The effect of chronotherapy on delirium in critical care - a systematic review.
Identifieur interne : 000704 ( Main/Exploration ); précédent : 000703; suivant : 000705The effect of chronotherapy on delirium in critical care - a systematic review.
Auteurs : Roseanne Luther [Royaume-Uni] ; Anne Mcleod [Royaume-Uni]Source :
- Nursing in critical care [ 1478-5153 ] ; 2018.
Descripteurs français
- KwdFr :
- MESH :
- enseignement et éducation : Personnel de santé.
- méthodes : Chronothérapie.
- prévention et contrôle : Délire avec confusion.
- épidémiologie : Délire avec confusion.
- Humains, Soins de réanimation, Unités de soins intensifs.
English descriptors
- KwdEn :
- MESH :
- education : Health Personnel.
- epidemiology : Delirium.
- methods : Chronotherapy.
- prevention & control : Delirium.
- Critical Care, Humans, Intensive Care Units.
Abstract
BACKGROUND
Delirium is highly prevalent within critical care and is linked to adverse clinical outcomes, increased mortality and impaired quality of life. Development of delirium is thought to be caused by multiple risk factors, including disruption of the circadian rhythm. Chronotherapeutic interventions, such as light therapy, music and use of eye shades, have been suggested as an option to improve circadian rhythm within intensive care units.
AIM
This review aims to answer the question: Can chronotherapy reduce the prevalence of delirium in adult patients in critical care?
DESIGN
This study is a systematic review of quantitative studies.
RESEARCH METHOD
Six major electronic databases were searched, and a hand search was undertaken using selected key search terms. Research quality was assessed using the critical appraisal skills programme tools. The studies were critically appraised by both authors independently, and data were extracted. Four themes addressing the research question were identified and critically evaluated.
FINDINGS
Six primary research articles that investigated different methods of chronotherapy were identified, and the results suggest that multi-component non-pharmacological interventions are the most effective for reducing the prevalence of delirium in critical care. The melatonergic agonist Ramelteon demonstrated statistically significant reductions in delirium; however, the reliability of the results in answering the review question was limited by the research design. The use of bright light therapy (BLT) and dynamic light application had mixed results, with issues with the research design and outcomes measured limiting the validity of the findings.
CONCLUSION
Multi-component non-pharmacological interventions, such as noise and light control, can reduce delirium in critical care, whereas other interventions, such as BLT, have mixed outcomes. Melatonin, as a drug, may be a useful alternative to sedative-hypnotics.
RELEVANCE TO CLINICAL PRACTICE
Chronotherapy can reduce the incidence of delirium within critical care, although further research is warranted. Staff education is essential in the implementation of chronotherapy.
DOI: 10.1111/nicc.12300
PubMed: 28508438
Affiliations:
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a systematic review.</title><author><name sortKey="Luther, Roseanne" sort="Luther, Roseanne" uniqKey="Luther R" first="Roseanne" last="Luther">Roseanne Luther</name><affiliation wicri:level="3"><nlm:affiliation>Acute Care Unit, Homerton University Hospital, Homerton NHS Trust, London, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Acute Care Unit, Homerton University Hospital, Homerton NHS Trust, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Mcleod, Anne" sort="Mcleod, Anne" uniqKey="Mcleod A" first="Anne" last="Mcleod">Anne Mcleod</name><affiliation wicri:level="4"><nlm:affiliation>Senior Lecturer in Critical Care, School of Health Sciences City, University of London, Northampton Square, London, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Senior Lecturer in Critical Care, School of Health Sciences City, University of London, Northampton Square, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName><orgName type="university">Université de Londres</orgName></affiliation></author></analytic><series><title level="j">Nursing in critical care</title><idno type="eISSN">1478-5153</idno><imprint><date when="2018" type="published">2018</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Chronotherapy (methods)</term><term>Critical Care (MeSH)</term><term>Delirium (epidemiology)</term><term>Delirium (prevention & control)</term><term>Health Personnel (education)</term><term>Humans (MeSH)</term><term>Intensive Care Units (MeSH)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Chronothérapie (méthodes)</term><term>Délire avec confusion (prévention et contrôle)</term><term>Délire avec confusion (épidémiologie)</term><term>Humains (MeSH)</term><term>Personnel de santé (enseignement et éducation)</term><term>Soins de réanimation (MeSH)</term><term>Unités de soins intensifs (MeSH)</term></keywords><keywords scheme="MESH" qualifier="education" xml:lang="en"><term>Health