gykwak03/KISS_delirium_papaers huggingface dataset:
Title: 중환자실 노인 환자에서 주관적 · 객관적 섬망 평가의 불일치에 영향을 미치는 요인: 환자와 간호사 특성과 섬망지식

Purpose: The purpose of this study was to identify the rate of discrepancy between nurses’ subjective and objective assessment of delirium in elderly patients in intensive care units (ICUs) and to explore factors influencing the discrepancy. Methods: Using a survey design, a total of 91 elderly patients and 47 nurses were recruited from three ICUs in C Hospital. While ICU nurses subjectively assessed prevalence of delirium in their patients, the researcher used the Confusion Assessment Method in the ICU (CAM-ICU) tool at the same time. Medical records were reviewed for participants’ demographic and disease-related characteristics. The nurses’ level of knowledge about delirium assessment was examined. Results: Twenty-seven percent of patients had delirium according to CAM-ICU assessment and the discrepancy rate between CAM-ICU and subjective assessments was 18.7% (x2=21.648, p<.001): 2.2% for false positives, and 16.5% for false negatives. Patient factors influencing the discrepancy between delirium assessment methods were using restraints, as well as lower Glasgow Coma Scale (GCS) scores and Richmond Agitation and Sedation Scale (RASS) scores, while a nurse factor was shorter length of time working in an ICU. Conclusion: The discrepancy rate was 18.7% with 16.5% for false negatives. An education program is necessary for nurses to improve their knowledge of symptom assessment for delirium and to receive training in the use of objective tools for delirium assessment.
Title: 일 종합병원 외과계 중환자실 환자의 섬망 발생 요인

Purpose : This study examined the prevalence of delirium-related factors in a surgical intensive care unit (SICU). Methods : This retrospective study enrolled 73 patients who were admitted to an SICU from October 1, 2016 to March 20, 2017 and who had been hospitalized for more than 72 hours. Data was collected by reviewing electronic medical records. Results : Delirium occurred in 46 (63.0%) patients. Its related factors were age, education, mechanical ventilator, sleep, narcotics, physical restraint, and central line catheters. Conclusion : The results indicate that sleep and physical restraint are significant factors related to delirium occurrence. The results of this study can help in developing guidelines for the prevention of delirium.
Title: 중환자 섬망 선별도구 개발

Purpose: This study was done to develop of the Korean intensive care delirium screening tool (KICDST). Methods: The KICDST was developed in 5 steps: Configuration of conceptual frame, development of preliminary tool, pilot study, reliability and validity test, development of final KICDST. Reliability tests were done using degree of agreement between evaluators and internal consistency. For validity tests, CVI (Content Validity Index), ROC (Receiver Operating Characteristics) analysis, known group technique and factor analysis were used. Results: In the reliability test, the degree of agreement between evaluators showed .80~1.00 and the internal consistency was KR-20=.84. The CVI was .83~1.00. In ROC analysis, the AUC (Area Under the ROC Curve) was .98. Assessment score was 4 points. The values for sensitivity, specificity, correct classification rate, positive predictive value, and negative predictive value were found to be 95.0%, 93.7%, 94.4%, 95.0% and 93.7%, respectively. In the known group technique, the average delirium screening tool score of the non-delirium group was $1.25{\pm}0.99$ while that of delirium group was $5.07{\pm}1.89$ (t= - 16.33, p <.001). The factors were classified into 3 factors (cognitive change, symptom fluctuation, psychomotor retardation), which explained 67.4% of total variance. Conclusion: Findings show that the KICDST has high sensitivity and specificity. Therefore, this screening tool is recommended for early identification of delirium in intensive care patients.
Title: 노인환자의 수술 후 섬망에 대한 회복실 간호사의 간호수행과 영향요인

Purpose: The purpose of this study was to identify factors associated with performance of nursing care for postoperative delirium of elderly patients among recovery room nurses. Methods: The research was a cross-sectional, descriptive design using questionnaires. The participants were 99 nurses from five urban recovery rooms. Data were analyzed using descriptive statistics, t-test, ANOVA and multiple regression with SPSS WIN 21.0. Results: The performance level of delirium nursing care was low because its mean score was 3.80 out of 5. Performance of nursing care was significantly positively correlated with the importance of nursing care and self-efficacy. Stepwise multiple regression analysis for performance of nursing care revealed that the most powerful predictor was the importance of nursing care. The importance of nursing care and self-efficacy explained 32.3% of the variance. Conclusion: The results indicate a need to enhance the performance of nursing care for postoperative delirium of elderly patients among recovery room nurses. The findings also suggest that consideration be given to strategies for improving the importance of nursing care and self-efficacy in developing programs to enhance the performance level of nursing care for elderly patients with postoperative delirium.
Title: 섬망사정도구를 사용하는 중환자실 간호사의 섬망인식, 섬망사정의 장애요인 및 섬망사정 수행의 중요도

