Qualitative analysis of staff views on caring for inpatients with delirium and Parkinson's disease: Challenges, tensions and team working.
9 affiliations
- 1Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK.
- 2Gateshead Health NHS Foundation Trust, Gateshead, UK.
- 3NIHR Biomedical Research Centre (BRC): Newcastle, Newcastle upon Tyne, UK.
- 4Newcastle upon Tyne NHS Foundation Trust, Newcastle upon Tyne, UK.
- 5Department of Neurological Sciences, Rush University Medical Center, Chicago, USA.
- 6Centre for Research in Ageing and Cognitive Health, University of Exeter, Exeter, UK.
- 7Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia.
- 8The Prince Charles Hospital, Metro North Mental Health, Brisbane, Queensland, Australia.
- 9Faculty of Nursing, QUT, Brisbane, Queensland, Australia.
Abstract
ObjectivesPeople with Parkinson's disease (PD) are at increased risk of delirium. Documentation of delirium is poor, with challenges in making a diagnosis due to overlapping symptoms. This study interviewed healthcare workers about their experiences of caring for inpatients with PD and delirium to explore their perspectives.DesignA qualitative study with semi-structured interviews and thematic analysis.ParticipantsTwelve healthcare staff, comprising five doctors and seven nurses.ResultsFour themes emerged: environmental pressures, relationship tensions, challenges and team working. We divided findings into those relevant to all inpatients with delirium and those specific to patients with PD and delirium. Environment pressures negatively impacted on all patients with delirium, and empathy was expressed for all carers/relatives. Staff anxiety was higher caring for patients with PD and relationship tensions occurred with juxtaposition of staff delirium expertise and patient/carer lived experience of PD. PD specific challenges were PD medications and a reciprocal relationship between diagnostic overshadowing and identifying the cause of delirium. Roles of ward nursing team to identify acute changes and doctors to identify and diagnose delirium in all patients was clearly defined.ConclusionsThis study identified knowledge gaps and lack of confidence specific to patients with delirium and PD. We recommend clearer definition of delirium superimposed on PD, with education and training on its complexity, alongside inclusion of expert-by-experience teaching. Future study of patient and carer views will help better understand the relationship tensions and how we can improve patient care and experiences.
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BibTeX
@article{cullinan2026qualitative,
title = {{Qualitative analysis of staff views on caring for inpatients with delirium and Parkinson's disease: Challenges, tensions and team working.}},
author = {Rachel Cullinan and Alison J Yarnall and Glenn Stebbins and John-Paul Taylor and David J Burn and Louise M Allan and Sarah J Richardson and Andrew Teodorczuk and Rachael A Lawson},
journal = {Journal of Parkinson's disease},
year = {2026},
month = oct,
doi = {10.1177/1877718x261499241},
url = {https://europepmc.org/article/MED/42924868},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Qualitative analysis of staff views on caring for inpatients with delirium and Parkinson's disease: Challenges, tensions and team working.
AU - Rachel Cullinan
AU - Alison J Yarnall
AU - Glenn Stebbins
AU - John-Paul Taylor
AU - David J Burn
AU - Louise M Allan
AU - Sarah J Richardson
AU - Andrew Teodorczuk
AU - Rachael A Lawson
PY - 2026
DA - 2026/10/23
JO - Journal of Parkinson's disease
DO - 10.1177/1877718x261499241
UR - https://europepmc.org/article/MED/42924868
AB - ObjectivesPeople with Parkinson's disease (PD) are at increased risk of delirium. Documentation of delirium is poor, with challenges in making a diagnosis due to overlapping symptoms. This study interviewed healthcare workers about their experiences of caring for inpatients with PD and delirium to explore their perspectives.DesignA qualitative study with semi-structured interviews and thematic analysis.ParticipantsTwelve healthcare staff, comprising five doctors and seven nurses.ResultsFour themes emerged: environmental pressures, relationship tensions, challenges and team working. We divided findings into those relevant to all inpatients with delirium and those specific to patients with PD and delirium. Environment pressures negatively impacted on all patients with delirium, and empathy was expressed for all carers/relatives. Staff anxiety was higher caring for patients with PD and relationship tensions occurred with juxtaposition of staff delirium expertise and patient/carer lived experience of PD. PD specific challenges were PD medications and a reciprocal relationship between diagnostic overshadowing and identifying the cause of delirium. Roles of ward nursing team to identify acute changes and doctors to identify and diagnose delirium in all patients was clearly defined.ConclusionsThis study identified knowledge gaps and lack of confidence specific to patients with delirium and PD. We recommend clearer definition of delirium superimposed on PD, with education and training on its complexity, alongside inclusion of expert-by-experience teaching. Future study of patient and carer views will help better understand the relationship tensions and how we can improve patient care and experiences.
SN - 1877-7171
SN - 1877-718X
ER -