Nursing Practices for Preventing Delirium in Patients with Cancer with Prognoses of Months and Weeks: A Multi-Site Cross-Sectional Study in Japan.

Abstract

Background: Delirium is a condition characterized by an acute and transient disturbance in attention, cognition, and consciousness. It is increasingly prevalent at the end of life in patients with cancer. While non-pharmacological nursing interventions are essential for delirium prevention, their effectiveness in terminally ill patients with cancer remains unclear.

Objectives: This study examined the nursing support practices employed to prevent delirium in terminally ill patients with cancer in palliative care units (PCUs) in Japan.

Methods: This cross-sectional study administered an online survey to 2448 nurses from 162 institutions with PCUs in Japan.

Results: Regarding nursing practices with patients with a prognosis of months and weeks, multi-component intervention, family support, and dehydration prevention were practiced frequently, whereas bright light therapy was practiced less frequently. The specialist team approach was practiced by approximately 50% of participants. Regarding multicomponent intervention in cases with a prognosis of months and weeks, adjustments in the sleep environment and pain management were practiced by more than 90% of the participants, whereas early exercise, vision or hearing assistance, and patient education on delirium were implemented by less than 50%. The management of intravenous injection routes and catheters was implemented by participants approximately 20% more frequently in cases with a prognosis of weeks than those with a prognosis of months.

Conclusion: The primary methods of nursing support for preventing delirium in patients with terminal cancer were multicomponent intervention, family support, and dehydration prevention. Further research is necessary to develop and implement appropriate nursing support strategies.