Document Detail

The meaning of acute confusional state from the perspective of elderly patients.
MedLine Citation:
PMID:  12112164     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: The aim of this study was to illuminate lived experience of having been in an acute confusional state (ACS) as narrated by elderly patients in orthopaedic care. METHOD: Qualitative study with phenomenological hermeneutic method for analysing the data based on narrative interviews. Fifty patients (67-96 years of age) who developed ACS during hospitalisation and in all cases the ACS ceased during their stay on the ward were interviewed once lucid again regarding the course of the event, their experiences, memories and interpretation of what had happened during the ACS. RESULTS: The meaning of the patients' lived experiences of being and having been confused was interpreted as 'Being trapped in incomprehensible experiences and a turmoil of past and present and here and there', comprising the themes trying to get a grip on the experience of the confusion, encountering past, present and the realm of the imagination as reality during the period of confusion and confronting the idea of having been confused. Contradictory to earlier research the patients remembered and could tell in great detail about their ACS. While confused, the confusional state means that impressions of all kinds invade the mind of the person and are experienced as reality, making him/her a victim of these impressions rather than the one who controls what comes into his/her mind. While in the middle of these experiences the person simultaneously senses that the impressions are unreal, thus indicating that he/she is in some sort of borderland between understanding and not understanding. The things that come into the mind of the person can either be frightening or neutral or enjoyable scenarios that seem to be mainly familiar but can also be unknown. These scenarios seem to be a mixture of past and present, of events and people while they seem to float from location to location. CONCLUSIONS: The findings indicates that what takes place during the ACS is not nonsense but probably a mix of the patient's life history, their present situation and above all a form of communication concerning their emotional state and inner experiences in this new situation. The findings also indicated that one possible approach to the patients is to confirm and support the patients in narrating their experiences both during the confusion and also after the ACS had ceased.
Edith M Andersson; Ingalill R Hallberg; Astrid Norberg; Anna-Karin Edberg
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Publication Detail:
Type:  Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  International journal of geriatric psychiatry     Volume:  17     ISSN:  0885-6230     ISO Abbreviation:  Int J Geriatr Psychiatry     Publication Date:  2002 Jul 
Date Detail:
Created Date:  2002-07-11     Completed Date:  2002-08-21     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8710629     Medline TA:  Int J Geriatr Psychiatry     Country:  England    
Other Details:
Languages:  eng     Pagination:  652-63     Citation Subset:  IM    
Copyright Information:
Copyright 2002 John Wiley & Sons, Ltd.
Department of Nursing, University of Lund, Lund, Sweden.
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MeSH Terms
Acute Disease
Aged / psychology*
Aged, 80 and over
Confusion / nursing*,  psychology*
Mental Recall
Tape Recording

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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