{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T21:14:05Z","timestamp":1782767645698,"version":"3.54.5"},"reference-count":27,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2022,7,18]],"date-time":"2022-07-18T00:00:00Z","timestamp":1658102400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Healthcare"],"abstract":"<jats:p>In this case study, ward staff found it difficult to establish a therapeutic relationship with a patient with advanced gastric cancer because they misdiagnosed delirium as a psychogenic reaction to the cancer diagnosis. This article reports on the process and effects of intervention by a liaison nurse. The liaison nurse recognized the misdiagnosis and approached the ward staff via a psychiatrist-led team. This enabled rapid revision of the treatment policy. The liaison nurse contributed to the continuation of treatment by enabling the ward staff and patient to understand each other better and to collaborate to build a relationship and control the patient\u2019s mental health symptoms, including attention disorder and excessive demands. The patient and family had different views on discharge because of the patient\u2019s mental health issues. The liaison nurse encouraged the ward staff to inform the family caregiver about the patient\u2019s medical condition, the expected future course of the disease, and likely symptoms, and provide appropriate professional services. This enabled the patient to be discharged in line with their wishes. This case highlights the role of the liaison nurse in coordinating care and helping ward staff to recognize symptoms and provide appropriate care and support for patients and their families.<\/jats:p>","DOI":"10.3390\/healthcare10071335","type":"journal-article","created":{"date-parts":[[2022,7,18]],"date-time":"2022-07-18T11:32:23Z","timestamp":1658143943000},"page":"1335","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Intervention of Coordination by Liaison Nurse Where Ward Staff Struggled to Establish a Therapeutic Relationship with a Patient Because of Failure to Recognize Delirium: A Case Study"],"prefix":"10.3390","volume":"10","author":[{"given":"Yuri","family":"Nakai","sequence":"first","affiliation":[{"name":"Faculty of Nursing, University of Kochi, 2751-1 Ike, Kochi City 780-8515, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yusuke","family":"Nitta","sequence":"additional","affiliation":[{"name":"Department of Neuropsychiatry, Kanazawa Medical University, 1-1 Uchinada, Kahoku 920-0265, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reiko","family":"Hashimoto","sequence":"additional","affiliation":[{"name":"Department of Neuropsychiatry, Kanazawa Medical University, 1-1 Uchinada, Kahoku 920-0265, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,7,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"669","DOI":"10.1056\/NEJM199903043400901","article-title":"A Multicomponent Intervention to Prevent Delirium in Hospitalized Older Patients","volume":"340","author":"Inouye","year":"1999","journal-title":"N. Engl. J. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1176\/appi.psy.50.3.218","article-title":"Falls in the General Hospital: Association With Delirium, Advanced Age, and Specific Surgical Procedures","volume":"50","author":"Lakatos","year":"2009","journal-title":"Psychosomatics"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1297","DOI":"10.1007\/s001340101017","article-title":"Delirium in an Intensive Care Unit: A Study of Risk Factors","volume":"27","author":"Dubois","year":"2001","journal-title":"Intensive Care Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1007\/s00391-015-0871-6","article-title":"What Does Delirium Cost?","volume":"49","author":"Weinrebe","year":"2016","journal-title":"Z. Gerontol. Geriat."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1001\/jama.2010.1013","article-title":"Delirium in Elderly Patients and the Risk of Postdischarge Mortality, Institutionalization, and Dementia: A Meta-Analysis","volume":"304","author":"Witlox","year":"2010","journal-title":"JAMA"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"M\u00e9ndez-Mart\u00ednez, C., Fern\u00e1ndez-Mart\u00ednez, M.N., Garc\u00eda-Su\u00e1rez, M., Mart\u00ednez-Isasi, S., Fern\u00e1ndez-Fern\u00e1ndez, J.A., and Fern\u00e1ndez-Garc\u00eda, D. (2021). Related Factors and Treatment of Postoperative Delirium in Old Adult Patients: An Integrative Review. Healthcare, 9.","DOI":"10.3390\/healthcare9091103"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1016\/j.ejcsup.2013.07.008","article-title":"Drug-Associated Delirium in Cancer Patients","volume":"11","author":"Caraceni","year":"2013","journal-title":"Eur. J. Cancer Suppl."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"442","DOI":"10.1016\/j.genhosppsych.2007.05.006","article-title":"Delirium: Patient Characteristics That Predict a Missed Diagnosis at Psychiatric Consultation","volume":"29","author":"Kishi","year":"2007","journal-title":"Gen. Hosp. Psychiatry"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2427","DOI":"10.1007\/s00520-015-2610-3","article-title":"The Frequency of Missed Delirium in Patients Referred to Palliative Care in a Comprehensive Cancer Center","volume":"23","author":"Fan","year":"2015","journal-title":"Support Care Cancer"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1176\/appi.psy.47.5.367","article-title":"Differences in Characteristics and Outcome of Delirium as Based on Referral Patterns","volume":"47","author":"Mittal","year":"2006","journal-title":"Psychosomatics"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1017\/S1478951509990861","article-title":"Characteristics, interventions, and outcomes of misdiagnosed delirium in cancer patients","volume":"8","author":"Wada","year":"2010","journal-title":"Palliat. Supportive Care"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1016\/j.ctrv.2012.08.001","article-title":"Comprehensive Approaches to Managing Delirium in Patients with Advanced Cancer","volume":"39","author":"Kang","year":"2013","journal-title":"Cancer Treat. Rev."