간호이론 기반 입원 환자의 섬망 연구에 대한 체계적 문헌고찰

Abstract

Purpose: This systematic review aimed to synthesize nursing theory-based delirium studies. Methods: Six electronic databases were searched via combinations of the key terms “delirium” , “nursing theory” , “hospital” , and “patient”. In total, 338 articles were found, and 87 duplicates were removed. Three independent reviewers screened and read the remaining articles and selected 12 articles. Characteristics of the included studies and theory application related information were extracted. Keywords of the studies were classified and analyzed based on the nursing meta-paradigm. Results: Studies on delirium utilized various theories that included grand (n=4), middle-range (n=4), and situation specific theories (n=4). Regarding theory application, eight studies used nursing theory as a conceptual framework, three studies developed new nursing theories on delirium, and one evaluated an existing theory. In three studies out of four RCTs (Randomized controlled trials), theory-based delirium interventions proved effective in reducing the incidence, duration, and severity of delirium. Nursing theories also helped explain nurses’ clinical reasoning and caregiver engagement in delirium. Keyword analysis results showed that elderly and intensive care unit patients are high risk groups. Conclusion: Nursing theories could be applied to various study designs; however, the number of nursing theory-based literature is limited. Further application in practice, research, and education should be promoted continuously.