Olson Daiwai, Lynn Mary, Thoyre Suzanne M, Graffagnino Carmelo
Duke University, Durham, NC, USA.
Neurocrit Care. 2007;7(3):227-31. doi: 10.1007/s12028-007-0069-x.
The Ramsay scale which is internationally one of the most frequently cited sedation assessment tools has not had adequate psychometric evaluation. The objective of this study was to test the inter-rater reliability of the Ramsay scale.
This study was based on a prospective, single-blinded randomized design targeted to provide a psychometric analysis of the Ramsay scale. Following informed consent nurses were provided with written instructions on use of the Ramsay scale. A total of 241 critical care nurses were recruited from seven specialty critical care units in a major teaching institution; 237 nurses completed the study. After reviewing the written instructions, nurses viewed one out of six randomly selected videos of a sedation assessment and then scored that video using the Ramsay scale. Each nurse viewed and independently scored only one video using the Ramsay scale.
Across the 237 nurses, who scored one out of six videos using the Ramsay scale a Kappa of 0.28 was obtained.
Based on these findings, there is insufficient evidence to support the reliability of the Ramsay scale as a measure of sedation assessment.
拉姆齐量表是国际上最常被引用的镇静评估工具之一，但尚未进行充分的心理测量学评估。本研究的目的是测试拉姆齐量表的评分者间信度。
本研究基于前瞻性、单盲随机设计，旨在对拉姆齐量表进行心理测量学分析。在获得知情同意后，向护士提供了关于使用拉姆齐量表的书面说明。从一所主要教学机构的七个专科重症监护病房招募了241名重症监护护士；237名护士完成了研究。在阅读书面说明后，护士观看了六个随机选择的镇静评估视频中的一个，然后使用拉姆齐量表对该视频进行评分。每位护士仅使用拉姆齐量表观看并独立评分一个视频。
在237名使用拉姆齐量表对六个视频中的一个进行评分的护士中，kappa值为0.28。
基于这些发现，没有足够的证据支持拉姆齐量表作为镇静评估指标的可靠性。
