Evidence map›Paper›PMID 31028053›Full record

ArticleCMAJ open

Feasibility and acceptability of family administration of delirium detection tools in the intensive care unit: a patient-oriented pilot study.

Karla D Krewulak, Bonnie G Sept, Henry T Stelfox, E W Ely, Judy E Davidson, Zahinoor Ismail, Kirsten M Fiest

Open access · diamondAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in CMAJ open. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers.

0numbers the graph read from it
0cells of the map it votes in
25citing papers in PubMed
6.0field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

25 citing papers in PubMed, 56 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 1 country.

Karla D KrewulakDepartments of Critical Care Medicine (Krewulak, Sept, Stelfox, Fiest), Community Health Sciences (Stelfox, Ismail, Fiest) and Psychiatry (Ismail), O'Brien Institute for Public Health (Stelfox, Ismail, Fiest) and Hotchkiss Brain Institute (Ismail), Cumming School of Medicine, University of Calgary; Critical Care Strategic Clinical Network (Krewulak, Sept, Stelfox, Fiest), Alberta Health Services, Calgary, Alta.; Tennessee Valley Veterans Affairs Geriatric Research Education Clinical Center (Ely) and Critical Illness, Brain Dysfunction, and Survivorship Center (Ely), Vanderbilt University Medical Center, Nashville, Tenn.; Department of Education, Development and Research (Davidson), University of California, San Diego Health, San Diego, Calif.
Bonnie G SeptDepartments of Critical Care Medicine (Krewulak, Sept, Stelfox, Fiest), Community Health Sciences (Stelfox, Ismail, Fiest) and Psychiatry (Ismail), O'Brien Institute for Public Health (Stelfox, Ismail, Fiest) and Hotchkiss Brain Institute (Ismail), Cumming School of Medicine, University of Calgary; Critical Care Strategic Clinical Network (Krewulak, Sept, Stelfox, Fiest), Alberta Health Services, Calgary, Alta.; Tennessee Valley Veterans Affairs Geriatric Research Education Clinical Center (Ely) and Critical Illness, Brain Dysfunction, and Survivorship Center (Ely), Vanderbilt University Medical Center, Nashville, Tenn.; Department of Education, Development and Research (Davidson), University of California, San Diego Health, San Diego, Calif.
Henry T StelfoxDepartments of Critical Care Medicine (Krewulak, Sept, Stelfox, Fiest), Community Health Sciences (Stelfox, Ismail, Fiest) and Psychiatry (Ismail), O'Brien Institute for Public Health (Stelfox, Ismail, Fiest) and Hotchkiss Brain Institute (Ismail), Cumming School of Medicine, University of Calgary; Critical Care Strategic Clinical Network (Krewulak, Sept, Stelfox, Fiest), Alberta Health Services, Calgary, Alta.; Tennessee Valley Veterans Affairs Geriatric Research Education Clinical Center (Ely) and Critical Illness, Brain Dysfunction, and Survivorship Center (Ely), Vanderbilt University Medical Center, Nashville, Tenn.; Department of Education, Development and Research (Davidson), University of California, San Diego Health, San Diego, Calif.
E W ElyDepartments of Critical Care Medicine (Krewulak, Sept, Stelfox, Fiest), Community Health Sciences (Stelfox, Ismail, Fiest) and Psychiatry (Ismail), O'Brien Institute for Public Health (Stelfox, Ismail, Fiest) and Hotchkiss Brain Institute (Ismail), Cumming School of Medicine, University of Calgary; Critical Care Strategic Clinical Network (Krewulak, Sept, Stelfox, Fiest), Alberta Health Services, Calgary, Alta.; Tennessee Valley Veterans Affairs Geriatric Research Education Clinical Center (Ely) and Critical Illness, Brain Dysfunction, and Survivorship Center (Ely), Vanderbilt University Medical Center, Nashville, Tenn.; Department of Education, Development and Research (Davidson), University of California, San Diego Health, San Diego, Calif.
Judy E DavidsonDepartments of Critical Care Medicine (Krewulak, Sept, Stelfox, Fiest), Community Health Sciences (Stelfox, Ismail, Fiest) and Psychiatry (Ismail), O'Brien Institute for Public Health (Stelfox, Ismail, Fiest) and Hotchkiss Brain Institute (Ismail), Cumming School of Medicine, University of Calgary; Critical Care Strategic Clinical Network (Krewulak, Sept, Stelfox, Fiest), Alberta Health Services, Calgary, Alta.; Tennessee Valley Veterans Affairs Geriatric Research Education Clinical Center (Ely) and Critical Illness, Brain Dysfunction, and Survivorship Center (Ely), Vanderbilt University Medical Center, Nashville, Tenn.; Department of Education, Development and Research (Davidson), University of California, San Diego Health, San Diego, Calif.
Zahinoor IsmailDepartments of Critical Care Medicine (Krewulak, Sept, Stelfox, Fiest), Community Health Sciences (Stelfox, Ismail, Fiest) and Psychiatry (Ismail), O'Brien Institute for Public Health (Stelfox, Ismail, Fiest) and Hotchkiss Brain Institute (Ismail), Cumming School of Medicine, University of Calgary; Critical Care Strategic Clinical Network (Krewulak, Sept, Stelfox, Fiest), Alberta Health Services, Calgary, Alta.; Tennessee Valley Veterans Affairs Geriatric Research Education Clinical Center (Ely) and Critical Illness, Brain Dysfunction, and Survivorship Center (Ely), Vanderbilt University Medical Center, Nashville, Tenn.; Department of Education, Development and Research (Davidson), University of California, San Diego Health, San Diego, Calif.
Kirsten M FiestDepartments of Critical Care Medicine (Krewulak, Sept, Stelfox, Fiest), Community Health Sciences (Stelfox, Ismail, Fiest) and Psychiatry (Ismail), O'Brien Institute for Public Health (Stelfox, Ismail, Fiest) and Hotchkiss Brain Institute (Ismail), Cumming School of Medicine, University of Calgary; Critical Care Strategic Clinical Network (Krewulak, Sept, Stelfox, Fiest), Alberta Health Services, Calgary, Alta.; Tennessee Valley Veterans Affairs Geriatric Research Education Clinical Center (Ely) and Critical Illness, Brain Dysfunction, and Survivorship Center (Ely), Vanderbilt University Medical Center, Nashville, Tenn.; Department of Education, Development and Research (Davidson), University of California, San Diego Health, San Diego, Calif. kmfiest@ucalgary.ca.
O'Brien Institute · AUInstitute of Public Health Zadar

