The Current Status of Orthopedic Healthcare Workers'Knowledge of Postoperative Delirium:a Questionnaire Survey
Objective To investigate the current status of orthopedic healthcare workers'knowledge of postoperative delirium(POD)in orthopedics at different levels of hospitals and with different professional titles in Jiangxi province.Methods A cross-sectional study was conducted using a questionnaire survey among qualified orthopedic healthcare professionals in Jiangxi province.The questionnaire included basic information about healthcare professionals,as well as diagnosis,treatment,management,and current learning status of POD.Results A total of 1153 valid questionnaires were collected,including 508 doctors(44.06%)and 645 nurses(55.94%);among them,472 had junior professional titles,479 had intermediate professional titles,and 202 had senior professional titles.26.19%(302 individuals)of the healthcare professionals had no clinical experience with POD,among whom nurses accounted for 76.82%.The diagnostic criteria for POD included disorientation,sleep-wake cycle disruption,perceptual disturbances,emotional instability,and delusions.65.30%of orthopedic surgeons(286/438)chose to make their own diagnosis for patients with mild symptoms,while seeking consultation from specialized departments for more severe cases;22.14%(97/438)opted for self-diagnosis,and 12.56%(55/438)preferred to consult with the psychosomatic medicine department first;among them,orthopedic surgeons with higher working years and professional titles chose self-diagnosis at a higher proportion than those with lower working years and professional titles(P＜0.01).49.94%(218/438)of healthcare workers would take measures to prevent POD;83.43%(710/851)of healthcare workers would engage in preoperative POD education for surgical patients,with 27.5%providing detailed preoperative education;the proportion of physicians who offered POD education was higher than that of nurses[88.04%(388/438)vs.77.97%(322/413),P＜0.01].Moreover,65.1%(554/851)of healthcare institutions lacked systematic POD treatment/management protocols;the proportion of tertiary hospitals with standardized protocols was higher than that of non-tertiary hospitals[38.59%(208/539)vs.28.53%(89/312),P＜0.05];the proportion of healthcare workers involved in the diagnosis or care of POD was higher in tertiary hospitals than in non-tertiary hospitals[77.67%(539/694)vs 67.97%(312/459),P＜0.05].The proportion of healthcare workers concerned about POD-related manifestations was higher in tertiary hospitals than in non-tertiary hospitals[80.15%(432/539)vs 73.40%(229/312),P＜0.05];the proportion of nurses concerned about POD after surgery was higher than that of doctors[81.36%(336/413)vs 74.2%(325/438),P＜0.01].Olanzapine was identified as the most frequently used medication for POD.447.83%(407/851)of healthcare professionals would conduct follow-up visits for POD patients after discharge,with a higher proportion of physicians than nurses[(51.14%(224/438)vs 44.31%(183/413),P＜0.01];the follow-up rate among intermediate medical personnel was higher than that of both junior and senior physicians(P＜0.01);61.70%(525/851)of healthcare professionals would learn about POD,but they still believed that POD prevention and treatment did not receive sufficient attention.Conclusion There is significant variability in the diagnosis and management of POD among orthopedic healthcare professionals in Jiangxi province,depending on hospital level,professional title,and role of the healthcare provider.Overall,orthopedic healthcare professionals need to strengthen systematic and professional education and training on POD.
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