Confusão

: a dimensão do subdiagnóstico

Abstract

It has been recognized that the syndrome of confusion is frequently poor documented and underreported. Furthermore, this situation is believed to delay the patients’ recovery and can result in serious damages for the hospitalized patient. The present study was carried out in a Central University Hospital, where several medical and nursing records, as well as “nurse’s perception”, were interpreted in order to analyze the degree of confusion’s under-diagnosis. It was developed a non-experimental descriptive, correlational and exploratory study, whose systematic procedures were taken according to a quantitative paradigm. The data was collected in 31 departments, where 111 records of patients with confusion were selected and analyzed. The “nurse’s perception” item was also interpreted as data and registered during an interview. The information extracted from the patients’ records and from the interview was subjected to a content analysis by using the CIPE ® (version 1), a model which had been established a priori. The behavior characteristics more often documented were: illogical speech; hyperactive and hypoactive behavior; disorientation; interactive aggressive behavior and refusal to cooperate with nursing care. According to nurses’ records, the interventions most frequently reported were those related to the item “Immobilize”, as for example, restrain patients by using cot-sides while in bed. The final goal of this study is the identification of the degree of confusion’s under-diagnosis. For this purpose it was analyzed the documentation of confusion in the patients’ records. The under-diagnosis was identified in 14 patients, which corresponds to 12,6% of the cases. After the analysis made to the nurses’ speech during the interview it was concluded that in 30,6% of the cases there was a lack of perception regarding the patients’ condition. Finally, it was also concluded that the number of confused patients, who did not have any indicator of confusion in the documentation, as well as in the “nurse’s perception”, was of 9 patients, which corresponds to 8,1% of the cases.

Date of Award	2008
Original language	Portuguese
Awarding Institution	Universidade Católica Portuguesa
Supervisor	Abel Paiva (Supervisor) & Paulo Oliveira Marques (Supervisor)