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundFamily-administered delirium detection tools may serve as valuable diagnostic adjuncts because family caregivers may be better able than providers to detect changes in patient cognition and behaviour from pre-illness levels of functioning. The aim of this pilot study was to assess the feasibility and acceptability of family-administered tools to detect delirium in critically ill patients.

methodsIn this single-centre pilot tool validation study conducted in August and September 2017, eligible family caregivers used the Family Confusion Assessment Method (FAM-CAM) and the Sour Seven questionnaire to detect delirium during the patient's intensive care unit (ICU) stay. We calculated descriptive statistics for all study variables. Patients and family caregivers were involved as research partners throughout the study. A patient-orient research approach was taken, engaging patients and family caregivers as full partners.

resultsOf 141 patients admitted to the ICU, 75 were eligible, of whom 53 were approached; 21 patients (40%), 23/38 family caregivers (60%) and 17/38 dyads (i.e., patient and family caregiver enrolled together) (45%) consented to participate. The most common reason for nonenrolment was refusal by the family, who commonly reported feeling overwhelmed. The completion rate for the FAM-CAM and Sour Seven questionnaire was 74% (17/23). Among 13 dyads, family caregivers detected delirium in 5 patients (38%) using the FAM-CAM, and delirium or possible delirium in 8 patients (62%) using the Sour Seven questionnaire, whereas trained research assistants detected delirium in 8 patients (62%) using the Confusion Assessment Method for the Intensive Care Unit 7 and the Richmond Agitation-Sedation Scale (κ coefficient for agreement between the former and the FAM-CAM and Sour Seven questionnaire 0.62 and 0.85, respectively).

interpretationAdministration of the FAM-CAM and Sour Seven questionnaire by family caregivers to detect delirium in the ICU is feasible and acceptable, although, as with most family engagement strategies, it was not desired by all. Results from this pilot study support a definitive study with a larger sample to enable calculation of inferential statistics, but additional recruitment strategies are necessary to improve the response rate.

Identifiers

PMID31028053
PMCPMC6488481
OpenAlexW2942045577

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.