Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Confusion”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 91 records · Page 5Linked to original sources
PubMed1978

A comparison of the effects of filtering and sensorineural hearing loss on patients of consonant confusions.

It has been found that listeners with sensorineural hearing loss who show similar patterns of consonant confusions also tend to have similar audiometric profiles. The present study determined whether normal listeners, presented with filtered speech, would produce consonant confusions similar to those previously reported for the hearing-impaired listener. Consonant confusion matrices were obtained from eight normal-hearing subjects for four sets of CV and VC nonsense syllables presented under six high-pass and six-low pass filtering conditions. Patterns of consonant confusion for each condition were described using phonological features in sequential information analysis. Severe low-pass filtering produced consonant confusions comparable to those of listeners with high-frequency hearing loss. Severe high-pass filtering gave a result comparable to that of patients with flat or rising audiograms. And, mild filtering resulted in confusion patterns comparable to those of listeners with essentially normal hearing. An explanation in terms of the spectrum, the level of speech, and the configuration of this individual listener's audiogram is given.

Audiometry↗
PubMed1999

Similarity as a risk factor in drug-name confusion errors: the look-alike (orthographic) and sound-alike (phonetic) model.

BACKGROUND: One of every four medication errors reported in the United States is a name-confusion error. The rate of name-confusion errors might be reduced if new and confusing names were not allowed on the market and if safeguards could be put in place to avoid confusion between existing names. OBJECTIVES: To evaluate several prognostic tests of drug-name confusion, alone and in combination, with respect to their sensitivity, specificity, and overall accuracy. RESEARCH DESIGN: Case-control study. Twenty-two different computerized measures of orthographic similarity, orthographic distance, and phonetic similarity were used to compute similarity/distance scores for n = 1,127 cases (ie, pairs of names that appeared in published error reports or national error databases) and n = 1,127 controls. MAIN OUTCOME MEASURES: Mean similarity/distance scores were compared across cases and controls. The performance of each measure at distinguishing between cases and controls was evaluated by tenfold crossvalidation. Dose-response relationships were examined. Univariate and multivariate logistic regression models were formed and evaluated by 10 fold crossvalidation. RESULTS: Cases had significantly higher similarity scores than controls. Every measure of similarity proved to be a significant risk factor for error. There was a significant increasing trend in the odds-ratio as a function of similarity. A three-predictor logistic regression model had crossvalidated sensitivity of 93.7%, specificity of 95.9% and accuracy of 94.8%. CONCLUSIONS: A sensitive and specific test of drug-name confusion potential can be formed using objective measures of orthographic similarity, orthographic distance, and phonetic distance.

Analysis of Variance↗
PubMedDate not supplied

Significance of the confusion test in cerebral palsy.

The confusion test examines ankle dorsiflexion in patients with cerebral palsy. Orthopedists have related this test to swing-phase activity of the tibialis anterior, and have used it as a prerequisite for tendon transfer. To determine the validity of this assumption, ankle dorsiflexion was tested in 47 normal children. Forty-seven percent had a positive, unresisted confusion test, and 97% had a positive, resisted confusion test. Twenty-three patients with cerebral palsy who had a positive confusion test underwent gait analysis. Tibialis anterior electromyographs showed wide variability. Sagittal-plane ankle-movement curves revealed five patterns. Thirty-three percent of the patients showed abnormal swing-phase dorsiflexion, and 61% had abnormal swing-phase plantar-flexion. We conclude that the confusion test evaluates a normal, patterned response, and is positive in most children with cerebral palsy. Although a positive confusion test shows that active ankle dorsiflexion is possible, it is not predictive of swing-phase ankle kinematics.

Ankle↗
PubMed2005

Recognition of delirium in ICU patients: a diagnostic study of the NEECHAM confusion scale in ICU patients.

