The Long-Term Impact of Delirium: An Integrative Review of Patient Experiences

Abstract

Objectives This integrative review explores patients' recall of delirium post-discharge and synthesises existing research on the long-term impact of delirium from the patients' perspective. The findings will inform post-discharge strategies, offering healthcare professionals valuable insights to support patient recovery.

Methods An integrative review of the literature was utilised following the Whittemore and Knafl methodology. Six electronic databases were searched to identify relevant studies. Studies that met inclusion criteria were appraised using the Mixed Methods Appraisal Tool (MMAT) and then analysed using thematic analysis to identify key themes across all articles. The PRISMA checklist was used to evaluate the current research.

Results Fifteen studies were included in the review. Following thematic analysis, two primary themes emerged: (1) Emotional and psychological burden, including anxiety, flashbacks, vivid hallucinations, and chronic sleep disturbances, and (2) Memories of care and connection, emphasising the role of healthcare professionals and social support in recovery. Patients reported feelings of shame, guilt and embarrassment related to delirium-associated memories, particularly their interactions with staff and loved ones. The attitudes and communication styles of healthcare professionals significantly influenced participants' outcomes, with supportive and empathetic care alleviating distress. Family, friends and fellow patients played a crucial role in reassuring participants and reducing feelings of isolation.

Conclusions Effective post-discharge strategies are essential to support patients' long-term recovery and minimise the lasting impact of delirium. Future research should focus on developing interventions to support patients during the post-discharge phase of their delirium.