ArticlePalliative medicine2023
'It's tough. It is hard': A qualitative interview study of staff and volunteers caring for hospice in-patients with delirium.
Article in Palliative medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
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Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it, 11 citations in OpenAlex.
- Barriers to healthcare professionals screening, recognizing, and managing delirium in the adult patients receiving specialist palliative care: a mixed-methods systematic review.BMC palliative care · 2025Pooled it
- Intravenous haloperidol or chlorpromazine-which is more effective to improve agitation and communication in agitated delirium at the end of life?The oncologist · 2025Article
- Delirium prevention in hospices: Opportunities and limitations - A focused ethnography.Palliative medicine · 2025Article
- Causal relationships between delirium and Parkinson's disease: a bidirectional two-sample Mendelian randomization study.European journal of medical research · 2024Article
- Improving hospice delirium guideline adoption through an understanding of barriers and facilitators: A mixed-methods study.PloS one · 2024Article
- Causal relationships between delirium and Alzheimer's disease: a bidirectional two-sample Mendelian randomization study.European journal of medical research · 2023Observational
Corrections and comments
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Authors and funding
11 authors at 8 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDelirium is a distressing condition often experienced by hospice in-patients. Increased understanding of current multidisciplinary care of delirium is needed to develop interventions in this setting. AIM(S): To explore hospice staff and volunteers' practice, its influences and what may need to change to improve hospice delirium care.
designQualitative interview study using behaviour change theory from a critical realist stance. SETTING/
participantsThirty-seven staff, including different professional groups and roles, and volunteers were purposively sampled from two in-patient hospices.
resultsWe found that participants' practice focus was on managing hyperactive symptoms of delirium, through medication use and non-pharmacological strategies. Delirium prevention, early recognition and hypoactive delirium received less attention. Our theoretically-informed analysis identified this focus was influenced by staff and volunteers' emotional responses to the distress associated with hyperactive symptoms of delirium as well as understanding of delirium prevention, recognition and care, which varied between staff groups. Non-pharmacological delirium management was supported by adequate staffing levels, supportive team working and a culture of person-centred and family-centred care, although behaviours that disrupted the calm hospice environment challenged this.
conclusionsOur findings can inform hospice-tailored behaviour change interventions that develop a shared team understanding and engage staff's emotional responses to improve delirium care. Reflective learning opportunities are needed that increase understanding of the potential to reduce patient distress through prevention and early recognition of delirium, as well as person-centred management. Organisational support for adequate, flexible staffing levels and supportive team working is required to support person-centred delirium care.
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