Personnel</term></keywords><keywords scheme="MESH" qualifier="enseignement et éducation" xml:lang="fr"><term>Personnel de santé</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Delirium</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Chronotherapy</term></keywords><keywords scheme="MESH" qualifier="méthodes" xml:lang="fr"><term>Chronothérapie</term></keywords><keywords scheme="MESH" qualifier="prevention & control" xml:lang="en"><term>Delirium</term></keywords><keywords scheme="MESH" qualifier="prévention et contrôle" xml:lang="fr"><term>Délire avec confusion</term></keywords><keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Délire avec confusion</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Critical Care</term><term>Humans</term><term>Intensive Care Units</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Humains</term><term>Soins de réanimation</term><term>Unités de soins intensifs</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b></p><p>Delirium is highly prevalent within critical care and is linked to adverse clinical outcomes, increased mortality and impaired quality of life. Development of delirium is thought to be caused by multiple risk factors, including disruption of the circadian rhythm. Chronotherapeutic interventions, such as light therapy, music and use of eye shades, have been suggested as an option to improve circadian rhythm within intensive care units.</p></div><div type="abstract" xml:lang="en"><p><b>AIM</b></p><p>This review aims to answer the question: Can chronotherapy reduce the prevalence of delirium in adult patients in critical care?</p></div><div type="abstract" xml:lang="en"><p><b>DESIGN</b></p><p>This study is a systematic review of quantitative studies.</p></div><div type="abstract" xml:lang="en"><p><b>RESEARCH METHOD</b></p><p>Six major electronic databases were searched, and a hand search was undertaken using selected key search terms. Research quality was assessed using the critical appraisal skills programme tools. The studies were critically appraised by both authors independently, and data were extracted. Four themes addressing the research question were identified and critically evaluated.</p></div><div type="abstract" xml:lang="en"><p><b>FINDINGS</b></p><p>Six primary research articles that investigated different methods of chronotherapy were identified, and the results suggest that multi-component non-pharmacological interventions are the most effective for reducing the prevalence of delirium in critical care. The melatonergic agonist Ramelteon demonstrated statistically significant reductions in delirium; however, the reliability of the results in answering the review question was limited by the research design. The use of bright light therapy (BLT) and dynamic light application had mixed results, with issues with the research design and outcomes measured limiting the validity of the findings.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSION</b></p><p>Multi-component non-pharmacological interventions, such as noise and light control, can reduce delirium in critical care, whereas other interventions, such as BLT, have mixed outcomes. Melatonin, as a drug, may be a useful alternative to sedative-hypnotics.</p></div><div type="abstract" xml:lang="en"><p><b>RELEVANCE TO CLINICAL PRACTICE</b></p><p>Chronotherapy can reduce the incidence of delirium within critical care, although further research is warranted. Staff education is essential in the implementation of chronotherapy.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">28508438</PMID><DateCompleted><Year>2019</Year><Month>09</Month><Day>25</Day></DateCompleted><DateRevised><Year>2019</Year><Month>09</Month><Day>25</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1478-5153</ISSN><JournalIssue CitedMedium="Internet"><Volume>23</Volume><Issue>6</Issue><PubDate><Year>2018</Year><Month>11</Month></PubDate></JournalIssue><Title>Nursing in critical care</Title><ISOAbbreviation>Nurs Crit Care</ISOAbbreviation></Journal><ArticleTitle>The effect of chronotherapy on delirium in critical care - a systematic review.</ArticleTitle><Pagination><MedlinePgn>283-290</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1111/nicc.12300</ELocationID><Abstract><AbstractText Label="BACKGROUND">Delirium is highly prevalent within critical care and is linked to adverse clinical outcomes, increased mortality and impaired quality of life. Development of delirium is thought to be caused by multiple risk factors, including disruption of the circadian rhythm. Chronotherapeutic interventions, such as light therapy, music and use of eye shades, have been suggested as an option to improve circadian rhythm within intensive care units.</AbstractText><AbstractText Label="AIM">This review aims to answer the question: Can chronotherapy reduce the prevalence of delirium in adult patients in critical care?</AbstractText><AbstractText Label="DESIGN">This study is a systematic review of quantitative studies.