How do occupational therapists understand and respond to delirium in acute stroke? A grounded theory exploration
Date
2018-08-01Author
Carin-Levy, Gail
Nicol, Kath
McVittie, Chris
Van Wijck, F.
Mead, G.
Metadata
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Carin-Levy, G., Nicol, K., McVittie, C., Van Wijck, F. & Mead, G. (2018) How do occupational therapists understand and respond to delirium in acute stroke? A grounded theory exploration [Abstract]. In: RCOT 2018 Annual Conference and Exhibition 11 – 13 June 2018 Book of Abstracts. British Journal of Occupational Therapy, 81(8 suppl. 1), p. 21.
Abstract
Purpose and aims: Delirium is a serious complication following
a stroke, often leading to severe adverse effects (Carin-Levy
et al. 2012). Identifying delirium following a stroke can be
challenging due to the complexity of cognitive screening in
this population (Lees et al. 2013). This study explored how
occupational therapists (OTs) understand delirium and what
actions are taken when working with a patient exhibiting
delirium symptoms. Design: Abbreviated grounded theory.
Methods: Two online focus groups utilising case vignettes
conducted with occupational therapists working in acute stroke
units across Scotland. Analytical steps consistent with grounded
theory methodology led to the emergence of themes. Results:
Five participants were recruited. None of the participants
received delirium training, and none confidently discussed
delirium symptoms, frequently referring to the term ‘confusion’.
Participants suggested using generic cognitive assessments
rather than delirium-specific tools. Despite this, the key principles
of the initial management of delirium were discussed confidently
and participants demonstrated the values of person centredness,
effective team work and a real care for the welfare of the
persons with whom they are working. Conclusion: Occupational
therapists can struggle to identify delirium in acute stroke;
however, the key principles of delirium management were
confidently discussed and an ethos of person centredness was
demonstrated. Occupational therapists are experts in cognitive
assessment of stroke patients (Scottish Intercollegiate Guidelines
Network 2010), therefore, training in delirium identification
should be targeted at this professional group in order to be able
to comply with best practice guidelines on delirium management
(Healthcare Improvement Scotland 2014).