title: Identification of confusion among the elderly in an acute care setting.
abstract: An exploratory, descriptive study was conducted in a large acute care hospital to determine: (1) the indicator/descriptors used by staff nurses to arrive at the diagnosis of confusion, and (2) which indicators/descriptors are perceived as most significant in such a diagnosis. In addition, because the literature frequently cites the occurrence of nurses stereotyping patients as confused and thereby treating them as confused (Libow's self-fulfilling prophecy), the third question explored was the type and quantity of information that was given to nurses at intershift report. A self-constructed interview schedule was used on a sample of 25 staff nurses who were primary caregivers of a confused patient on a given day. Content analysis revealed emergent themes of confusion in two domains: cognitive and behavioral. The findings from this study revealed nurses used cognitive descriptors more frequently to diagnose confusion; however, a large majority of nurses used a combination of both cognitive and behavioral descriptors for diagnosis. Nurses also used independent assessment based on their own observations rather than those from the night nurse in arriving at a nursing diagnosis of confusion. This investigation responds to the need to "confirm defining characteristics of the phenomenon of confusion" posited by Foreman. In addition, results from this study will provide a basis for a taxonomy on the phenomenon of confusion. It is hoped that such a taxonomical classification will enable nurses to assess the confused patient more effectively.
authors.forename: E M
authors.initials: EM
authors.lastname: Yeaw
authors.forename: J H
authors.initials: JH
authors.lastname: Abbate
mesh_terms: D000328:Adult; D000368:Aged / Q000523:psychology*; D015400:Clinical Nursing Research; D003221:Confusion / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009730:Nursing Assessment; D012494:Sampling Studies; D012660:Semantics; D014705:Verbal Behavior