TY - JOUR
T1 - Delirium Burden in Patients and Family Caregivers
T2 - Development and Testing of New Instruments
AU - Racine, Annie M.
AU - D'Aquila, Madeline
AU - Schmitt, Eva M.
AU - Gallagher, Jacqueline
AU - Marcantonio, Edward R.
AU - Jones, Richard N.
AU - Inouye, Sharon K.
AU - Schulman-Green, Dena
AU - Tommet, Douglas
AU - Abrantes, Tatiana
AU - Armstrong, Brett
AU - Bertrand, Sylvia
AU - Butters, Angelee
AU - D'Aquila, Madeline
AU - Gallagher, Jacqueline
AU - Kettell, Jennifer
AU - Nee, Jacqueline
AU - Parisi, Katelyn
AU - Vella, Margaret
AU - Xu, Guoquan
AU - Weiner, Lauren
AU - Fong, Tamara
AU - Hshieh, Tammy
AU - Racine, Annie
AU - Schmitt, Eva M.
AU - Schulman, Dena Green
AU - Tabloski, Patricia A.
AU - Travison, Thomas
AU - Inouye, Sharon K.
AU - Jones, Richard N.
N1 - Publisher Copyright:
© The Author(s) 2018. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: [email protected].
PY - 2019/9/17
Y1 - 2019/9/17
N2 - BACKGROUND AND OBJECTIVES: Delirium creates distinct emotional distress in patients and family caregivers, yet there are limited tools to assess the experience. Our objective was to develop separate patient and family caregiver delirium burden instruments and to test their content and construct validity.RESEARCH DESIGN AND METHODS: Two hundred forty-seven patients and 213 family caregivers were selected from an ongoing prospective cohort of medical-surgical admissions aged ≥70 years old. New patient and family caregiver delirium burden instruments were developed and used to measure the subjective experiences of in-hospital delirium. Delirium and delirium severity were measured by the Confusion Assessment Method (CAM) and CAM-Severity (long form).RESULTS: Both Delirium Burden (DEL-B) instruments consist of eight questions and are measured on a 0 - 40 point scale. Final questions had good clarity and relevancy, as rated by the expert panel, and good internal consistency (Cronbach's α = .82-.86). In the cohort validation, Patient DEL-B (DEL-B-P) was 5.1 points higher and Family Caregiver DEL-B (DEL-B-C) was 5.8 points higher, on average, for patients who developed delirium compared to those who did not (p < .001). Test-retest reliability of DEL-B-C at baseline and 1 month was strong (correlation = .73). Delirium severity was mildly-moderately correlated with DEL-B-P (correlation = .34) and DEL-B-C (correlation = .26), suggesting contribution of other factors.DISCUSSION AND IMPLICATIONS: We created instruments to reliably measure and evaluate the burden of delirium for patients and their family caregivers. Although additional validation is indicated, these instruments provide a key first step toward measuring and improving the subjective experience of delirium for patients and their families.
AB - BACKGROUND AND OBJECTIVES: Delirium creates distinct emotional distress in patients and family caregivers, yet there are limited tools to assess the experience. Our objective was to develop separate patient and family caregiver delirium burden instruments and to test their content and construct validity.RESEARCH DESIGN AND METHODS: Two hundred forty-seven patients and 213 family caregivers were selected from an ongoing prospective cohort of medical-surgical admissions aged ≥70 years old. New patient and family caregiver delirium burden instruments were developed and used to measure the subjective experiences of in-hospital delirium. Delirium and delirium severity were measured by the Confusion Assessment Method (CAM) and CAM-Severity (long form).RESULTS: Both Delirium Burden (DEL-B) instruments consist of eight questions and are measured on a 0 - 40 point scale. Final questions had good clarity and relevancy, as rated by the expert panel, and good internal consistency (Cronbach's α = .82-.86). In the cohort validation, Patient DEL-B (DEL-B-P) was 5.1 points higher and Family Caregiver DEL-B (DEL-B-C) was 5.8 points higher, on average, for patients who developed delirium compared to those who did not (p < .001). Test-retest reliability of DEL-B-C at baseline and 1 month was strong (correlation = .73). Delirium severity was mildly-moderately correlated with DEL-B-P (correlation = .34) and DEL-B-C (correlation = .26), suggesting contribution of other factors.DISCUSSION AND IMPLICATIONS: We created instruments to reliably measure and evaluate the burden of delirium for patients and their family caregivers. Although additional validation is indicated, these instruments provide a key first step toward measuring and improving the subjective experience of delirium for patients and their families.
KW - Caregiver burden
KW - Delirium burden
KW - Distress
KW - Family caregiver
KW - Instrument development
KW - Patient burden
KW - Delirium
KW - Surveys and Questionnaires/standards
KW - Reproducibility of Results
KW - Prospective Studies
KW - Humans
KW - Cost of Illness
KW - Male
KW - Caregivers/psychology
KW - Psychometrics/instrumentation
KW - Aged, 80 and over
KW - Female
KW - Aged
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U2 - 10.1093/geront/gny041
DO - 10.1093/geront/gny041
M3 - Article
C2 - 29746694
AN - SCOPUS:85057821918
SN - 0016-9013
VL - 59
SP - e393-e402
JO - Gerontologist
JF - Gerontologist
IS - 5
ER -