</AbstractText><AbstractText Label="RESEARCH METHOD">Six major electronic databases were searched, and a hand search was undertaken using selected key search terms. Research quality was assessed using the critical appraisal skills programme tools. The studies were critically appraised by both authors independently, and data were extracted. Four themes addressing the research question were identified and critically evaluated.</AbstractText><AbstractText Label="FINDINGS">Six primary research articles that investigated different methods of chronotherapy were identified, and the results suggest that multi-component non-pharmacological interventions are the most effective for reducing the prevalence of delirium in critical care. The melatonergic agonist Ramelteon demonstrated statistically significant reductions in delirium; however, the reliability of the results in answering the review question was limited by the research design. The use of bright light therapy (BLT) and dynamic light application had mixed results, with issues with the research design and outcomes measured limiting the validity of the findings.</AbstractText><AbstractText Label="CONCLUSION">Multi-component non-pharmacological interventions, such as noise and light control, can reduce delirium in critical care, whereas other interventions, such as BLT, have mixed outcomes. Melatonin, as a drug, may be a useful alternative to sedative-hypnotics.</AbstractText><AbstractText Label="RELEVANCE TO CLINICAL PRACTICE">Chronotherapy can reduce the incidence of delirium within critical care, although further research is warranted. Staff education is essential in the implementation of chronotherapy.</AbstractText><CopyrightInformation>© 2017 British Association of Critical Care Nurses.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Luther</LastName><ForeName>Roseanne</ForeName><Initials>R</Initials><AffiliationInfo><Affiliation>Acute Care Unit, Homerton University Hospital, Homerton NHS Trust, London, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>McLeod</LastName><ForeName>Anne</ForeName><Initials>A</Initials><Identifier Source="ORCID">0000-0002-1726-4139</Identifier><AffiliationInfo><Affiliation>Senior Lecturer in Critical Care, School of Health Sciences City, University of London, Northampton Square, London, UK.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D000078182">Systematic Review</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2017</Year><Month>05</Month><Day>15</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>Nurs Crit Care</MedlineTA><NlmUniqueID>9808649</NlmUniqueID><ISSNLinking>1362-1017</ISSNLinking></MedlineJournalInfo><CitationSubset>N</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D019454" MajorTopicYN="N">Chronotherapy</DescriptorName><QualifierName UI="Q000379" MajorTopicYN="Y">methods</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D003422" MajorTopicYN="Y">Critical Care</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D003693" MajorTopicYN="N">Delirium</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="Y">epidemiology</QualifierName><QualifierName UI="Q000517" MajorTopicYN="N">prevention & control</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006282" MajorTopicYN="N">Health Personnel</DescriptorName><QualifierName UI="Q000193" MajorTopicYN="Y">education</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D007362" MajorTopicYN="N">Intensive Care Units</DescriptorName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="Y">Adult intensive care</Keyword><Keyword MajorTopicYN="Y">practice development/innovation</Keyword><Keyword MajorTopicYN="Y">psychological issues during and after intensive care</Keyword><Keyword MajorTopicYN="Y">sensory imbalance</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2016</Year><Month>09</Month><Day>21</Day></PubMedPubDate><PubMedPubDate PubStatus="revised"><Year>2017</Year><Month>04</Month><Day>17</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2017</Year><Month>04</Month><Day>18</Day></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2017</Year><Month>5</Month><Day>17</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2019</Year><Month>9</Month><Day>26</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2017</Year><Month>5</Month><Day>17</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">28508438</ArticleId><ArticleId IdType="doi">10.1111/nicc.12300</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>Royaume-Uni</li></country><region><li>Angleterre</li><li>Grand Londres</li></region><settlement><li>Londres</li></settlement><orgName><li>Université de Londres</li></orgName></list><tree><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Luther, Roseanne" sort="Luther, Roseanne" uniqKey="Luther R" first="Roseanne" last="Luther">Roseanne Luther</name></region><name sortKey="Mcleod, Anne" sort="Mcleod, Anne" uniqKey="Mcleod A" first="Anne" last="Mcleod">Anne Mcleod</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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