The usefulness of bright light therapy for patients after oesophagectomy

Nonpharmacological Interventions to Prevent Delirium: An Evidence-Based Systematic Review

“…Seven studies [18][19][20][21][22][23][24] were done in critically ill patients, 5 in geriatric general medicine patients, 9-13 3 in postoperative patients, [14][15][16] and 2 in patients who had a hip fracture. 7,8 A total of 13 of the studies were prospective investigations, [7][8][9][10][11]13,15,16,18,[21][22][23][24] and 4 were randomized control trials.…”

“…7,8 A total of 13 of the studies were prospective investigations, [7][8][9][10][11]13,15,16,18,[21][22][23][24] and 4 were randomized control trials. [14][15][16]24 The Confusion Assessment Method or the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) was the most frequently used tool and was used in 10 studies. [7][8][9][10]13,[19][20][21][22][23] The Neelon and Champagne Confusion Scale was used in 4 evaluations, [14][15][16]24 and the Intensive Care Delirium Screening Checklist, 18 the Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition; DSM-IV), 12 and the Delirium Screening Scale 12 were each used once.…”

“…[7][8][9][10][11][12][13][14][15][18][19][20][21] Among these, 9 revealed a benefit of the nonpharmacological intervention. [8][9][10][12][13][14][15]20,21 Table 3 gives the interventions used in the individual studies. Among the interventions that were beneficial, the mean reduction in the incidence of delirium was 24.7%, with a range of 9.7% to 31.8%.…”

“…The most common interventions associated with any clinical benefit were mobilization, 8,10,[20][21][22][23] reorientation, 9,10,13,18,21 education of nurses, 7,10,12,18,23 and music therapy. 9,16,18,20,21 A single nonpharmacological intervention was examined in 5 studies, 12,[14][15][16]24 and multiple nonpharmacological interventions were examined in 12 investigations. [7][8][9][10]11,13,[18][19][20][21][22][23] Delirium is associated with multiple negative consequences, including increased length of stay, higher health care costs, and even increased mortality.…”

“…Unfortunately, most of the literature is on nonpharmacological interventions used in either general medicine, geriatric, or perioperative patients. [7][8][9][10][11][12][13][14][15][16] Although critically ill patients certainly differ from most of the populations of patients studied, one can reasonably assume that critically ill patients, who are at the highest risk for delirium, would also benefit from nonpharmacological interventions. Large randomized controlled trials with a multi-interventional approach that includes pharmacological and nonpharmacological approaches to prevent delirium are needed.…”