Authors (including presenting author) :
Lin HC (1), Choi KS Alex (1), Ku HL Florence (1), Hui N (1), Wong KK (1)
Affiliation :
(1) Occupational Therapy Department, United Christian Hospital
Introduction :
Delirium is an acute or subacute neurobehavioral syndrome caused by transient disruption of neuronal activity. 20-30% of patients developed delirium in medical ward. It might lead to increased morbidity, mortality, cost of care and poor functional and cognitive recovery. Meanwhile, it causes imminent distress to families and medical caregiver. Inmu Relax is an electrical care tool that provide musical stimulation, tactile sense and vibration. The sensor inside inmu relax would transform the touch and movement into soothing music so as to occupy patient with peaceful environment and motivate patient to participate in OT functional training. It reduced agitated behavior and improve patient’s engagement. Evidence indicated that Imnu Relax provide a positive effect in sense of safety and wellbeing and level of functional disorder. Studies revealed that most patients reported the reduction of anxiety, excessive thought and meanwhile improved sleep quality after using Inmu relax.
Objectives :
To introduce musical sensory stimulation using “Inmu Relax” on patient with delirium in acute medical setting. To promote positive behavioral changes through occupational engagement and cognitive stimulation . Inclusion criteria: Diagnosed/ delirium features identified by medical staff, cooperative, able follow single command, not reluctant to treatment .
Methodology :
The pilot study program was designed to carry out cognitive stimulation by adding on the Inmu Relax musical sensory simulation on top of the conventional program which including reality orientation, ADL training, cognitive stimulation (clapping and beats and movement imitation). 3-5 training sessions were provided. Pre and post training evaluation including Hong Kong Brief Cognitive Test, 4 AT, Digit Forward Span, Modified Barthel Index and Numerical Rating Scale (mood) were completed.
Result & Outcome :
7 participants recruited in the program, while 3 of them completed the training sessions. The others dropped out due to transferring out to convalescent hospital or discharge within 1-2days. 3 out of 7 of patients improved in alertness and able to engage in cognitive assessment and actively participated in further training. For a talkative patient with hyperactive delirium, her mood became stable and calm and leg restraints could be off after 1-session treatment. In view of psychological aspect, a majority of patients reported that it improved their mood status and they would like to receive the treatment again. For the NPRS (mood) score, the mean score from the completed data increased from 2.7 to 7.7 out of 10. Their attention span also increased in some patients from 5 minutes to 10 minutes. Furthermore, it helped to calm down depressed mood and meaningless crying for another agitated patient during session. This study suggested the usefulness of the music sensory stimulation added on conventional OT cognitive stimulation program for delirium. The program showed positive effects in alertness, attention and psychosocial aspects. However, due to relatively small sample size and no control group, further studies are warranted on the intervention in future.
