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Exploring the Effectiveness of Intelligent Audiovisual Interventions in Delirium, Agitation, and Pain Among Middle Aged and Elderly Patients in Emergency Intensive Care Units: A Quasi-Experimental Study

16 août 2026 mis à jour par: Taipei Veterans General Hospital, Taiwan

The goal of this nonrandomized, quasi-experimental clinical trial is to evaluate whether an intelligent audiovisual intervention can prevent delirium and reduce delirium severity, agitation, and pain among adults aged 55 years or older admitted to an emergency intensive care unit (EICU). The main questions it aims to answer are:

Does the intelligent audiovisual intervention reduce the incidence and severity of delirium compared with routine care? Does the intervention improve agitation and pain scores compared with routine care?

Researchers will compare participants receiving the intelligent audiovisual intervention plus routine care with participants receiving routine care alone. Participants will be assigned according to the week of EICU admission: those admitted during odd-numbered weeks will receive the intervention, while those admitted during even-numbered weeks will receive routine care.

Participants in the intervention group will:

View a structured audiovisual program containing a prerecorded message from a family member, current date and weather information, and images of the area surrounding the hospital.

Receive the intervention for 2 minutes per session, 3 times daily for 2 consecutive days, beginning within 24 hours after EICU admission.

Participants in both groups will undergo assessments of delirium, agitation, and pain 3 times daily for 2 consecutive days. Delirium incidence and severity will be assessed using the Confusion Assessment Method for the Intensive Care Unit-7 (CAM-ICU-7). Agitation will be evaluated using the Richmond Agitation-Sedation Scale (RASS), and pain will be assessed using either the Numerical Rating Scale (NRS) or the Face, Legs, Activity, Cry, and Consolability (FLACC) scale.

Aperçu de l'étude

Statut

Pas encore de recrutement

Les conditions

Intervention / Traitement

Type d'étude

Interventionnel

Inscription (Estimé)

128

Phase

  • N'est pas applicable

Contacts et emplacements

Cette section fournit les coordonnées de ceux qui mènent l'étude et des informations sur le lieu où cette étude est menée.

Coordonnées de l'étude

Critères de participation

Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.

Critère d'éligibilité

Âges éligibles pour étudier

  • Adulte
  • Adulte plus âgé

Accepte les volontaires sains

Non

La description

Inclusion Criteria:

  1. Aged 55 years or older.
  2. Admitted to the emergency intensive care unit within the previous 24 hours.
  3. No delirium at baseline, defined as a negative Confusion Assessment Method for the Intensive Care Unit assessment and a CAM-ICU-7 score of 0-2.
  4. Acute Physiology and Chronic Health Evaluation II (APACHE II) score ≥14.
  5. Sufficiently alert to communicate, with a Glasgow Coma Scale score of E4V4-5M6 or E4VTM6.
  6. Diagnosed with an infection or an infection-related critical illness, such as sepsis, urinary tract infection, or pneumonia.

Exclusion Criteria:

  1. Diagnosed visual or hearing impairment that would interfere with receiving the audiovisual intervention.
  2. History of substance abuse.
  3. History of psychiatric illness.
  4. Moribund status, receipt of a palliative care consultation, or an expected survival of 7 days or less.
  5. Unable to communicate in Mandarin Chinese or Taiwanese Hokkien.
  6. No family caregiver available to participate in preparation of the audiovisual intervention.
  7. History of surgery within the previous 7 days.
  8. Montreal Cognitive Assessment (MoCA) score <23.

Plan d'étude

Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.

Comment l'étude est-elle conçue ?

Détails de conception

  • Objectif principal: Soins de soutien
  • Répartition: Non randomisé
  • Modèle interventionnel: Affectation parallèle
  • Masquage: Aucun (étiquette ouverte)

Armes et Interventions

Groupe de participants / Bras
Intervention / Traitement
Expérimental: Intelligent Audiovisual Intervention
Participants will receive routine care plus a structured intelligent audiovisual intervention beginning within 24 hours after admission to the emergency intensive care unit. The audiovisual program includes a prerecorded message from a family member, current date and weather information, and images of the area surrounding the hospital to provide cognitive orientation cues and emotional support. The intervention will be delivered for 2 minutes per session, 3 times daily (at 7:00 AM, 5:00 PM, and 9:00 PM) for 2 consecutive days. Participants will also receive routine family visiting twice daily.
A structured, personalized audiovisual intervention designed to provide cognitive reorientation and emotional support. The program incorporates person, time, and place orientation cues, including a prerecorded message from a family member using the participant's name and familiar language; current date, weather, and temperature information presented through automated audiovisual content; and images of the area surrounding the hospital. Participants will receive the intervention for 2 minutes per session, 3 times daily (at 7:00 AM, 5:00 PM, and 9:00 PM) for 2 consecutive days, beginning within 24 hours after admission to the emergency intensive care unit. The intervention will be provided in addition to routine care.
Aucune intervention: Routine Care
Participants will receive routine care without the intelligent audiovisual intervention. Routine care includes standard medical and nursing care and family visiting twice daily, at 11:00 AM and 7:00 PM, for 1 hour per visit. Participants will undergo the same assessments of delirium, agitation, and pain as those in the experimental arm.

