Otani, H., Morita, T., Uno, S., Yamamoto, R., Hirose, H., Matsubara, T., . . . Sasaki, K. (2014). Effect of leaflet-based intervention on family members of terminally ill patients with cancer having delirium: Historical control study. American Journal of Hospice and Palliative Medicine, 31, 322–326. 

DOI Link

Study Purpose

To assess the effects of an informational leaflet about delirium on family-perceived distress, the need for improvement in professional care for delirium, and the knowledge about the causes of delirium in patients during the end of life

Intervention Characteristics/Basic Study Process

Palliative care practitioners distributed an informational leaflet on delirium as part of their routine care of patients. Families of patients who experienced delirium at the end of life were then contacted by mail six months after the patient had died to complete a questionnaire about their experience.

Sample Characteristics

  • N = 113   
  • MEAN AGE = 74 years
  • MALES: 61%, FEMALES: 39%
  • CURRENT TREATMENT: Not applicable
  • KEY DISEASE CHARACTERISTICS: Predominately spouse of patient (42%) or child of patient (36%)

Setting

  • SITE: Multi-site   
  • SETTING TYPE: Multiple settings    
  • LOCATION: Japan

Phase of Care and Clinical Applications

  • PHASE OF CARE: End-of-life care
  • APPLICATIONS: Palliative care 

Study Design

Single-arm, historical control

Measurement Instruments/Methods

A questionnaire was developed for the study that measured family distress (single item), the need for improvements in professional care for delirium (single item), and knowledge of the causes of delirium (single item). A Likert-type scale was used for each question.

Results

The intervention group had a better understanding of certain aspects of the causes of delirium (p < 0.001). No difference was reported between the historical control and intervention groups in terms of the levels of family-perceived distress or the need for improvement in professional care for delirium.

Conclusions

An educational leaflet may improve family members' knowledge and understanding about some of the causes of delirium at the end of life.

Limitations

  • Risk of bias (no control group)
  • Risk of bias (no random assignment)
  • Risk of bias (no appropriate attentional control condition)
  • Unintended interventions or applicable interventions not described that would influence results
  • Measurement validity/reliability questionable
  • Low return rate
  • Potential for recall bias among both groups surveyed

Nursing Implications

Written information about expected symptoms, such as delirium, may be helpful in increasing family members' knowledge.