重症监护病房韩国意识模糊评估方法的翻译与验证。
Translation and validation of the Korean Confusion Assessment Method for the Intensive Care Unit.
机构信息
Seoul National University College of Medicine, Jongno-gu, Republic of Korea.
出版信息
BMC Psychiatry. 2011 May 23;11:94. doi: 10.1186/1471-244X-11-94.
BACKGROUND
Delirium is a common problem and associated with poor outcomes in intensive care unit (ICU) patients. Diagnosis of delirium in ICU patients is limited and usually underdiagnosed by physicians. The Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) is one of the most widely used screening methods for detection of ICU delirium. Our goal was to translate and validate the CAM-ICU for use in the Korean ICU setting.
METHODS
Translation of the CAM-ICU was done according to the guidelines suggested by the Translation and Cultural Adaptation Group. For validation and interrater reliability assessment of the Korean CAM-ICU, two nurses independently assessed delirium in ICU patients and the results were compared with the reference evaluation, which was done by a psychiatrist using the Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV).
RESULTS
Twenty-two patients were evaluated by two nurses and one psychiatrist expert independently. During the study period, we have continuously educated study nurses. Based on DSM-IV criteria, 16 out of 22 (72.7%) patients developed delirium. The sensitivities of the two nurses' evaluations using the Korean CAM-ICU were 89.80% for nurse 1 and 77.40% for nurse 2. Their specificities were 72.40% and 75.80% and their overall accuracy was 83.33% and 88.37% respectively. The Korean CAM-ICU was done with reasonable interrater reliability between nurse 1 and nurse 2 (κ = 0.81, p < 0.001).
CONCLUSIONS
The Korean CAM-ICU showed good validity and could be incorporated into clinical practice in Korean ICUs.
TRIAL REGISTRATION
ISRCTN: ISRCTN50265663.
背景
谵妄是重症监护病房（ICU）患者常见的问题，并与不良预后相关。ICU 患者的谵妄诊断受到限制，通常被医生漏诊。《重症监护谵妄评估法（CAM-ICU）》是检测 ICU 谵妄最常用的筛查方法之一。我们的目标是将 CAM-ICU 翻译并验证为适用于韩国 ICU 环境。
方法
根据翻译和文化适应小组建议的指南进行 CAM-ICU 的翻译。为了验证和评估韩国 CAM-ICU 的内部一致性，两名护士独立评估 ICU 患者的谵妄，结果与精神病医生使用《精神障碍诊断与统计手册第四版（DSM-IV）》进行的参考评估进行比较。
结果
两名护士和一名精神病医生专家独立评估了 22 名患者。在研究期间，我们持续对研究护士进行教育。根据 DSM-IV 标准，22 名患者中有 16 名（72.7%）出现了谵妄。两名护士使用韩国 CAM-ICU 的评估敏感性分别为护士 1 的 89.80%和护士 2 的 77.40%。他们的特异性分别为 72.40%和 75.80%，总体准确性分别为 83.33%和 88.37%。护士 1 和护士 2 之间的韩国 CAM-ICU 具有合理的内部一致性（κ=0.81，p<0.001）。
结论
韩国 CAM-ICU 显示出良好的有效性，可以纳入韩国 ICU 的临床实践中。
试验注册
ISRCTN: ISRCTN50265663。
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