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1016\/j.jpsychores.2008.05.017","article-title":"The Delirium Experience: A Review","volume":"65","author":"Leonard","year":"2008","journal-title":"J. Psychosom. Res."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1016\/j.iccn.2011.11.004","article-title":"Delirium: A Review of the Nurses Role in the Intensive Care Unit","volume":"28","author":"Boot","year":"2012","journal-title":"Intensive Crit. Care Nurs."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Kitajima, M., Miyata, C., Tamura, K., Kinoshita, A., and Arai, H. (2020). Factors associated with the job satisfaction of certified nurses and nurse specialists in cancer care in Japan: Analysis based on the Basic Plan to Promote Cancer Control Programs. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0232336"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"262","DOI":"10.3928\/00220124-20071101-03","article-title":"The Role of the Clinical Nurse Specialist in Promoting Evidence-Based Practice and Effecting Positive Patient Outcomes","volume":"38","author":"LaSala","year":"2007","journal-title":"J. Contin. Educ. Nurs."},{"key":"ref_17","unstructured":"(2022, May 22). Psychiatric Medicine (2011_11_2) Ministry of Health, Labour and Welfare (Japanese), Available online: https:\/\/www.mhlw.go.jp\/stf\/shingi\/2r9852000001trya-att\/2r9852000001ts1s.pdf."},{"key":"ref_18","first-page":"130","article-title":"Practice of Psychiatry Liaison Teams at General Hospitals without a Specialized Psychiatry Inpatient Unit (Japanese)","volume":"25","author":"Koichi","year":"2013","journal-title":"Jpn. J. Gen. Hosp. Psychiatry"},{"key":"ref_19","unstructured":"(2022, May 22). Japan Nursing Association Qualification Certification System, Japan Nursing Association (Japanese). Available online: https:\/\/nintei.nurse.or.jp\/nursing\/qualification\/cns."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1191\/0269216304pm879oa","article-title":"Delirium in Advanced Cancer Patients","volume":"18","author":"Centeno","year":"2004","journal-title":"Palliat. Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1176\/appi.psy.49.2.104","article-title":"Misdiagnosed Delirium in Patient Referrals to a University-Based Hospital Psychiatry Department","volume":"49","author":"Swigart","year":"2008","journal-title":"Psychosomatics"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Ozga, D., Krupa, S., Witt, P., and M\u0119drzycka-D\u0105browska, W. (2020). Nursing Interventions to Prevent Delirium in Critically Ill Patients in the Intensive Care Unit during the COVID19 Pandemic\u2014Narrative Overview. Healthcare, 8.","DOI":"10.3390\/healthcare8040578"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"961","DOI":"10.1093\/jjco\/hys127","article-title":"Hypomanic Episode During Recurrent Gastric Cancer Treatment: Report of a Rare Case and Literature Review","volume":"42","author":"Matsunaga","year":"2012","journal-title":"Jpn. J. Clin. Oncol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"571","DOI":"10.1046\/j.1365-2648.2001.01873.x","article-title":"Components of a Proper Hospital Discharge for Elders","volume":"35","author":"Bull","year":"2001","journal-title":"J. Adv. Nurs."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1016\/S0897-1897(00)80004-X","article-title":"Differences in Family Caregiver Outcomes by Their Level of Involvement in Discharge Planning","volume":"13","author":"Bull","year":"2000","journal-title":"Appl. Nurs. Res."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"590","DOI":"10.3390\/nursrep11030056","article-title":"Discharge Plan to Promote Patient Safety and Shared Decision Making by a Multidisciplinary Team of Healthcare Professionals in a Respiratory Unit","volume":"11","author":"Nnate","year":"2021","journal-title":"Nurs. Rep."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"e3162","DOI":"10.1590\/1518-8345.3069.3162","article-title":"Liaison Nurse Activities at Hospital Discharge: A Strategy for Continuity of Care","volume":"27","author":"Aued","year":"2019","journal-title":"Rev. Lat.-Am. Enferm."}],"container-title":["Healthcare"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9032\/10\/7\/1335\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T23:53:11Z","timestamp":1760140391000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9032\/10\/7\/1335"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,7,18]]},"references-count":27,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2022,7]]}},"alternative-id":["healthcare10071335"],"URL":"https:\/\/doi.org\/10.3390\/healthcare10071335","relation":{},"ISSN":["2227-9032"],"issn-type":[{"value":"2227-9032","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,7,18]]}}}