Occupational therapy to improve the quality of life of people with delirium admitted to an intensive care unit

Cassinell, Nicole and Hersche-Cupelli, Ruth and Pozzi, Christian (2022) Occupational therapy to improve the quality of life of people with delirium admitted to an intensive care unit. In: European Delirium Association - 16th Annual Meeting, 04.11.2022, Milano, Italia. (Unpublished)

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Abstract

Background/Objectives: The number of annual ICU admissions due to critical illness are rapidly increasing in western medicine. Associated with the intensive care environment, the critical illness can induce the brain to react in the form of neuropsychiatric symptoms and disorders including delirium, which can have an incidence of 87%. This has negative implications on the person’s cognitive status and quality of life and on his/her caregivers’. Despite this, the syndrome remains underestimated and understudied, presenting typically 50% of cases lost. In addition, there is no single intervention or medication to treat delirium, making it difficult to manage it. The aim of this review is to detect the effectiveness of early occupational therapy care for delirium patients in intensive care unit. Materials and Methods: The research methodology used is literature review, which has been conducted on the PubMed database. Several MASH terms, concerning delirium, occupational therapy, and long-term outcomes, were used to form a search string. This string yielded a total of 118 publications. Articles involving pediatric patients or intervention in non-acute settings were excluded, resulting in a total of seven articles eligible for this review. Results: The results suggest that occupational therapy’s interventions have positive effects in preventing delirium in the selected/this population. Among these interventions, the most widely used is cognitive stimulation, which is offered while performing activities of daily living. Currently, there is no evidence of improved long-term outcomes. Conclusions: Current evidence reports positive results regarding feasibility and implementation of early occupational therapy in the ICU for patients with delirium. It is necessary to conduct more studies with larger samples in order to detect the effectiveness of the interventions and to be able to generalize their effect. Evidence and guidelines suggest that good outcomes require implementation of interdisciplinary care combined with sedation limitation and early mobilization

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