BACKGROUND: A delirium, is a serious, high-frequency complication in intensive care unit (ICU) patients. The consequences of this complication range from high morbidity and mortality to greater need for nursing care. Despite these, delirium is often not recognized and there for not treated. In this study a nursing screening instrument, the NEECHAM confusion scale, was studied for early recognition of delirium ICU patients. This scale proved valid and reliable in several studies in the general hospital population. METHODS: In this study validity and reliability were tested in a prospective cohort of 105 patients. Gold standard for delirium was an independent DSM-IV diagnosis. User friendliness was tested by structured evaluation of nurses' experiences working with the scale. RESULTS: The NEECHAM confusion scale showed high internal consistency (Cronbach's alpha 0.88) and an interrater reliability of Cohen's Kappa 0.60. The concurrent validity with the DSM-IVcriteria showed a strong link (chi-square 67.52, p [less than or equal to] 0.001). Sensitivity was high, 97% and specificity was good 83%. ICU nurses completed the NEECHAM confusion rating in 3.69, +/- 1.21 minutes average. In general the nurses were positive about the NEECHAM confusion scale. They were able to collect data during regular care, but experienced problems in rating the scale in intubated patients. The items in themselves were clear, the content validity, measured by the language used was rated good. CONCLUSION: The psychometric characteristics of the NEECHAM confusion scale of this ICU study are generally consistent with validity research previously reported for the general hospital population. The psychometric characteristics and the ease of use of the NEECHAM confusion scale enables ICU nurses to early recognize delirium. Further study, especially in intubed patients is recommended.

Journal Article↗
PubMed2003

[The nursing phenomenon "chronic confusion" in relation to the diagnosis "dementia"].

This article is about the results of a literature analysis, focusing on the two questions: 1) What is the understanding of "Chronic confusion"? and 2) How is the nursing diagnosis "Chronic confusion" delineated from the diagnosis "Dementia"? The review is based on the databases CINAHL, MEDLINE and GEROLIT. A review of the literature revealed that there is basic agreement regarding the characteristic "cognitive impairment" but there are differences in the question as to how this cognitive impairment manifests itself in practice. Moreover most authors described socially and emotionally altered behaviors which accompany the phenomenon. There is, however, no clear vision on the status of such socially and emotionally altered behaviors: Do they have to be present for "Chronic confusion" to be diagnosed or not? In addition, it seems inconsistent to include the mild stage of Dementia in the "Chronic confusion" diagnosis. This analysis indicates that much work remains to be done to validate the characteristics of "Chronic confusion". As long as the diagnosis is not clear, imprecise labeling of patients and ineffective interventions cannot be avoided.

Chronic Disease↗
PubMed1996

Analysis of perceptual confusions between nine sets of consonant-vowel sounds in normal and dyslexic adults.

It is widely accepted that most developmental dyslexics perform poorly on tasks which assess phonological awareness. One reason for this association might be that the early or "input" phonological representations of speech sounds are distorted or noisy in some way. We have attempted to test this hypothesis directly. In Experiment 1, we measured the confusions that adult dyslexics and controls made when they listened to nine randomly presented consonant-vowel (CV) segments [sequence: see text] under four conditions of increasing white noise masking. Subjects could replay stimuli and were under no obligation to respond quickly. Responses were selected with a computer mouse from a set of nine letter-strings, corresponding to the auditory stimuli, presented on a VDU. While the overall pattern of confusions made by dyslexics and controls was very similar for this stimulus set, dyslexics confused [sequence: see text] significantly more than did controls. In Experiment 2, subjects heard each stimulus once only and were forced to respond as quickly as possible. Under these timed conditions, the pattern of confusions made by dyslexics and controls was the same as before, but dyslexics took longer to respond than controls. The slower responses of dyslexics in Experiment 2 could have arisen because: (a) they were slower at processing the auditory stimuli than controls, (b) they had worse visual pattern memory for letter strings than controls, (c) they were slower than controls at using the computer mouse. In Experiments 3, 4 and 5 subjects carried out control tasks which eliminated each of these possibilities and confirmed that the results from the auditory tasks genuinely reflected subjects' speech perception. We propose that the fine structure of dyslexics' input phonological representations should be further explored with this confusion paradigm by using other speech sounds containing VCs, CCVs and VCCs.

Adult↗
PubMed1989

The confusion technique untangled: its theoretical rationale and preliminary classification.