Purpose: This study was conducted to identify the perception, barriers, and importance of delirium assessment of intensive care unit nurses utilizing a tool for delirium assessment. Methods: The subjects were 150 intensive care unit nurses who routinely use the CAM-ICU to screen delirium. Data were collected using self-report questionnaires and analyzed using descriptive statistics and ranking. Results: Most intensive care unit nurses had experience of education about delirium and delirium assessment, and had assessed over once in a shift. However, a small number of nurses recognized utilizing their assessment result and the effect on higher mortality and underdiagnosed and preventable problem. The first rank of barriers was being too busy to assess patients and the second was difficulty of interpreting intubated patients. The importance of delirium assessment was considered lower than assessing catheter placement and level of pain. Conclusion: The study identified intensive care unit nurses' use of a delirium assessment tool, and the perception, barriers, and importance of delirium assessment. Furthermore, it is necessary to develop education programs to improve the early recognition of delirium by intensive care unit nurses.
Title: 중환자실 환자의 통증, 진정 및 섬망 관리

Pain, agitation and delirium (PAD) occur frequently in mechanically ventilated patients in the intensive care unit (ICU). Consequently, analgesics and sedatives are frequently administered to critically ill patients with the aim of treating PAD, decreasing the physiological stress response, and improving synchrony with mechanical ventilation. However, many of the analgesics and sedatives in current use can lead to adverse outcomes, including longer durations of mechanical ventilation, prolonged ICU stays, delirium, and an increased risk of death, particularly when these agents are administered at excessive doses for prolonged periods. The purpose of this review is to provide an overview of the initial evaluation and monitoring of, and the medications commonly prescribed for, PAD. Moreover, we highlight the major recommendations of the recent guidelines published by the Korean Society of Critical Care Medicine and American College of Critical Care Medicine. (Korean J Med 2014;86:546-556)
Title: CAM-ICU로 평가한 중환자실의 섬망 발생률과 섬망 발생 위험요인

Purpose: Screening of delirium using delirium assessment tools could promote delirium detection, however,there is lack of report about regular delirium assessment in Korea. This study was intended to describe theprevalence and related risk factors of delirium in intensive care unit (ICU). Methods: The Confusion AssessmentMethod for the ICU (CAM-ICU) data which were evaluated by nurses in ICUs was obtained through retrospectivechart review. Data were analyzed using descriptive statistics, Chi-square test, t-test, Mann-Whitney U test, andstepwise logistic regression. Results: Delirium was evaluated in 125 patients. The incidence rate of delirium was27.2% with a high prevalence of hypoactive delirium compared to hyperactive delirium (61.8 vs. 38.2%). Thosewith delirium were older, had hypertension, stayed longer in hospital, receiving ventilator support, had morenumber of catheters, had low serum protein and albumin level. Delirium incidence also varied according todiagnosis. Age, diagnosis of gastrointestinal disease, and application of ventilator were the significant risk factorsfor the incidence of delirium. Conclusion: Routine delirium screening is important for early detection ofdelirium. Identification of high-risk group and running delirium prevention programs could improve earlyrecognition of delirium in ICU.
Title: 회복실에 대한 사전 정보제공과 보호자 상주 중재가 수술 직후 각성 시 소아 청소년 환아의 불안, 섬망 및 통증에 미치는 효과