Que mesure l'étude ?

Principaux critères de jugement

Mesure des résultats
Description de la mesure
Délai
Incidence of Delirium Assessed Using the CAM-ICU-7
Délai: From baseline through the end of Day 2; assessed 3 times daily
Delirium will be assessed using the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU-7). The outcome will be reported as the percentage of participants with at least one positive CAM-ICU-7 assessment during the 2-day assessment period.
From baseline through the end of Day 2; assessed 3 times daily
Change From Baseline in Delirium Severity Assessed Using the CAM-ICU-7
Délai: Baseline through the end of Day 2; assessed 3 times daily
Delirium severity will be measured using the CAM-ICU-7. Total scores range from 0 to 7, with higher scores indicating greater delirium severity. Scores of 0 to 2 indicate no delirium, 3 to 5 indicate mild to moderate delirium, and 6 to 7 indicate severe delirium. Changes from baseline will be evaluated across the scheduled assessments.
Baseline through the end of Day 2; assessed 3 times daily

Mesures de résultats secondaires

Mesure des résultats
Description de la mesure
Délai
Change From Baseline in Richmond Agitation-Sedation Scale Score
Délai: Baseline through the end of Day 2; assessed 3 times daily
Agitation and sedation will be assessed using the Richmond Agitation-Sedation Scale (RASS). Scores range from -5 to +4. A score of 0 indicates that the participant is alert and calm, positive scores indicate increasing agitation, and negative scores indicate increasing levels of sedation.
Baseline through the end of Day 2; assessed 3 times daily
Change From Baseline in Pain Intensity Score
Délai: Baseline through the end of Day 2; assessed 3 times daily
Pain intensity will be assessed using the 11-point Numerical Rating Scale (NRS) for participants able to self-report or the Face, Legs, Activity, Cry, and Consolability (FLACC) scale for participants unable to communicate reliably. Both scales range from 0 to 10, with higher scores indicating greater pain intensity.
Baseline through the end of Day 2; assessed 3 times daily

Collaborateurs et enquêteurs

C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.

Parrainer

Publications et liens utiles

La personne responsable de la saisie des informations sur l'étude fournit volontairement ces publications. Il peut s'agir de tout ce qui concerne l'étude.

Dates d'enregistrement des études

Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.

Dates principales de l'étude

Début de l'étude (Estimé)

1 août 2026

Achèvement primaire (Estimé)

31 décembre 2028

Achèvement de l'étude (Estimé)

31 décembre 2028

Dates d'inscription aux études

Première soumission

16 août 2026

Première soumission répondant aux critères de contrôle qualité

16 août 2026

Première publication (Réel)

20 août 2026

Mises à jour des dossiers d'étude

Dernière mise à jour publiée (Réel)

20 août 2026

Dernière mise à jour soumise répondant aux critères de contrôle qualité

16 août 2026

Dernière vérification

1 août 2026

Plus d'information

Termes liés à cette étude

Autres numéros d'identification d'étude

  • 2026-08-007BC

Plan pour les données individuelles des participants (IPD)

Prévoyez-vous de partager les données individuelles des participants (DPI) ?

NON

Description du régime IPD

Individual participant data will not be shared because the study involves critically ill patients and contains sensitive clinical information. In addition, the personalized audiovisual materials may include family members' voices and contextual information that could increase the risk of participant identification. Study data will be securely maintained and used only for the purposes approved by the institutional review board and described in the informed consent process.

Informations sur les médicaments et les dispositifs, documents d'étude

Étudie un produit pharmaceutique réglementé par la FDA américaine

Non

Étudie un produit d'appareil réglementé par la FDA américaine

Non

Ces informations ont été extraites directement du site Web clinicaltrials.gov sans aucune modification. Si vous avez des demandes de modification, de suppression ou de mise à jour des détails de votre étude, veuillez contacter register@clinicaltrials.gov. Dès qu'un changement est mis en œuvre sur clinicaltrials.gov, il sera également mis à jour automatiquement sur notre site Web .