Pengaruh Cognitive Therapy dalam Mencegah Kejadian Delirium pada Pasien Kritis di Intensive Care Unit (ICU)

Abstract

During the admission period, critically ill patient have risk of various health problems including delirium. Delirium is an acute condition of attention declining and cognitive dysfunction, which is life threatening but actually preventable. Cognitive therapy for the patient is aimed to give brain stimulation and to connect them with the environment. To date, there are no researches have been conducted on the effect of cognitive therapy for critically ill patient in Indonesia. Thus, this study aimed to analyze the effect of cognitive therapy on preventing delirium in critically ill patient at intensive care unit (ICU). This study was conducted with quasi-experiment design, where post-test was only conducted on control group. The sample of this study consist of 64 patients (32 patients of control group and 32 patients of intervention group) whose eligible to inclusion and exclusion criteria. Cognitive therapy was given to the patients of intervention group twice a day for 3 days. Delirium was observed by Confusion Assessment Method for ICU (CAM-ICU). Among 32 patients in control group, 20 of them experienced delirium. While only 4 of 32 patients in intervention group experienced delirium. The risk factors for delirium were adult age, male gender, cardiovascular diseases, sedation, and the decreasing of RASS and MMSE value. The p-value of 7.016x10-5 was obtained by Fisher’s Exact statistical test. This study suggests that cognitive therapy is an effective method for preventing delirium in critically ill patient at intensive care unit (ICU). Thus, this therapy should be adapted to reduce the risk of other health problems in critically ill patient.