Overview and Strategy Analysis of Technology-Based Nonpharmacological Interventions for In-Hospital Delirium Prevention and Reduction: Systematic Scoping Review
BackgroundDelirium 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...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
JMIR Publications
2021-08-01
|
| Series: | Journal of Medical Internet Research |
| Online Access: | https://www.jmir.org/2021/8/e26079 |
| _version_ | 1797735793465229312 |
|---|---|
| author | Chan Mi Kim Esther M van der Heide Thomas J L van Rompay Gijsbertus J Verkerke Geke D S Ludden |
| author_facet | Chan Mi Kim Esther M van der Heide Thomas J L van Rompay Gijsbertus J Verkerke Geke D S Ludden |
| author_sort | Chan Mi Kim |
| collection | DOAJ |
| description |
BackgroundDelirium 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.
ObjectiveThis 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?
MethodsA 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.
ResultsA 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).
ConclusionsTechnology-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.
Trial Registration PROSPERO International Prospective Register of Systematic Reviews CRD42020175874; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=175874 |
| first_indexed | 2024-03-12T13:03:18Z |
| format | Article |
| id | doaj.art-470d5b160caa4514a97aa84f3b7b928b |
| institution | Directory Open Access Journal |
| issn | 1438-8871 |
| language | English |
| last_indexed | 2024-03-12T13:03:18Z |
| publishDate | 2021-08-01 |
| publisher | JMIR Publications |
| record_format | Article |
| series | Journal of Medical Internet Research |
| spelling | doaj.art-470d5b160caa4514a97aa84f3b7b928b2023-08-28T18:33:48ZengJMIR PublicationsJournal of Medical Internet Research1438-88712021-08-01238e2607910.2196/26079Overview and Strategy Analysis of Technology-Based Nonpharmacological Interventions for In-Hospital Delirium Prevention and Reduction: Systematic Scoping ReviewChan Mi Kimhttps://orcid.org/0000-0003-0495-9158Esther M van der Heidehttps://orcid.org/0000-0003-4566-9472Thomas J L van Rompayhttps://orcid.org/0000-0002-6126-5462Gijsbertus J Verkerkehttps://orcid.org/0000-0003-3533-2446Geke D S Luddenhttps://orcid.org/0000-0003-4508-9865 BackgroundDelirium 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. ObjectiveThis 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? MethodsA 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. ResultsA 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). ConclusionsTechnology-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. Trial Registration PROSPERO International Prospective Register of Systematic Reviews CRD42020175874; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=175874https://www.jmir.org/2021/8/e26079 |
| spellingShingle | Chan Mi Kim Esther M van der Heide Thomas J L van Rompay Gijsbertus J Verkerke Geke D S Ludden Overview and Strategy Analysis of Technology-Based Nonpharmacological Interventions for In-Hospital Delirium Prevention and Reduction: Systematic Scoping Review Journal of Medical Internet Research |
| title | Overview and Strategy Analysis of Technology-Based Nonpharmacological Interventions for In-Hospital Delirium Prevention and Reduction: Systematic Scoping Review |
| title_full | Overview and Strategy Analysis of Technology-Based Nonpharmacological Interventions for In-Hospital Delirium Prevention and Reduction: Systematic Scoping Review |
| title_fullStr | Overview and Strategy Analysis of Technology-Based Nonpharmacological Interventions for In-Hospital Delirium Prevention and Reduction: Systematic Scoping Review |
| title_full_unstemmed | Overview and Strategy Analysis of Technology-Based Nonpharmacological Interventions for In-Hospital Delirium Prevention and Reduction: Systematic Scoping Review |
| title_short | Overview and Strategy Analysis of Technology-Based Nonpharmacological Interventions for In-Hospital Delirium Prevention and Reduction: Systematic Scoping Review |
| title_sort | overview and strategy analysis of technology based nonpharmacological interventions for in hospital delirium prevention and reduction systematic scoping review |
| url | https://www.jmir.org/2021/8/e26079 |
| work_keys_str_mv | AT chanmikim overviewandstrategyanalysisoftechnologybasednonpharmacologicalinterventionsforinhospitaldeliriumpreventionandreductionsystematicscopingreview AT esthermvanderheide overviewandstrategyanalysisoftechnologybasednonpharmacologicalinterventionsforinhospitaldeliriumpreventionandreductionsystematicscopingreview AT thomasjlvanrompay overviewandstrategyanalysisoftechnologybasednonpharmacologicalinterventionsforinhospitaldeliriumpreventionandreductionsystematicscopingreview AT gijsbertusjverkerke overviewandstrategyanalysisoftechnologybasednonpharmacologicalinterventionsforinhospitaldeliriumpreventionandreductionsystematicscopingreview AT gekedsludden overviewandstrategyanalysisoftechnologybasednonpharmacologicalinterventionsforinhospitaldeliriumpreventionandreductionsystematicscopingreview |