Delirium Stigma Among Healthcare Staff

Abstract

Older people with delirium occupy more than one third of acute medical beds and require increased medical attention, as care at present is suboptimal. In addition, since delirium is undetected, it should form a target for teaching in wards. Moreover, as people with delirium are largely dependent on daily interactions and care by inpatients professional staff, it is important to address stigmatisation of these vulnerable patients. This is especially important as previous studies have shown that negative staff attitudes towards these patients undermine good care. This single center cross-sectional study was designed to determine the extent of institutional stigma among health professionals involved in the care of people with delirium. For this, professional staff working on medical wards and in communities were approached to fill in a questionnaire containing the adapted Delirium Stigma Scale and the EuroQol five dimensions (EQ-5D-5L) questionnaire. Additional demographic information concerning their education and professional and personal experience with delirium was also collected. The characteristics associated with stigma were determined from the sample. The findings of our study provide an insight into the high level of stigmatisation of delirium patients among professionals (mean 11.66/18 points). This was not related to professionals’ own experiences of delirium, their educational and professional backgrounds, or them having received formal delirium education. However, working closely with people with delirium seems to have a positive impact on the de-stigmatisation of this population among health professionals. Our findings that attitudes are not influenced by formal delirium teaching need to be incorporated into the design of interprofessional educational interventions. Accordingly, we advocate more direct patient-oriented and care delivered teaching interventions.

The ethical implications of preventing hospital delirium in older adults: A scoping review

“…However, educational and experience-related aspects did not play an important role with regard to stigmatization. 52 By contrast, in a more recent study, Mossello et al (2020) 53 suggested that health personnel ′ s education can improve their attitudes toward delirium patients and increase awareness of the condition.…”

“…Mukaetova-Ladinska et al . (2019) 52 found that professionals who worked closely with patients with delirium attained the destigmatization of these patients. However, educational and experience-related aspects did not play an important role with regard to stigmatization.…”

“…These benefits have been associated with a lower incidence of delirium. 51 Regarding relational ethics about nurses' feelings, Mukaetova-Ladinska et al (2019) 52 found a high level of stigmatization of patients with delirium among healthcare professionals. Our results suggest that training healthcare professionals can reduce the incidence, severity, and duration of delirium, 21 but the training of healthcare professionals was not related to their attitudes.…”

“…Our results suggest that training healthcare professionals can reduce the incidence, severity, and duration of delirium, 21 but the training of healthcare professionals was not related to their attitudes. Mukaetova-Ladinska et al (2019) 52 found that professionals who worked closely with patients with delirium attained the destigmatization of these patients. However, educational and experience-related aspects did not play an important role with regard to stigmatization.…”

Reasons to Engage in and Learning Experiences From Different Play Strategies in a Web-Based Serious Game on Delirium for Medical Students: Mixed Methods Design

“…Our study showed that students gained more insight into what a delirious patient endures during delirious episodes; however, in actual practice, understanding of the patient’s needs is often lacking [ 6 , 7 ]. It would be interesting and relevant to study if and how students and health care professionals who work with delirious patients change their behaviors and attitudes when they encounter delirious patients in real life, after playing the game, particularly since destigmatization seems to occur when working closely with delirious patients who use to be stigmatized [ 35 ].…”