Purpose: The purpose of this study was to test whether pre-operative visual information and parental presence had positive effects on anxiety, delirium, and pain in pediatric patients who awoke from general anesthesia in a post-surgical stage. Methods: This study used a non equivalent control-group post test design (n=76). Independent variables were provision of pre-operative visual information and parental presence for post-surgical pediatric patients in PACU (post anesthesia care unit). Dependent variables were anxiety, delirium, and pain in the pediatric patients measured three times at 10 minute intervals after extubation in the PACU. Measurements included Numerical Rating Scale for assessing state anxiety, Pediatric Anesthesia Emergence Delirium Scale by Sikich & Lerman (2004) for delirium, and Objective Pain Scale by Broadman, Rice & Hannallah (1988) for pain. Results: Experimental group showed significantly decreased state anxiety at time points-10, 20, and 30 minutes after extubation. Delirium was significantly lower at 10 minutes and 30 minutes after extubation in the experimental group. Pain was significantly lower at 10 minutes after extubation in the experimental group. Conclusion: The results of this study suggest that this intervention can be a safe pre-operative nursing intervention for post-surgical pediatric patients at PACU.
Title: 한국어판 간호 섬망 선별 도구 개발 및 검증

Purpose: The aims of this study were to develop and test the validity of the Korean Nursing Delirium Scale (Nu-DESC) for older patients in hospital. Methods: The Korean Nu-DESC was developed based on the Nu-DESC (Gaudreau, 2005), and revised according to nursing records related to signs and symptoms of older patients with delirium (n=361) and the results of a pilot study (n=42) in one general hospital. To test the validity of the Korean Nu-DESC, 75 older patients whom nurses suspected of delirium from 731 older patients from 12 nursing units were assessed by bedside nurses using the Korean Nu-DESC. A Receiver Operating Characteristic Curve of the Korean Nu-DESC was constructed with an accompanying Area Under the Curve (AUC). Results: Specific examples such as irritable, kidding, sleeping tendency, which were observed by bedside nurses in Korea, were identified in the five features of signs and symptoms of delirium in the instrument. The Korean Nu-DESC was psycho-metrically valid and had a sensitivity and specificity of .81-.76 and .97-.73, respectively. The AUC were .89, .74. Conclusion: Results of this study indicate that the Korean Nu-DESC is well-suited for widespread clinical use in busy inpatients settings and shows promise as a research instrument.
Title: 외과계 중환자실의 섬망 발생 위험요인 조사연구

Purpose: The purpose of this study was to examine the frequency and the course of delirium, and identify risk factors for the development of delirium in surgical intensive care unit (SICU). Methods: Subjects older than 19 years admitted to the SICU were recruited. After informed written consent, enrolled subjects had baseline cognitive and functional assessments. Subjects were assessed daily for delirium using the Confusion Assessment Method-ICU (CAM-ICU). Results: During the study period, 110 patients were enrolled. The overall incidence of delirium was 20% (22/110). The average time to onset of delirium was 3.04(${\pm}1.25$) days. Several variables were associated with an increased risk of delirium including older age (p<.05), higher admission APACHE II score (p<.001), use of opioid and analgesics (p<.01), using physical restraints (p<.001), and intraoperative hypotension (p<.05). In a multivariate logistic regression model, using physical restraints (p<.001), intraoperative hypotension (p<.05), and older age (p<.05) remained significant predictors of the delirium development. Conclusion: Using physical restraints, intraoperative hypotension and older age was strongly associated with development of delirium in the SICU. Prevention measures need to focus on identifying patients at higher risk for delirium development.
Title: 요양병원과 종합병원 간호사들의 섬망에 대한 인식과 간호지식정도

Purpose: This study was done to compare the comprehension and knowledge about delirium in nurses working at long-term care hospitals (NLH) with nurses working at a general hospital (NGH). Method: The participants were 191 nurses from a general hospital and 7 long-term care hospitals in Chungnam. The tool for comprehension consisted of the needs and importance of delirium education and the confidence of management for early detection, caring and prevention of delirium. The tool for knowledge of delirium developed by the author consisted of causing factors, symptoms, caring and prevention of delirium. Result: The comprehension of need and importance of delirium education was higher than the confidence for delirium management in participants. NLH nurses had a higher level in comprehension of the need and importance of delirium education and a lower level in confidence of delirium management than NGH nurses. The mean for delirium knowledge was 75.32% for all participants. The knowledge of NLH nurses was significantly lower than those of NGH nurses. All nurses showed low scores in confidence and knowledge of delirium prevention. Conclusion: A systematic educational program for nurses to enhance the ability for assessment, early detection and prevention of delirium for institutionalized elderly patients needs to be developed.
Title: 일 종합병원 간호사들의 섬망에 대한 인식 및 교육요구에 관한 기초조사

