10.1002/cncr.24215
Bruera E, Bush SH, Willey J, Paraskevopoulos T, Li Z, Palmer JL et al. Impact of Delirium and recall on the level or distress in patients with advanced cancer and their family caregivers. Cancer. 2009 May 1;115(9):2004-2012. https://doi.org/10.1002/cncr.24215
Bruera, Eduardo ; Bush, Shirley H. ; Willey, Jie ; Paraskevopoulos, Timotheos ; Li, Zhijun ; Palmer, J. Lynn ; Cohen, Marlene Z ; Sivesind, Debra ; Elsayem, Ahmed. / Impact of Delirium and recall on the level or distress in patients with advanced cancer and their family caregivers. In: Cancer. 2009 ; Vol. 115, No. 9. pp. 2004-2012.
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abstract = "Background: Delirium has been the most frequent neuropsychiatry complication in patients with advanced cancer. This exploratory study aimed to determine the proportion of patients who were able to recall their experience of delirium and the level of distress experienced by patients, family caregivers, and healthcare professionals. METHODS: Patients with advanced cancer who had completely recovered from an acute delirium episode, had Memorial Delirium Assessment Scale score <13, and had a family caregiver present during the delirium were studied. Patients were given the Delirium Experience Questionnaire. Patients' and family caregivers' demographics, and the frequency and distress associated with different delirium symptoms were also collected. Bedside nurses and palliative care specialists reported the frequency of recalled delirium symptoms and their distress score. RESULTS: A total of 99 patient/family caregiver dyads participated in the study. The main identified causes for delirium were opioids. infection. brain metastases. hypercalcemia, and dehydration. There were 73 patients (74{\%}) who remembered the episode of being delirious. with 59 of 73 patients (81{\%}) reporting the experience as distressing (median distress level of 3). The median overall delirium distress score was higher in family caregivers (median. 3; 25{\%}-75{\%} quar-tile, 2-4) than in patients (median, 2; 25{\%}-75{\%} quartile, 0-3) (P =.0004). Bedside nurses and palliative care specialists expressed low median overall delirium distress scores (median, 0; 25{\%}-75{\%} quartile 0-1). CONCLUSIONS: The majority of patients with advanced cancer recalled their experience of delirium, causing moderate to severe distress in both patients and family caregivers. Appropriate interventions to reduce this distress are needed.",
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AU - Bush, Shirley H.

AU - Willey, Jie

AU - Paraskevopoulos, Timotheos

AU - Li, Zhijun

AU - Palmer, J. Lynn

AU - Cohen, Marlene Z

AU - Sivesind, Debra

AU - Elsayem, Ahmed

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N2 - Background: Delirium has been the most frequent neuropsychiatry complication in patients with advanced cancer. This exploratory study aimed to determine the proportion of patients who were able to recall their experience of delirium and the level of distress experienced by patients, family caregivers, and healthcare professionals. METHODS: Patients with advanced cancer who had completely recovered from an acute delirium episode, had Memorial Delirium Assessment Scale score <13, and had a family caregiver present during the delirium were studied. Patients were given the Delirium Experience Questionnaire. Patients' and family caregivers' demographics, and the frequency and distress associated with different delirium symptoms were also collected. Bedside nurses and palliative care specialists reported the frequency of recalled delirium symptoms and their distress score. RESULTS: A total of 99 patient/family caregiver dyads participated in the study. The main identified causes for delirium were opioids. infection. brain metastases. hypercalcemia, and dehydration. There were 73 patients (74%) who remembered the episode of being delirious. with 59 of 73 patients (81%) reporting the experience as distressing (median distress level of 3). The median overall delirium distress score was higher in family caregivers (median. 3; 25%-75% quar-tile, 2-4) than in patients (median, 2; 25%-75% quartile, 0-3) (P =.0004). Bedside nurses and palliative care specialists expressed low median overall delirium distress scores (median, 0; 25%-75% quartile 0-1). CONCLUSIONS: The majority of patients with advanced cancer recalled their experience of delirium, causing moderate to severe distress in both patients and family caregivers. Appropriate interventions to reduce this distress are needed.

AB - Background: Delirium has been the most frequent neuropsychiatry complication in patients with advanced cancer. This exploratory study aimed to determine the proportion of patients who were able to recall their experience of delirium and the level of distress experienced by patients, family caregivers, and healthcare professionals. METHODS: Patients with advanced cancer who had completely recovered from an acute delirium episode, had Memorial Delirium Assessment Scale score <13, and had a family caregiver present during the delirium were studied. Patients were given the Delirium Experience Questionnaire. Patients' and family caregivers' demographics, and the frequency and distress associated with different delirium symptoms were also collected. Bedside nurses and palliative care specialists reported the frequency of recalled delirium symptoms and their distress score. RESULTS: A total of 99 patient/family caregiver dyads participated in the study. The main identified causes for delirium were opioids. infection. brain metastases. hypercalcemia, and dehydration. There were 73 patients (74%) who remembered the episode of being delirious. with 59 of 73 patients (81%) reporting the experience as distressing (median distress level of 3). The median overall delirium distress score was higher in family caregivers (median. 3; 25%-75% quar-tile, 2-4) than in patients (median, 2; 25%-75% quartile, 0-3) (P =.0004). Bedside nurses and palliative care specialists expressed low median overall delirium distress scores (median, 0; 25%-75% quartile 0-1). CONCLUSIONS: The majority of patients with advanced cancer recalled their experience of delirium, causing moderate to severe distress in both patients and family caregivers. Appropriate interventions to reduce this distress are needed.

KW - Confusion

KW - Delirium

KW - Neoplasms

KW - Palliative care

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