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Not yet recruitingNCT07776002Updated Aug 20, 2026

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

An interventional study of Intelligent Audiovisual Intervention in Delirium Confusional State, sponsored by Taipei Veterans General Hospital, Taiwan. Not yet recruiting. Open to participants aged 55 Years and older. Per ClinicalTrials.gov, last updated 2026-08-20.

Sponsored by Taipei Veterans General Hospital, Taiwan · Not applicable, Interventional, and Supportive care

Phase
Not applicable
Study type
Interventional
Enrollment
128
Allocation
Non-randomized
Ages
55 Years and older
Sex
All
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Study summary

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.

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Conditions studied

  • Delirium Confusional State

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Keywords

  • Emergency Intensive Care Unit
  • Family intervention
  • Intelligent Audiovisual
  • Middle-aged and Older Adults
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Who can participate

Ages eligible
55 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

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

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.
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Study design

Phase
Not applicable
Primary purpose
Supportive care
Allocation
Non-randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
128 participants (estimated)

Study arms

  • Experimental
    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.

    Behavioral: Intelligent Audiovisual Intervention

  • No 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.

Interventions

  • BehavioralIntelligent Audiovisual Intervention

    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.

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What researchers measure

Primary outcomes

  1. Incidence of Delirium Assessed Using the CAM-ICU-7

    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.

    Time frame: From baseline through the end of Day 2; assessed 3 times daily

  2. Change From Baseline in Delirium Severity Assessed Using the CAM-ICU-7

    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.

    Time frame: Baseline through the end of Day 2; assessed 3 times daily

Secondary outcomes

  1. Change From Baseline in Richmond Agitation-Sedation Scale Score

    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.

    Time frame: Baseline through the end of Day 2; assessed 3 times daily

  2. Change From Baseline in Pain Intensity Score

    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.

    Time frame: Baseline through the end of Day 2; assessed 3 times daily

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Study locations

No study locations are listed for this record.

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References and documents

Publications

  • Khan BA, Perkins AJ, Gao S, Hui SL, Campbell NL, Farber MO, Chlan LL, Boustani MA. The Confusion Assessment Method for the ICU-7 Delirium Severity Scale: A Novel Delirium Severity Instrument for Use in the ICU. Crit Care Med. 2017 May;45(5):851-857. doi: 10.1097/CCM.0000000000002368. PubMed 28263192 ↗
  • Waszynski CM, Milner KA, Staff I, Molony SL. Using simulated family presence to decrease agitation in older hospitalized delirious patients: A randomized controlled trial. Int J Nurs Stud. 2018 Jan;77:154-161. doi: 10.1016/j.ijnurstu.2017.09.018. Epub 2017 Oct 7. PubMed 29100197 ↗
  • Ma Y, Zhang Y, Cui N, Guo Z, Jin J. The effects of structured family auditory stimulation on preventing ICU delirium among patients with unplanned admissions: A randomized controlled study. Intensive Crit Care Nurs. 2025 Aug;89:103944. doi: 10.1016/j.iccn.2025.103944. Epub 2025 Feb 5. PubMed 39914153 ↗
  • Munro CL, Cairns P, Ji M, Calero K, Anderson WM, Liang Z. Delirium prevention in critically ill adults through an automated reorientation intervention - A pilot randomized controlled trial. Heart Lung. 2017 Jul-Aug;46(4):234-238. doi: 10.1016/j.hrtlng.2017.05.002. Epub 2017 Jun 9. PubMed 28606450 ↗

Individual participant data

Plan to share: No — 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.

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Registry details

Key details

Study ID
NCT07776002
Lead sponsor
Taipei Veterans General Hospital, Taiwan
Responsible party
Sponsor
First posted
Aug 20, 2026
Start date
Aug 1, 2026 (estimated)
Primary completion
Dec 31, 2028 (estimated)
Completion
Dec 31, 2028 (estimated)
Last update
Aug 20, 2026

Study contacts

Li Fang-Yu
Contact
fylee6@vghtpe.gov.tw
+886 966-914-515

Oversight

FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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