%0 Journal Article
%@ 1438-8871
%I JMIR Publications
%V 23
%N 8
%P e26079
%T Overview and Strategy Analysis of Technology-Based Nonpharmacological Interventions for In-Hospital Delirium Prevention and Reduction: Systematic Scoping Review
%A Kim,Chan Mi
%A van der Heide,Esther M
%A van Rompay,Thomas J L
%A Verkerke,Gijsbertus J
%A Ludden,Geke D S
%+ Department of Design, Production, and Management, Faculty of Engineering Technology, University of Twente, De Horst (Building 20), Enschede, Netherlands, 31 53 489 8450, c.m.kim@utwente.nl
%K intensive care unit
%K delirium
%K delirium prevention
%K delirium reduction
%K delirium treatment
%K technology
%K technology-based intervention
%K strategy
%K nonpharmacological
%K systematic scoping review
%D 2021
%7 26.8.2021
%9 Review
%J J Med Internet Res
%G English
%X Background: Delirium prevention is crucial, especially in critically ill patients. Nonpharmacological multicomponent interventions for preventing delirium are increasingly recommended and technology-based interventions have been developed to support them. Despite the increasing number and diversity in technology-based interventions, there has been no systematic effort to create an overview of these interventions for in-hospital delirium prevention and reduction. Objective: This systematic scoping review was carried out to answer the following questions: (1) what are the technologies currently used in nonpharmacological technology-based interventions for preventing and reducing delirium? and (2) what are the strategies underlying these currently used technologies? Methods: A systematic search was conducted in Scopus and Embase between 2015 and 2020. A selection was made in line with the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Studies were eligible if they contained any type of technology-based interventions and assessed delirium-/risk factor–related outcome measures in a hospital setting. Data extraction and quality assessment were performed using a predesigned data form. Results: A total of 31 studies were included and analyzed focusing on the types of technology and the strategies used in the interventions. Our review revealed 8 different technology types and 14 strategies that were categorized into the following 7 pathways: (1) restore circadian rhythm, (2) activate the body, (3) activate the mind, (4) induce relaxation, (5) provide a sense of security, (6) provide a sense of control, and (7) provide a sense of being connected. For all technology types, significant positive effects were found on either or both direct and indirect delirium outcomes. Several similarities were found across effective interventions: using a multicomponent approach or including components comforting the psychological needs of patients (eg, familiarity, distraction, soothing elements). Conclusions: Technology-based interventions have a high potential when multidimensional needs of patients (eg, physical, cognitive, emotional) are incorporated. The 7 pathways pinpoint starting points for building more effective technology-based interventions. Opportunities were discussed for transforming the intensive care unit into a healing environment as a powerful tool to prevent delirium. Trial Registration:  PROSPERO International Prospective Register of Systematic Reviews CRD42020175874; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=175874 
%M 34435955
%R 10.2196/26079
%U https://www.jmir.org/2021/8/e26079
%U https://doi.org/10.2196/26079
%U http://www.ncbi.nlm.nih.gov/pubmed/34435955