This article examines the historical development of Milton H. Erickson's theoretical approach to hypnosis using confusion. Review of the literature suggests that the Confusion Technique, in principle, consists of a two-stage "confusion-restructuring" process. The article also attempts to categorize several examples of confusion suggestions by seven linguistic characteristics: (1) antonyms, (2) homonyms, (3) synonyms, (4) elaboration, (5) interruption, (6) echoing, and (7) uncommon words. The Confusion Technique is an important yet little studied strategy developed by Erickson. More work is urged to investigate its nature and properties.

Cognition Disorders↗
PubMed2005

The confusion effect in predatory neural networks.

A simple artificial neural network model of image reconstruction in sensory maps is presented to explain the difficulty predators experience in targeting prey in large groups (the confusion effect). Networks are trained to reconstruct multiple randomly conformed "retinal" images of prey groups in an internal spatial map of their immediate environment. They are then used to simulate prey targeting by predators on groups of specific conformation. Networks trained with the biologically plausible associative reward-penalty method produce a more realistic model of the confusion effect than those trained with the popular but biologically implausible backpropagation method. The associative reward-penalty model makes the novel prediction that the accuracy-group size relationship is U shaped, and this prediction is confirmed by empirical data gathered from interactive computer simulation experiments with humans as "predators." The model further predicts all factors known from previous empirical work (and most factors suspected) to alleviate the confusion effect: increased relative intensity of the target object, heterogeneity of group composition, and isolation of the target. Interestingly, group compaction per se is not predicted to worsen predator confusion. This study indicates that the relatively simple, nonattentional mechanism of information degradation in the sensory mapping process is potentially important in generating the confusion effect.

Animals↗
PubMedDate not supplied

Acute confusion: nursing intervention in older patients.

Older patients are at high risk for developing acute confusion while hospitalized with an associated increased risk of morbidity and mortality. Causes for acute confusion include physiologic, psychosocial, and environmental alterations. Often not recognized by nurses, acute confusion needs to be differentiated from depression and dementia. Nursing assessment of acute confusion should include baseline data on cognition, behavior, and functional status. Standard, routine, and systematic assessments of cognition, behavior, and functional status need to be ongoing during hospitalization if nurses are to identify and manage acute confusion in hospitalized older patients.

Acute Disease↗
PubMed2004

The effect of music listening on acute confusion and delirium in elders undergoing elective hip and knee surgery.

This study was undertaken to determine the effect of music on elders undergoing elective hip and knee surgery who experience acute confusion and delirium postoperatively. Postoperative confusion and delirium in elders often cause complications that negatively effect recovery. Music listening was introduced as an intervention to an experimental group. Nurses documented episodes of acute confusion and delirium experienced by elders postsurgically. Scores from a readiness-to-ambulate profile to determine if patients were cognitively ready for postoperative therapy were evaluated. There was a significant decrease in the number of episodes of postoperative confusion among those in the experimental group compared with those in the non-listening control group. In addition, the experimental group had significantly higher scores on the readiness-to-ambulate profile than the control group. These findings indicate that music listening is an effective nursing intervention that can be used to decrease acute postoperative confusion and delirium in elders undergoing elective hip and knee surgery.

Acute Disease↗
PubMed2006

Prospective comparison of acute confusion severity with duration of post-traumatic amnesia in predicting employment outcome after traumatic brain injury.

BACKGROUND: Measurement of the duration of post-traumatic amnesia (PTA) is common practice, serving as an important index of the severity of traumatic brain injury (TBI) and a predictor of functional outcome. However, controversy exists regarding the nature of PTA; some studies indicate that it is a confusional state with symptoms that extend beyond disorientation and amnesia. OBJECTIVE: To evaluate the contribution of the severity of acute confusion 1 month after TBI to prediction of employment at 1 year after injury, comparing it with PTA duration. METHODS: Prospective study involving 171 participants with complete data, who met the study criteria, from 228 consecutive TBI Model System admissions. Outcome measures included weekly administration of the Delirium Rating Scale-Revised-98 (DelRS-R98) to measure the severity of acute confusion. Evaluations closest to 1 month after injury were used for study purposes. Duration of PTA was defined as the interval from injury until two consecutive Galveston Orientation and Amnesia Test scores of > or = 76 were obtained within a period of 24-72 h. Univariable and multivariable logistic regression were used to predict employment status at 1 year after injury. RESULTS: Age, education and DelRS-R98 were significant predictors accounting for 34% of outcome variance. Individuals with greater confusion severity at 1 month after injury, older age and lower levels of education were less likely to be employed at 1 year after injury. Severity of confusion was more strongly associated with employment outcome (r(s) = -0.39) than was PTA duration (r(s) = -0.34). CONCLUSIONS: In addition to demographic indices, severity of acute confusion makes a unique contribution to predicting late outcome after TBI.

