The Relationship between Knowledge, Attitude, and Practices of Nursing staffs on Post-operative Delirium in the Elderly

Main Article Content

Sirimart Piyawattanapong
Mayuree Leethong-in
Supavadee Thiengtham
Sawitree Sommongkol
Tharinee Phetcharat
Sagheemas Kaewkot


Background and Objective: Nurses are responsible for understanding, monitoring, preventing and manipulating the post-operative delirium in elderly patients. This study aimed to investigate the levels and relationship among nurses’ knowledge, attitudes, and performance about caring post-operative delirium in the elderly patients. 

Methods: This correlational study was carried out among 94 registered nurses in Surgical and Orthopedic nursing department, Srinagarind hospital, faculty of Medicine, Khon Kaen university. The data collection consisted of the knowledge questionnaire on post-operative delirium, the attitude questionnaire on post-operative delirium and the behavioral nursing practice questionnaire on post-operative delirium in the elderly patients that had the reliabilities at 0.70, 0.83 and 0.91, respectively. Data were analyzed by using descriptive statistics and Spearman’s Rho.

Results: The response rate were 97.92% (96/94). The study depicted that 78.7% of the participants demonstrated a good level of knowledge. It is also suggested that 44.7% of the nurses have positive attitudes toward caring post-operative delirium in elderly patients, and 79.8% of them frequently perform post-operative caring of delirium in elderly patients at a high level. The knowledge and attitude did not have the correlation with practices of nurses on post-operative delirium in the elderly patients (p=.111 and .913, respectively).

Conclusion: The majority of the nurses were considered as being well educated, having positive attitudes, and giving care to the elderly patients consistently. Therefore, to maintain the quality of nursing care for post-operative elderly patients, seminar sessions which both provide knowledge and encourage nurses to have positive attitudes should be regularly and continuously conducted. 


Download data is not yet available.

Article Details

Original Articles


1. American Geriatrics Society Expert Panel on Postoperative Delirium in Older Adults. American geriatrics society abstracted clinical practice guideline for postoperative delirium in older adults. J Am Geriatr Soc 2015; 63: 142–50.
2. Rudolph JL, Marcantonio ER. Review articles: postoperative delirium: acute change with long-term implications. Anesth Analg 2011; 112: 1202–11.
3. Quinlan N, Rudolph JL. Postoperative delirium and functional decline after noncardiac surgery. J Am Geriatr Soc 2011; 59: S301–4.
4. Rizk P, Morris W, Oladeji P, Huo M. Review of postoperative delirium in geriatric patients undergoing hip surgery. Geriatr Orthop Surg Rehabil 2016; 7: 100–5.
5. Muangpaisan W, Wongprikron A, Srinonprasert V, Suwanpatoomlerd S, Sutipornpalangkul W, Assantchai P. Incidence and risk factors of acute delirium in older patients with hip fracture in Siriraj hospital. J Med Assoc Thai 2015; 98: 423–30.
6. Inouye SK, Robinson T, Blaum C, Busby-Whitehead J, Boustani M, Chalian A, et al. Postoperative delirium in older adults: best practice statement from the American Geriatrics Society. J Am Coll Surg 2015; 220: 136–148.e1.
7. Siddiqi N, Harrison JK, Clegg A, Teale EA, Young J, Taylor J, et al. Interventions for preventing delirium in hospitalised non-ICU patients. Cochrane Ddatabase Syst Rev 2016; 3: CD005563.
8. Yang, Y.-H. Comprehension and Knowledge about Delirium in Nurses Working at Long-Term Care Hospitals or General Hospitals. J Korean Acad Soc Nurs Educ 2010; 16: 312–20.
9. Voyer P, Richard S, Doucet L, Danjou C, Carmichael PH. Detection of delirium by nurses among long-term care residents with dementia. BMC Nurs 2008; 7: 4.
10. Ajoy Sunil A. An evaluation of nursing practices regarding delirium assessments in adult critical care units in Western seaboard region of Ireland [Internet]. National University of Ireland Galway; 2014. [cited February 7, 2018]; Available from:
11. Hare M, Wynaden D, McGowan S, Landsborough I, Speed G. A questionnaire to determine nurses’ knowledge of delirium and its risk factors. Contemp Nurse 2008; 29: 23–31.
12. Kim MY, Eun Y. Knowledge, performance and stress about care for delirium orthopedic hospital nurses. J Muscle Jt Heal 2013; 20: 72–80.
13. Lee KH, Park ML, Kim GY. A study of knowledge, recognition and practice about delirium in general hospital nurses. Adv Sci Technol Lett 2016; 122: 56-9.
14. Mouchoux C, Fassier T, Rippert P, Comte B, Castel-Kremer E, Barth X, et al. Nursing staff knowledge on postoperative delirium in older inpatients: an exploratory survey. Adv Practice Nurs 2015; 1: 102.
15. Park YS, Kim K, Song K, Kang J. A preliminary survey of nurses’ understanding of delirium and their need for delirium education: in a university hospital. J Korean Acad Nurs 2006; 36: 1183–92.
16. Uppanisakorn S, Seangnhern U, Intaraksa P, Chinnawong T. Factors related to the knowledge about delirium in critical ill patients among nurse. Thai J Crit Care Med 2010; 17: 6–12.
17. Eastwood GM, Peck L, Bellomo R, Baldwin I, Reade MC. A questionnaire survey of critical care nurses’ attitudes to delirium assessment before and after introduction of the CAM-ICU. Aust Crit Care 2012; 25:162–9.
18. Tangchonlatip K, Vapattanawong P, Chamchan C, Kanungsukkasem U, Vong-Ek P, Punpuingm S. Value of Thai elderly: perspectives from two genrations. In: Thaweecit S, Boonyamanond, S, Editors. Population and social 2010: Value of the elderly from the eyes of Thai society. NakhonPathom: Institute for population and social research, 2010: 29–61.
19. Flagg B, Cox L, Mcdowell S, Mwose JM, Buelow JM. Nursing identification of delirium. Clin Nurse Spec 2010; 24: 260-6.
20. Hamdan-Mansour AM, Farhan NA, Othman EH, Yacoub MI. Knowledge and nursing practice of critical care nurses caring for patients with delirium in intensive care units in Jordan. J Contin Educ Nurs 2010; 41: 571–6.
21. Liu Y-E, Norman IJ, While AE. Nurses’ attitudes towards older people and working with older patients: an explanatory model. J Nurs Manag 2015; 23: 965–73.
22. Devlin JW, Fong JJ, Howard EP, Skrobik Y, McCoy N, Yasuda C, et al. Assessment of delirium in the intensive care unit: nursing practices and perceptions. Am J Crit care 2008; 17: 555–65.
23. Nursing department Srinagarind hospital Faculty of Medicine Khon Kaen university. Manual of nursing care system for Hospitalized elderly patients. Khon Kaen: Khon Kaen university, 2013.
24. Bandura A. Social foundations of thought and action: a social cognitive theory. Englewood Cliffs, NJ: Prentice-Hall, 1986.
25. de Guzman AB, Jimenez BCB, Jocson KP, Junio AR, Junio DE, Jurado JBN, et al. Filipino nursing students’ behavioral intentions toward geriatric care: a Structural Equation Model (SEM). Educ Gerontol 2013; 39: 138–54.
26. Lovell M. Caring for the elderly: changing perceptions and attitudes. J Vasc Nurs 2006; 24: 22–6.