Date of Award


Degree Name

PhD Nursing

Dissertation Committee

Joseph F. Burkard, DNSc, CRNA, Chair; Sally Brosz Hardin, PhD, RN, FAAN, Dean; Karen Skerrett, PhD, RN


Emergence Delirium, General anesthesia, Middle East, nursing, United States Military Combat Veterans


This dissertation study examined the phenomenon of emergence delirium in U.S. military combat veterans. Emergence delirium is a post-anesthetic phenomenon that occurs immediately following emergence from general anesthesia and is characterized by agitation, confusion, and violent physical and/or verbal behavior. Clinical evidence suggests that emergence delirium is occurring with greater frequency among military personnel returning from conflict in the Middle East. This body of work is a culmination of three distinctive phases and is presented in three individual manuscripts. The first manuscript, "Risk Factors for Emergence Delirium in U.S. Military Members," was published in the Journal of PeriAnesthesia Nursing with the purpose of concept development surrounding the risk factors for emergence delirium. Since this was the first time this phenomenon had been explored, it was important to present it in the form of a literature review. The second manuscript entitled, "Content Validation of the Pediatric Anesthesia Emergence Delirium Scale for use in Adults: A Survey of Nurse Anesthetists Regarding the Concept of Emergence Delirium" described the results of a mixed method study conducted to define the concept of emergence delirium in adults, while content validating a pediatric instrument for its use in the adult population. The results suggested that the Pediatric Anesthesia Emergence Delirium Scale was a valid instrument for use in clinical research with adults. Finally, the third manuscript entitled, "The Incidence of and Risk Factors for Emergence Delirium in U.S. Military Combat Veterans" was written to present the findings of an observational, prospective, and correlational designed study to discover the incidence of emergence delirium in a sample of 130 combat veterans undergoing surgery at one military treatment facility. The results suggested that anxiety, depression, and posttraumatic stress disorder are risk factors for emergence delirium; the overall incidence was 20%.

Document Type

Dissertation: Open Access



Included in

Nursing Commons