Nassar Junior Antonio Paulo, Pires Neto Ruy Camargo, de Figueiredo Walquiria Barcelos, Park Marcelo
Faculdade deMedicina da Universidade de São Paulo, Discipline of Medical Emergencies, Hospital das Clínicas, São Paulo, Brazil.
Sao Paulo Med J. 2008 Jul;126(4):215-9. doi: 10.1590/s1516-31802008000400003.
Sedation scales are used to guide sedation protocols in intensive care units (ICUs). However, no sedation scale in Portuguese has ever been evaluated. The aim of this study was to evaluate the validity and reliability of Portuguese translations of four sedation-agitation scales, among critically ill patients: Glasgow Coma Score, Ramsay, Richmond Agitation-Sedation Scale (RASS) and Sedation-Agitation Scale (SAS).
Validation study in two mixed ICUs of a university hospital.
All scales were applied to 29 patients by four different critical care team members (nurse, physiotherapist, senior critical care physician and critical care resident). We tested each scale for interrater reliability and for validity, by correlations between them. Interrater agreement was measured using weighted kappa (k) and correlations used Spearman's test.
136 observations were made on 29 patients. All scales had at least substantial agreement (weighted k 0.68-0.90). RASS (weighted k 0.82-0.87) and SAS (weighted k 0.83-0.90) had the best agreement. All scales had a good and significant correlation with each other.
All scales demonstrated good interrater reliability and were comparable. RASS and SAS showed the best correlations and the best agreement results in all professional categories. All these characteristics make RASS and SAS good scales for use at the bedside, to evaluate sedation-agitation among critically ill patients in terms of validity, reliability and applicability.
镇静评分量表用于指导重症监护病房（ICU）的镇静方案。然而，葡萄牙语的镇静评分量表从未经过评估。本研究的目的是评估四种镇静-躁动评分量表的葡萄牙语翻译版本在危重症患者中的有效性和可靠性，这四种量表分别为：格拉斯哥昏迷评分、拉姆齐评分、里士满躁动-镇静量表（RASS）和镇静-躁动量表（SAS）。
在一家大学医院的两个综合ICU进行的验证研究。
由四名不同的重症监护团队成员（护士、物理治疗师、资深重症监护医师和重症监护住院医师）对29名患者应用所有量表。我们通过量表之间的相关性来测试每个量表的评分者间信度和效度。使用加权kappa（κ）测量评分者间一致性，相关性使用斯皮尔曼检验。
对29名患者进行了136次观察。所有量表至少有实质性一致性（加权κ为0.68 - 0.90）。RASS（加权κ为0.82 - 0.87）和SAS（加权κ为0.83 - 0.90）具有最佳一致性。所有量表之间均具有良好且显著的相关性。
所有量表均显示出良好的评分者间信度且具有可比性。RASS和SAS在所有专业类别中显示出最佳相关性和最佳一致性结果。所有这些特征使RASS和SAS成为床边使用的良好量表，可从有效性、可靠性和适用性方面评估危重症患者的镇静-躁动情况。