Purpose: The purpose of this survey was to investigate clinical nurses' understanding of delirium and their educational need of delirious patient care. Method: A survey questionnaire regarding nurses' general perception and understanding of delirium, experience with delirious patients and educational need was developed and conducted with 179 clinical nurses in a university hospital in Seoul. Data was analyzed using descriptive statistics. Results: Nurses thought that delirium was one of the most important nursing problems and they considered it to be more treatable than to be preventable. However, the majority of nurses were ilot confident in caring for delirious patients. Nurses reported that delirium happened most often after surgery, and that possible contributing factors could be changes in physical environment and anxiety/stress, as well as medication and long-term isolation. Thirteen nursing interventions were identified but half of the nurses utilized only one or two of the thirteen. The most frequently used intervention was reorienting the patient followed by medication and emotional support, presenting family, and close observation. 99.5% of nurses addressed the importance of professional education on delirium care, especially in the area of intervention and management. Conclusion: The results support the strong need for development of a multi-component educational program on delirium care.
Title: 증례 / Famotidine에 의한 섬망 1예

The use of histamine (H2)-receptor blockers has been associated with central nervous system (CNS) toxicities manifesting as delirium, mental confusion, dizziness, and hallucination. Elderly patients with renal or hepatic dysfunction are more susceptible to these adverse reactions. Most of these reactions have been reported with both cimetidine and ranitidine. Famotidine, one of H2 blockers, has been shown to be effective in improving symptoms and healing gastrointestinal lesions. Since 1986, an estimated 18.8 million worldwide patients have been treated with famotidine, but CNS adverse reactions associated with famotidine have been reported very rarely. The authors report a case of famotidine-associated delirium in an elderly patient with mild renal insufficiency, which was cleared completely after stopping the administration of famotidine. (Korean J Gastroenterol 2001;37:128-131)
Title: Lithium 투약도중 과나트륨혈증과 섬망을 동반한 신장성 뇨붕증 환자 1례

Lithium is a widely used important drug in the treatment of manic-depressive illness and its prevention of relapse. However, this drug has a Low therapeutic index, therefore, it has many attendant side effects. The most prevalent renal effect of lithium is impairment of concentrating ability and this defect appeared into overt polyuria. A renal lesion is confined to the collecting tubule and 12-20% of patients taking lithium suffer from nephrogenic diabetes insipidus. This nephrogenic diabetes insipidus causes the states of extracellular fluid depletion, hypernatremia and precipitates lithium intoxication. In such situation, symptoms of nephrogenic diabetes insipidus and lithium intoxication are very similar, so we should be very cautious to discriminate them. We herein report a patient characterized by a prolonged stuporous state, hypernatremia and severe nephrogenic diabetes insipidus during lithium therapy.
Title: 뇌졸중 후 섬망의 두부 침전기자극술을 포함한 한의복합치료에 대한 증례 보고 1례

Objectives: This case study aimed to provide evidence of the combined use of Korean Medicine treatments, including electroacupuncture (EA) on scalp acupoints, as a useful intervention for post-stroke delirium. Methods: The patient in this study was diagnosed with Cerebral Infarction in Right Corpus Callosum and post-stroke delirium. The patient received eight sessions of EA on scalp acupoints, rehabilitation medicine treatment, and other Korean Medicine treatments such as acupuncture and herbal medicine. Evaluation of treatment effectiveness was done mainly through the Memorial Delirium Assessment Scale Korean (MDAS-K) and Mini-Mental State Examination Korean (MMSE-K). Results: MDAS-K score dropped from 20 to 9 and MMSE-K score increased from 15 to 21 during hospitalization, showing improvement in symptoms. Conclusions: Combined use of Korean medicine treatments including EA on scalp acupoints may be an effective treatment for post-stroke delirium.
Title: 진정수면제를 음독한 노인 입원 환자에서 발생한 섬망에 대한 한의복합중재 증례보고

