Effect of multi-disciplinary cooperative intervention under life help program on delirium prevention and physiological and psychological improvement of elderly patients with craniocerebral tumors in intensive care unit

Yanfei HUANG; Minjuan XIE

ABSTRACT

Objective:

To explore the effect of multidisciplinary collaborative intervention under hospital elder life program (HELP) on improvement of craniocerebral tumor elderly patients′ delirium prevention, physical and psychological status in ICU.

Methods:

Totally 89 craniocerebral tumor elderly patients undergoing craniocerebral tumor surgery under general anesthesia in ICU from Guangzhou Red Cross Hospital were selected as the research objects. 45 patients treated from January 2019 to January 2020 were set as the control group and given routine nursing intervention, and 44 patients treated from February 2020 to January 2021 were set as the observation group and given multidisciplinary collaborative intervention under HELP theory. The incidence of delirium, physiological, psychological recovery and complications during ICU stay were compared between the two groups before and after intervention.

Results:

Before intervention, there was no significant difference in the scores of various indexes between the observation group and the control group ( P>0.05). After the intervention, the mean arterial pressure, heart rate, intracranial pressure, SaO 2 and the score of modified Barthel index in the observation group were (92.15 ± 7.08) mmHg (1 mmHg=0.133kPa), (77.58 ± 3.68) times/min, (114.84 ± 10.35) mmH 2O (1 mmH 2O=0.009 8 kPa), 0.95 ± 0.04 and (80.21 ± 9.42) points, and those in the control group were (96.44 ± 7.15) mmHg, (74.29 ± 3.29) times/min, (136.28 ± 10.24) mmH 2O, 0.90 ± 0.05 and (62.44 ± 8.15) points, and there were statistically significant differences between two groups ( t values were 2.84-9.82, all P<0.01). After the intervention, scores of critical illness nutritional risk, ICU delirium screening, mental state and sleep disorder in the observation group were (4.79 ± 0.38), (1.27 ± 0.21), (43.24 ± 3.27) and (18.44 ± 2.17) points, those in the control group were (4.18 ± 0.37), (2.07 ± 0.30), (40.05 ± 3.21) and (20.14 ± 2.18) points, there were significant differences between two groups ( t values were 3.22-14.60, all P<0.01). After the intervention, the ICU stay time and the first time out of bed time in the observation group were (6.44 ± 0.52) d and (1.74 ± 0.32) d, which were statistically significantly lower than (7.69 ± 0.54) d and (2.43 ± 0.24) d in the control group ( t=11.12, 11.53, both P<0.01). After the intervention, the incidence of delirium in the observation group was 0, which was statistically significantly lower than 18.18% (8/45) in the control group ( χ2=8.99, P<0.01).

Conclusions:

Multidisciplinary collaborative intervention under HELP theory can effectively reduce the incidence of delirium, improve their physiological and psychological status, improve the quality of life of elderly patients after craniocerebral tumor surgery under general anesthesia.