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- Title
Overview and Strategy Analysis of Technology-Based Nonpharmacological Interventions for In-Hospital Delirium Prevention and Reduction: Systematic Scoping Review.
- Authors
Kim, Chan Mi; Heide, Esther M van der; Rompay, Thomas J L van; Verkerke, Gijsbertus J; Ludden, Geke D S; van der Heide, Esther M; van Rompay, Thomas J L
- Abstract
<bold>Background: </bold>Delirium prevention is crucial, especially in critically ill patients. Nonpharmacological multicomponent interventions for preventing delirium are increasingly recommended and technology-based interventions have been developed to support them. Despite the increasing number and diversity in technology-based interventions, there has been no systematic effort to create an overview of these interventions for in-hospital delirium prevention and reduction.<bold>Objective: </bold>This systematic scoping review was carried out to answer the following questions: (1) what are the technologies currently used in nonpharmacological technology-based interventions for preventing and reducing delirium? and (2) what are the strategies underlying these currently used technologies?<bold>Methods: </bold>A systematic search was conducted in Scopus and Embase between 2015 and 2020. A selection was made in line with the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Studies were eligible if they contained any type of technology-based interventions and assessed delirium-/risk factor-related outcome measures in a hospital setting. Data extraction and quality assessment were performed using a predesigned data form.<bold>Results: </bold>A total of 31 studies were included and analyzed focusing on the types of technology and the strategies used in the interventions. Our review revealed 8 different technology types and 14 strategies that were categorized into the following 7 pathways: (1) restore circadian rhythm, (2) activate the body, (3) activate the mind, (4) induce relaxation, (5) provide a sense of security, (6) provide a sense of control, and (7) provide a sense of being connected. For all technology types, significant positive effects were found on either or both direct and indirect delirium outcomes. Several similarities were found across effective interventions: using a multicomponent approach or including components comforting the psychological needs of patients (eg, familiarity, distraction, soothing elements).<bold>Conclusions: </bold>Technology-based interventions have a high potential when multidimensional needs of patients (eg, physical, cognitive, emotional) are incorporated. The 7 pathways pinpoint starting points for building more effective technology-based interventions. Opportunities were discussed for transforming the intensive care unit into a healing environment as a powerful tool to prevent delirium.<bold>Trial Registration: </bold>PROSPERO International Prospective Register of Systematic Reviews CRD42020175874; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=175874.
- Subjects
INTENSIVE care units; DELIRIUM; CONTROL (Psychology); DATA extraction; CIRCADIAN rhythms; HOSPITALS; FERRANS &; Powers Quality of Life Index; SYSTEMATIC reviews; MULTIDIMENSIONAL Health Locus of Control scales; CATASTROPHIC illness; TECHNOLOGY
- Publication
Journal of Medical Internet Research, 2021, Vol 23, Issue 8, pN.PAG
- ISSN
1439-4456
- Publication type
journal article
- DOI
10.2196/26079