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Abstract Utilization of Selected Characteristics in The Labeling of Confusion in the Elderly Patricann Furnari Brady 1985 The term confusion is often used as a nursing diagnosis. Yet, there is no consistent definition that indicates a systematic process is used in the labeling of elderly patients as confused. The research question for this descriptive association study was: “To what extent are selected characteristics utilized among nursing home staff in the labeling of elderly as confused?” The objectives of this study were as follows: 1) Identify the frequency of use of each of the selected characteristics in the clinical determination of confusion in the elderly by nursing home staff. 2) Determine the relationship between nursing home staffs’ Identification of selected characteristics present and the labeling of an elderly nursing home resident viewed on video as confused. Determine if there is a relationship between the demographic characteristics of nursing home staff and: a. Utilization of selected characteristics b. Identification of selected characteristics presented by a nursing home resident on video. c. Determination of confusion for a nursing home resident presented on video. The setting for this research study was a 113 bed intermediate/skilled level of care nursing home adjacent to a religious teaching hospital in a Midwestern town with a population of 30,000. The sample for this study was 26 individual staff members of the nursing home including registered nurses, licensed practical nurses, medication aides and nursing aides. The tool, developed by the investigator based on nursing literature, was comprised of four sections 1) demographic information; 2) list of selected characteristics: subjects were asked to indicate the degree of utilization of these characteristics in the labeling of confusion; 3) video response: the subjects were asked to indicate the presence or absence of the selected characteristics in response to a video and then indicate if the patient was confused; 4) definition of confusion. The most frequently used defining characteristics were: disorientation to time, disorientation to place, disorientation about people and hallucinations. The least frequently used defining characteristics were: sleep disturbance, restlessness, fear, anxiety, apathy, change in behavior and change in communications. Change in ability to problem solve showed the most variability in the utilization by the sample in labeling of elderly patients as confused. The association of the nursing home staff’s six main demographic variables and frequency of selected characteristics was analyzed through use of ANOVA. There was no significant relationship noted in the utilization of selected characteristics in the labeling of an elderly individual viewed on video as confused and the demographic data of the nursing home staff. Of the 26 respondents, only one subject correctly listed the characteristics of the nursing home resident viewed on video as predetermined by the investigator. Regardless of the position, education, age, employment length, or amount of time working with the elderly, there was no significant difference in the utilization of selected characteristics by nursing home staff in labeling and elderly nursing home individual as confused. No selected characteristic is utilized primarily by nursing home staff in labeling an elderly nursing home individual as confused. Thus, the investigator proposed a conceptual framework for the process of diagnosing and elderly nursing home patient as confused.
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