A Conceptual-Theoretical-Empirical Structure of Nursing for the Prevention of Delirium Based on the Dynamic Symptom Model

This study aims to develop a Conceptual-Theoretical-Empirical (C-T-E) structure for holistic nursing care, centered on delirium prevention and treatment in critically ill patients, based on the Dynamic Symptoms Model (DSM) as the theoretical framework.

The conceptual-theoretical-empirical structure is developed to test theories. The conceptual model or conceptual framework guides the test of the middle-range theory or theoretical framework, linking concepts and propositions. The concepts and propositions are then presented for testing through an empirical research method.

The C-T-E structure, based on the DSM, provides an understanding of delirium as a fluctuating and multifactorial syndrome. Besides, delirium has shown strong associations with physical, psychological, social, environmental, and spiritual antecedents. Thus, nurses and the healthcare team can prevent and reduce delirium in patients by reducing pain, mechanical ventilation, and sedatives, and by managing concomitant symptoms such as anxiety, fear, and suffering, while monitoring the trajectory of delirium. In conclusion, the C-T-E structure of the DSM in the context of delirium provides a theoretical framework for nurses and the healthcare team to personalize holistic, theoretically supported interventions.

The practical implications of this study allow us to understand delirium as an event in which various patient antecedents converge. For that, nurses can apply the DSM in nursing interventions to reduce delirium-causing factors in the environment and the patient's antecedents.

This study allows us to understand delirium as an event approach that integrates theory, research, and practice, contributing to delirium prevention and enhancing nursing care quality, expanding inclusive, person-centered healthcare, and reducing the gap between theory, research, and nursing practice, thereby enhancing understanding of the phenomenon.