Acute Disease↗
PubMed1991

Human tactile pattern recognition: active versus passive touch, velocity effects, and patterns of confusion.

1. Subjects without any previous experience in a tactile psychophysics task participated in a study of tactile letter recognition employing active and passive touch. In the active task, subjects reached through a curtain and examined embossed letters with horizontal, unidirectional finger strokes. In the passive task, subjects sat with their arms and hands immobilized while a rotating drum stimulator pressed the embossed letters onto the right index finger. The stimulus conditions in the passive task were identical to those used in neurophysiological experiments with monkeys. 2. A survey of 40 naive subjects who were not screened in any way showed a wide range of performance levels. There was no difference between the subjects in the active and passive tasks, either in overall mean percent correct scores, which were 49.0 and 50.7%, respectively or in the percent correct scores for individual letters whose product-moment correlation coefficient was 0.94. The active and passive groups, which contained 25 and 15 members, respectively, had no members in common. 3. Videotapes of the finger movements of eight subjects in the active task showed a characteristic V-shaped velocity profile (velocity vs. lateral position) starting at approximately 100 mm/s at the left-hand edge of the plate containing the embossed letter, decelerating to a minimum when the center of the finger was directly over the letter, and then accelerating away from the letter. The average minimum scanning velocity was 17 mm/s. 4. Scanning velocity had no significant effect on performance in the passive task between 20 and 40 mm/s. An increase to 80 mm/s produced a 16% decline in percent correct identifications. 5. Learning effects were evident across sessions even though subjects were given no feedback or training. The increase in mean percent correct judgments averaged 4% per session, which lasted for approximately 1 h. 6. Data from 64 subjects were pooled for detailed comparison of identification patterns in active and passive touch. The results were analyzed and found to be consistent with the hypothesis that the identification and confusion probabilities are identical in the two modes. We conclude that there is no difference between active and passive touch in form recognition when the stimulus pattern is smaller than a finger pad. 7. Data from all experiments were pooled to produce a single confusion matrix with 324 presentations per letter. The majority of erroneous responses are grouped in a small number of confusion pairs and the majority of those confusion pairs are strongly asymmetric. The probable neural mechanisms of some confusion patterns are discussed.

Adult↗
PubMed2003

Risk for acute confusion in sensory-impaired, rural, long-term-care elders.

Acute confusion is a common geriatric syndrome in long-term care (LTC) elders with prevalence rates of 10% to 39%. Sensory impairment, specifically vision and hearing impairment, is even more common in LTC, with prevalence rates of 40% to 90%. The purpose of this study was to investigate the risk relationship between sensory impairment and the development of acute confusion in LTC elders. Each resident (N = 114) underwent sensory screening and then was followed for 28 days to monitor for the onset of acute confusion. Twenty residents (17.5%) developed acute confusion, 60 residents (52.6%) were found to be visually impaired, 49 (44.1%) were hearing impaired, and 28 (24.6%) were found to be dually impaired. Significant relationships between vision impairment, odds ratio (OR) = 3.67, confidence interval (CI) (1.13, 11.92), and dual sensory impairment, OR = 2.88, CI (1.04, 8.26), with the development of acute confusion were identified.

Acute Disease↗
PubMed1992

Predictors of self-reported problems of confusion among the aged.