Objectives: The purpose of this study was to report the effectiveness of the combination of Korean medicine therapy on elderly patients with delirium due to overdose of sedative-hypnotics. Methods: The patient was diagnosed with delirium, which occurred after an overdose of sedative- hypnotics. The patient received Korean Medicine treatment, including herbal medicine, acupuncture, moxibustion and psychotherapy, and other treatments. The evaluation variables to check the effectiveness of the interventions were the Korean Version of the Delirium Rating Scale- Revised-98 (K-DRS-R-98) Mini-Mental State Examination-Korean (MMSE-K) Clinical Dementia Rating (CDR) and Manual Muscle Test (MMT). Results: During the hospitalization period, the K-DRS-R-98 score decreased from 31 to 4, MMSE-K score increased from 18 to 26. CDR score decreased from 2 to 0. MMT in the Right lower extremity was improved. Normal daily activities were possible. Conclusions: Combining Korean Medicine treatments, including herbal medicine, acupuncture, moxibustion, psychotherapy, and other treatments, may help alleviate delirium.
Title: 섬망을 호소하는 비경련성 간질 중첩증 환자에 대한 복합 한의치험 1례

Nonconvulsive Status Epilepticus(NCSE) refers to continuous epileptic condition with altered mental status and behavioral symptoms, but without convulsive movement at least 10 minutes. In Salzburg criteria, well known as the diagnostic criteria of NCSE, it is diagnosed with clinical symptoms, electroencephalogram (EEG), and effects before and after the use of antiepileptic drugs (AEDs). Commonly being used to treat NCSE, AEDs are likely to have adverse effects. In the present case, a 85-year-old female NCSE patient complaining delirium underwent combined Korean medical treatment by acupuncture and herbal medicine for 13 days. The effect of treatment was assessed with delirium scales including Delirium Rating Scale-Revised-98(DRS-R-98) and Assessment Test for Delirium & Cognitive Impairment(4AT) per 2 days. After the treatment, both DRS-R-98 and 4AT scores decreased, and orientation and mental status of patient improved. This case report suggests that Korean medical treatment might be an effective option without side for those NCSE patients complaining delirium.
Title: 수술 후 섬망 치험 1례를 통해 본 지언고론요법의 활용

Objectives: The purpose of this study was to report the effectiveness of the combination of Giungoroen-therapy, as well as other Korean medicine therapy on postoperative delirium. Methods: The patient was diagnosed with postoperative delirium, that occurred after arthroscopic debridement two months before hospitalization. The patient received Giungoroen-therapy in addition to conventional Korean Medicine treatment, including acupuncture, herbal medicine, and moxibustion. The evaluation variables to check the effectiveness of the interventions, were the Korean Nursing Delirium Screening Scale (Korean Nu-DESC) and the Korean Version of the Delirium Rating Scale-Revised-98 (K-DRS-R-98). Results: During the hospitalization period, the Korean Nu-DESC score decreased from 5 to 1, and the K-DRS-R-98 score decreased from 36 to 23. The subjective expression of anxiety had been reduced. Conclusions: The combination of Giungoroen-therapy, as well as other Korean medicine therapy including acupuncture, moxibustion, and herbal medicine may be useful in alleviating postoperative delirium.
Title: 柴胡加龍骨牡蠣湯으로 호전된 노인 섬망 환자 증례보고

Objective: The purpose of this study is to report the effects of Shihogayonggolmoryo-tang on elderly delirium. Methods: A patient suffering from delirium was treated with Shihogayonggolmoryo-tang herbal therapy for 35 days. To evaluate the therapeutic effects, the Korean version of the Mini Mental State Examination (MMSE-K) and the Korean Nursing Delirium Screening Scale (nu-DESC) were used twice a week. Results: After treatment, the patient’s MMSE-K score increased from 0 to 12, and the nu-DESC results decreased 4 to 0. Conclusion: These scores suggest that therapy with Shihogayonggolmoryo-tang has a positive effect on elderly delirium.
Title: 암 병원 간호사의 섬망에 대한 지식, 간호수행 및 스트레스

Purpose: We aimed to elucidate the relationship between the knowledge, nursing performance, and stress of delirium in cancer hospital nurses. The results might help provide better and appropriate nursing care to patients with delirium. Methods: As a descriptive study, 143 nurses who had worked for over one year at one cancer hospital in S city were included in this study. The data collection period was from February 1 to 15, 2021. Results: It was found that cancer hospital nurses with delirium-related nursing education had a high knowledge of delirium. Cancer hospital nurses who were married and had an educational background above graduate school showed relatively high nursing performance against delirium. Also, cancer hospital nurses had relatively high stress levels. Conclusion: Therefore, an opportunity to develop and participate in a systematic education program is necessary to raise cancer hospital nurses’ knowledge levels of delirium and improve nursing performance for delirium. Furthermore, it is necessary to have a stress management program for delirium for cancer hospital nurses.