Early recognition and nursing intervention strategies for delirium in severe patients
重症患者谵妄的早期识别与护理干预策略

摘要

目的 探讨基于ICU意识模糊评估法（CAM-ICU）量表联合多维度评估的早期识别模式，结合个性化护理干预在重症患者谵妄中的应用效果。方法 选取2023年1月至2025年12月本院重症医学科收治的120例重症患者作为研究对象，采用随机数字表法分为对照组和实验组各60例。对照组实施常规护理及谵妄被动识别，实验组采用CAM-ICU量表联合生理、心理、环境多维度评估进行谵妄早期识别，同步实施个性化护理干预，比较两组谵妄发生率、谵妄持续时间及护理满意度。结果 实验组谵妄发生率显著低于对照组（χ2=7.523，P=0.006）；实验组谵妄持续时间显著短于对照组（t=14.258，P<0.001）；实验组护理满意度显著高于对照组（χ2=8.571，P=0.003）。结论 CAM-ICU量表联合多维度评估可精准实现重症患者谵妄早期识别，配合个性化护理干预，能有效降低谵妄发生率、缩短谵妄持续时间，提升护理满意度，改善患者预后，具有重要的临床推广与应用价值。

Abstract

Objective To investigate the application of early recognition patterns based on the confusion assessment method of intensive care unit (CAM-ICU) scale combined with multidimensional assessment, along with personalized nursing interventions, in delirium among critically ill patients.
Methods A total of 120 critically ill patients admitted to the Department of Critical Care Medicine from January 2023 to December 2025 were selected as study subjects. They were randomly divided into a control group and an experimental group (60 cases each) using a random number table. The control group received routine nursing care and passive delirium identification, while the experimental group underwent early delirium identification using the CAM-ICU scale combined with physiological, psychological, and environmental multidimensional assessments, alongside personalized nursing interventions. The incidence of delirium, duration of delirium, and nursing satisfaction were compared between the two groups.
Results The experimental group showed a significantly lower incidence of delirium compared to the control group (χ2=7.523, P=0.006); the duration of delirium was significantly shorter in the experimental group (t=14.258, P<0.001); and nursing satisfaction was significantly higher in the experimental group (χ2=8.571, P=0.003).
Conclusion   The CAM-ICU scale combined with multidimensional assessment can accurately achieve early recognition of delirium in critically ill patients. When combined with personalized nursing interventions, it effectively reduces the incidence of delirium, shortens its duration, improves nursing satisfaction, and enhances patient prognosis, demonstrating significant clinical value for promotion and application.