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Melissa Hovak

Date of Award

Fall 2018

Document Type


Degree Name

Master of Science in Nursing (MSN)



Thesis Committee Chairperson

Lisa Ball PhD, RN, FNP-BC


delirium, prodrome, ICU, family member


Background: Delirium is a very common condition in the adult ICU setting and is associated with long term cognitive disabilities, functional decline, increased hospital length of stay, and overall poor health outcomes (Bull, Avery et al., 2015). There remains a limited amount of scholarly evidence related to the prodrome to delirium in an adult ICU setting (Hamdan-Mansour et al, 2010). With family members being key observers, they may recognize elusive signs and symptoms that can indicate early delirium events (Kerr et al., 2013).

Purpose: The purpose of this study was to explore the prevalence of the prodromal phase to delirium in adult ICU patients as perceived by their family member or close friend.

Method: A quantitative, simple descriptive survey design was used for this study. Nonprobability convenience sampling consisted of family members or close friends of adult ICU patients. A 17-question anonymous survey was designed from a researcher-developed tool based on Szarpa et al.’s (2013) prodrome to delirium grounded theory. The Statistical Package for Social Sciences (SPSS) was the program used for data analysis.

Findings: Sixty-four participants who were 18 years of age and older responded to the survey. Participants’ ages ranged from 22 to 85 years of age. The patients’ ages ranged from 24 to 84 years of age with a mean age of 55 years. Of those, 44 were males and 10 were females. The patients’ length of stay in the ICU ranged from one to 74 days with a mean of 9 days. More than 50% of participants identified most of the symptoms of the prodrome to delirium in adult patients in the ICU.

Conclusions: Signs and symptoms of the prodrome to delirium are prevalent and readily identifiable in adult patients in the ICU. Intervening to address delirium in adult patients in the ICU and supporting their family members is necessary and future research in this area is warranted.