Responses to questions on the 1984 Supplement on Aging to the National Health Interview Survey (NHIS) about the experience of personal confusion revealed that two-thirds of those interviewed reported never having an episode of confusion during the preceding year. Of those who reported episodes, fewer than one in five said they were happening with increased frequency. The many meanings of confusion found in the literature prompted a modest local study of what respondents understood by the term when asked the NHIS questions. Of those who admitted occasional confusion, almost two-thirds gave definitions that included memory loss or forgetfulness. Consequently, increased frequency of memory problems and difficulty in remembering were included with other variables in the analyses to identify significant predictors. They emerged the single best predictors of how often a respondent reported getting confused. Others were change in health status, number of functional limitations, educational attainment, and vision problems.

Aged↗
PubMed1993

Hospitalized elders. Risk of confusion with hip fracture.

Although frequently underdiagnosed, more than half of all patients admitted for the treatment of hip fracture are confused at the time of hospital admission or develop confusion sometime during the course of hospitalization. This study reveals the profound vulnerability of severely confused patients with hip fracture. Severely confused patients experience higher overall rates of medical complications and are more likely to be discharged to a nursing home. In addition to being at higher risk for medical complications, severely confused patients also appear to be at greater risk for being physically restrained.

Aged↗
PubMed2003

[Confused states as predictors of epileptic seizures during and after cerebrovascular accident].

UNLABELLED: The state of mental confusion is described as an dependent risk factor in development of early and late epileptic-onset seizures following CVI. The aim of this paper is to determine the influence of confused state as possible predictor of symptomatic seizures in the course and following CVI. MATERIAL AND METHODS: The patients who were treated in The Department of Neurology for early and late-onset seizures in the course and following CVI in the period between 1.1.1989 and 31.12.1998. RESULTS: We had total number of 106 patients with symptomatic seizures, 56 in the group of late-onset and 50 in the group of early seizures. 52.8% of the patients have a registered state of mental confusion at the admission to hospital (in the stage of acute CVI), 19.2% of patients had a clear sensorium. Disorder of consciousness of the type of coma was registered in 27.4% of the patients. There was statistically significant increase of the occurrence of mental confusion in the group of patients with late-onset seizures, 62.5% while there was a statistically significant increase of coma in conditions related to type, frequency and outcome of seizures. We can conclude that mental confusion has significant influence of the occurrence of late-onset seizures while it does not influence the type and frequency of seizures.

Confusion↗
PubMed2004

[Acute postoperative confusion in heart surgery patients].

Unlike other countries, Germany does not have data about the incidence of acute confusion following heart surgery. However, the occurrence of acute confusion does extend the hospitalization length by up to 13 days. Thus, this phenomenon is of high relevance for the health profession. This incidence study was performed with the goal to obtain exact information on the incidence rate of acute postoperative confusion after heart surgery (bypass and valve operations) through a multi-center evaluation. The data evaluation took place in the form of a convenient sample survey in three different German clinics specialized in heart surgery. The observation period lasted from the day of surgery up to the fifth postoperative day. In the context of this prospective cohort study, suitable study participants were all patients aged 18 or older who underwent heart surgery between February 1st and April 30th, 2000. At the end, 860 patients were included in the study. A total of 152 patients showed symptoms of acute confusion, meaning a total incidence of 17.4% (confidence interval 14-20%). The occurrence of this phenomenon was not symmetrical. A wide-spread occurrence could be observed particularly at night. Patients aged 81-91 were mainly affected, with an incidence of confusion of 43.5% in this group. The results confirm the clinical importance of this issue and require interdisciplinary approaches for solution.

Adult↗
PubMedDate not supplied

[Experiences of voluntary visitors with nonverbal communication in interaction with confused elderly patients in nursing homes].

20 confused elderly in nursing homes (average age 82), who were socially isolated and dependent of nursing care resulting from dementia and institutional factors, were visited by students of social work and student nurses of the elderly. The voluntary visitors were trained in client-centered therapy, reality orientation, non-verbal communication, sensory training, reinforcing daily functions and occupational therapy. The experiences with verbal and non-verbal communication (visual and hearing contact and touching) and with difficulties with the confused elderly, with feelings and the environmental factors are described. The visiting results in better understanding of the confused elderly and in increasing of supporting relationship. Confusion was ameliorated only in some confused elderly. Recommendations are given for voluntary visitors.

Aged↗