Towards understanding the nature and need of delirium guidelines across nations and cultures.


Journal

Aging clinical and experimental research
ISSN: 1720-8319
Titre abrégé: Aging Clin Exp Res
Pays: Germany
ID NLM: 101132995

Informations de publication

Date de publication:
Mar 2022
Historique:
received: 10 07 2021
accepted: 31 08 2021
pubmed: 10 9 2021
medline: 8 3 2022
entrez: 9 9 2021
Statut: ppublish

Résumé

Delirium is associated with a variety of adverse healthcare outcomes but is highly predictable, preventable and treatable. For this reason, numerous guidelines have been developed for delirium recognition, prevention and management across different countries and disciplines. Although research is adduced as evidence for these guidelines, a constant finding is the lack of implementation if they exist at all. Implementation is a human behaviour that can be influenced by various factors including culture at a micro- and macro-level. Hofstede's model proposes that national cultures vary along six consistent dimensions. Using this model, we examined the nature of delirium guidelines across countries in relation to Hofstede's six cultural dimensions. Data collected for each country on: the six dimensions of Hofstede's model, number of delirium guidelines approved by a National professional body of each country (through searching databases), the annual old-age dependency ratio for each country. Sixty-four countries had the completed six dimensions of Hofstede's model. Twenty of them (31%) had one or more delirium guidelines. The total number of different delirium guidelines was 45. Countries with formal delirium guidelines have significantly lower power distance among their members, are more individualistic societies, have lower levels of uncertainty avoidance and higher old-age dependency ratio compared to those without delirium guidelines. The development and implementation of delirium guidelines vary across countries. Specific combinations of cultural dimensions influence the production of delirium guidelines. Understanding these important cultural differences can facilitate more widespread acceptance and implementation of guidelines.

Sections du résumé

BACKGROUND BACKGROUND
Delirium is associated with a variety of adverse healthcare outcomes but is highly predictable, preventable and treatable. For this reason, numerous guidelines have been developed for delirium recognition, prevention and management across different countries and disciplines. Although research is adduced as evidence for these guidelines, a constant finding is the lack of implementation if they exist at all. Implementation is a human behaviour that can be influenced by various factors including culture at a micro- and macro-level. Hofstede's model proposes that national cultures vary along six consistent dimensions.
AIM OBJECTIVE
Using this model, we examined the nature of delirium guidelines across countries in relation to Hofstede's six cultural dimensions.
METHODS METHODS
Data collected for each country on: the six dimensions of Hofstede's model, number of delirium guidelines approved by a National professional body of each country (through searching databases), the annual old-age dependency ratio for each country.
RESULTS RESULTS
Sixty-four countries had the completed six dimensions of Hofstede's model. Twenty of them (31%) had one or more delirium guidelines. The total number of different delirium guidelines was 45. Countries with formal delirium guidelines have significantly lower power distance among their members, are more individualistic societies, have lower levels of uncertainty avoidance and higher old-age dependency ratio compared to those without delirium guidelines.
DISCUSSION/CONCLUSION CONCLUSIONS
The development and implementation of delirium guidelines vary across countries. Specific combinations of cultural dimensions influence the production of delirium guidelines. Understanding these important cultural differences can facilitate more widespread acceptance and implementation of guidelines.

Identifiants

pubmed: 34499343
doi: 10.1007/s40520-021-01978-w
pii: 10.1007/s40520-021-01978-w
pmc: PMC8427916
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

633-642

Informations de copyright

© 2021. The Author(s), under exclusive licence to Springer Nature Switzerland AG.

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Auteurs

Dimitrios Adamis (D)

Sligo Mental Health Services, Clarion Rd, Sligo, Ireland. dimaadamis@yahoo.com.
Research and Academic Institute of Athens, Athens, Greece. dimaadamis@yahoo.com.

Alastair Macdonald (A)

Clinical Outcomes Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.

Geraldine McCarthy (G)

Sligo Medical Academy, NUI Galway and Sligo Mental Health Services, Clarion Rd, Sligo, Ireland.

Alessandro Morandi (A)

Department of Rehabilitation and Aged Care "Fondazione Camplani" Hospital, Hospital Ancelle, Via Aselli 14, 26100, Cremona, Italy.
REFiT Bcn Research Group, ParcSanitari Pere Virgili and Valld'Hebrón Institute of Research, Barcelona, Spain.

Giuseppe Bellelli (G)

University of Milano-Bicocca, San Gerardo Hospital, Monza, Italy.

David Meagher (D)

Cognitive Impairment Research Group (CIRG), Graduate-Entry Medical School University of Limerick, Limerick, Ireland.

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Classifications MeSH