Detroyer Elke, Clement Paul M, Baeten Nele, Pennemans Michèle, Decruyenaere Marleen, Vandenberghe Joris, Menten Johan, Joosten Etienne, Milisen Koen
1Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium.
Palliat Med. 2014 Jan;28(1):79-86. doi: 10.1177/0269216313492187. Epub 2013 Jun 6.
The Delirium Observation Screening Scale (DOS) is designed to detect delirium by nurses' observations and has shown good psychometric properties. Its use in palliative care unit patients has not been studied.
To determine diagnostic and concurrent validity, internal consistency, and user-friendliness of the Delirium Observation Screening Scale administered by bedside nurses in palliative care unit patients.
In this descriptive study, psychometric properties of the Delirium Observation Screening Scale were tested by comparing the performance on the Delirium Observation Screening Scale (bedside nurses) to the algorithm of the Confusion Assessment Method and the Delirium Index (DI) (researchers). Paired observations were collected on three time points. Afterward, the user-friendliness of the Delirium Observation Screening Scale was determined by bedside nurses using a questionnaire.
SETTING/PARTICIPANTS: In total, 48 patients were recruited from one palliative care unit (PCU) of a university hospital. Of the 14 eligible bedside nurses of the palliative care unit, 10 participated in the study.
Delirium was present in 22.9% of patients. Diagnostic validity of the Delirium Observation Screening Scale was very good (area under the curve = 0.933), with 81.8% sensitivity, 96.1% specificity, 69.2% positive, and 98% negative predictive value. Concurrent validity of the Delirium Observation Screening Scale with the Delirium Index was moderate (rSpearman = 0.53, p = 0.001). The Cronbach's alpha for all Delirium Observation Screening Scale shift scores was 0.772. Generally, bedside nurses experienced the Delirium Observation Screening Scale as user-friendly. However, most Delirium Observation Screening Scale items (n = 11/13 items) need verbally active patients to perform the observations correctly.
The Delirium Observation Screening Scale can be used for delirium screening in verbally active palliative care unit patients. The scale was rated as easy to use and relevant. Further validation studies in this population are required.
谵妄观察筛查量表（DOS）旨在通过护士的观察来检测谵妄，并且已显示出良好的心理测量特性。尚未对其在姑息治疗病房患者中的应用进行研究。
确定姑息治疗病房护士使用的谵妄观察筛查量表在诊断和同时效度、内部一致性以及用户友好性方面的情况。
在这项描述性研究中，通过比较谵妄观察筛查量表（床边护士）与混乱评估方法和谵妄指数（DI）（研究人员）算法的表现，对谵妄观察筛查量表的心理测量特性进行了测试。在三个时间点收集了配对观察数据。之后，床边护士通过问卷确定了谵妄观察筛查量表的用户友好性。
设置/参与者：总共从一家大学医院的一个姑息治疗病房（PCU）招募了48名患者。在姑息治疗病房的14名符合条件的床边护士中，有10名参与了研究。
22.9%的患者存在谵妄。谵妄观察筛查量表的诊断效度非常好（曲线下面积 = 0.933），灵敏度为81.8%，特异度为96.1%，阳性预测值为69.2%，阴性预测值为98%。谵妄观察筛查量表与谵妄指数的同时效度中等（斯皮尔曼r = 0.53，p = 0.001）。所有谵妄观察筛查量表班次得分的克朗巴哈α系数为0.772。总体而言，床边护士认为谵妄观察筛查量表用户友好。然而，大多数谵妄观察筛查量表项目（n = 11/13项）需要能积极交流的患者才能正确进行观察。
谵妄观察筛查量表可用于能积极交流的姑息治疗病房患者的谵妄筛查。该量表被评为易于使用且相关。需要在该人群中进行进一步的验证研究。
