Incidence and assessment of delirium following open cardiac surgery; A systematic review and meta-analysis.

AIM: This systematic review and meta-analysis sought i) to provide an overview of the incidence of delirium following open cardiac surgery and ii) to investigate how incidences of delirium are associated with different assessment tools. METHODS AND RESULTS: A systematic search of studies investigating delirium following open cardiac surgery were conducted in Medline (Ovid), EMBASE, PsycINFO, CiNAHL and the Cochrane Database. Only studies with patients diagnosed or screened with a validated tool were included. Studies published from 2005 to 2021 were included in the meta-analysis.Of 7,126 individual studies retrieved, 106 met the inclusion criteria for the meta-analysis, hereof 31% of high quality. The weighted pooled incidence of delirium following open cardiac surgery across all studies was 23% (95% CI 20-26%), however we found a considerable heterogeneity (I2 = 99%), which could not be explained by subgroups or further sensitivity analyses. The most commonly applied screening tool for delirium is CAM/CAM-ICU. The lowest estimates of delirium were found by applying the Delirium Observation Scale (incidence 14%, 95% CI 8-20%), and the highest estimates in studies using "other" screening tools (Organic Brain Symptom Scale, Delirium Symptom Interview) pooled incidence of 43%, (95% CI 19 - 66%), however, only two studies applied these. CONCLUSION: Delirium following open cardiac surgery remains a complication with a high incidence of overall 23%, when applying a validated tool for screening or diagnosis. Nevertheless, this systematic review and meta-analyses highlight the significant inconsistency in current evidence regarding assessment tools and regimens. REGISTRATION: Prospero CRD42020215519.

A qualitative study on men's experiences of health after treatment for ischaemic heart disease.

AIMS: Globally, ischaemic heart disease (IHD) is one of the leading causes of mortality among men, and the health management of men is pivotal to prevention and recovery. Many men delay help-seeking and lack knowledge of disease symptomologies. Thus, the aim was to explore how men experience and manage their health while suffering from ischaemic heart disease and having received treatment with coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI). METHODS AND RESULTS: The study applied a qualitative approach designed within a phenomenological-hermeneutical methodology. Interviews were conducted between April and November 2019 with a criterion sample of 21 male patients within 1-2 weeks post-discharge. The analysis was guided by Paul Ricoeur's theory of text interpretation. After analysing the interviews, the following themes were identified: A functioning body as health, illuminating how a functioning body leads to a feeling of independence; misinterpreting signs of illness showing how symptoms are interpreted as signs of ageing rather than disease; and navigating life with ischaemic heart disease focusing on how men retain or maintain health after the threat to life. CONCLUSION: The findings of this study provide insight into men's health and their health management: illuminating how a functioning body can give men a sense of freedom and control, making it difficult to interpret signs of illness, and thus, failing to seek help and feel motivated to make changes when facing a serious health threat. These perspectives should be considered when planning future care and communication with male patients.

Transforming the experience of illness into action - Patient and spouses experiences of involvement in a patient and family advisory council.

OBJECTIVE: The objective was to explore patients' and spouses' perception and attitudes towards participating in a patient and family advisory council. METHODS: A qualitative study with interviews conducted within a phenomenological-hermeneutical frame, inspired by Ricoeur were conducted with current and former participants (patients and/or spouses) of a patient and family advisory council in Denmark. RESULTS: In total, 16 participants were interviewed (12 former patients/four spouses) with a mean age of 68 (range 49-79) and 44 % women. After the analysis, perceptions and attitudes towards participating in a patient advisory council emerged in four themes; "Payback", "A personal invitation", "A safe and equal atmosphere", and "Sharing, caring, and healing". CONCLUSION: Participants of an advisory council express a need for "paying it back" to the health care system. When being part of the advisory council, the participants expressed feeling a genuine engagement and interest from the health-care professionals - leading to a feeling of being equal and taken seriously. The advisory council increased the process of recovery by sharing narratives with peers. PRACTICAL VALUE: Experiences of being part of an advisory council lead to an understanding of "why" former patients and spouses participate. This knowledge can help others to recruit members.

Video-consulted rounds with caregivers: The experience of patients with cancer.

PURPOSE: This study aim to explore how adult patients admitted to an oncology ward experience video-consulted rounds with caregivers as a mean for family involvement. METHODS: The methodological framework for the study was Interpretative phenomenological analysis. Participant observations during video-consulted rounds and semi-structured interviews were conducted between November 2018 and March 2019 at the Department of Oncology, Odense University Hospital, Denmark. RESULTS: 15 patients participated in the study. Overall, patients experienced video-consulted rounds as a satisfactory way of involving their families in rounds while also creating a sense of presence and comfort. Appropriate positioning of stakeholders could influence the experience of virtual rounds. Limitations included the lack of physical care from caregivers, specifically when patients discussed serious matters with health care professionals. Furthermore, patients experienced challenges in reading body language when communicating virtually with their families. CONCLUSION: The study provides important knowledge regarding patients' experiences with video-consulted rounds with caregivers. In concordance with patients' experiences, video-consulted rounds can offer a family centered way to involve caregivers in patient rounds. However, there should be awareness in regard to how the technology is used and to which context it is applied.