Department of Surgery, University of Cincinnati, Cincinnati, OH, USA.
Crit Care Med. 2013 Sep;41(9 Suppl 1):S16-29. doi: 10.1097/CCM.0b013e3182a16879.
To describe and analyze the development and psychometric properties of subjective sedation scales developed for critically ill adult patients.
PubMed, MEDLINE, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, CINAHL, Scopus, ISI Web of Science, and the International Pharmaceutical Abstracts.
English-only publications through December 2012 with at least 30 patients older than 18 years, which included the key words of adult, critically ill, subjective sedation scale, sedation scale, validity, and reliability.
Two independent reviewers evaluated the psychometric properties using a standardized sedation scale psychometric scoring system.
Among the 19,000+ citations extracted for the 2013 Society of Critical Care Medicine's Clinical Practice Guidelines for the Management of Pain, Agitation and Delirium and from December 2010 to 2012, 36 articles were identified compassing 11 sedation scales. The scale development process, psychometric properties, feasibility, and implementation of sedation scales were analyzed using a 0-20 scoring system. Two scales demonstrated scores indicating "very good" published psychometric properties: Richmond Agitation-Sedation Scale (19.5) and the Sedation-Agitation Scale (19). Scores with "moderate" properties include the Vancouver Interaction and Calmness Scale (14.3), Adaptation to the Intensive Care Environment (13.7), Ramsay Sedation Scale (13.2), Minnesota Sedation Assessment Tool (13), and the Nursing Instrument for the Communication of Sedation (12.8). Scales with "low" properties included the Motor Activity Assessment Scale (11.5) and the Sedation Intensive Care Score (10.5). The New Sheffield Sedation Scale (8.5) and the Observer's Assessment of Alertness/Sedation Scale (3.7) demonstrated "very low" published properties.
Based on the current literature, and using a predetermined psychometric scoring system, the Richmond Agitation-Sedation Scale and the Sedation-Agitation Scale are the most valid and reliable subjective sedation scales for use in critically ill adult patients.
描述和分析为重症成年患者开发的主观镇静量表的发展和心理测量学特性。
PubMed、MEDLINE、Cochrane 系统评价数据库、Cochrane 对照试验中心注册、CINAHL、Scopus、ISI Web of Science 和国际药学文摘。
截至 2012 年 12 月的仅英文出版物，患者年龄均大于 18 岁，包含关键词“成人”、“重症”、“主观镇静量表”、“镇静量表”、“有效性”和“可靠性”。
两位独立评审员使用标准化镇静量表心理测量评分系统评估心理测量特性。
在 2013 年危重病医学会临床实践指南中提取的 20,000 多个关于疼痛、躁动和谵妄管理的引文以及 2010 年 12 月至 2012 年期间，确定了 36 篇涵盖 11 种镇静量表的文章。使用 0-20 评分系统分析了镇静量表的发展过程、心理测量特性、可行性和实施情况。两个量表的发表心理测量特性评分显示“非常好”：Richmond 躁动-镇静量表（19.5）和镇静-躁动量表（19）。评分显示“中等”特性的量表包括温哥华互动和镇静量表（14.3）、适应重症监护环境量表（13.7）、Ramsay 镇静量表（13.2）、明尼苏达镇静评估工具（13）和镇静沟通护理仪器量表（12.8）。评分显示“低”特性的量表包括运动活动评估量表（11.5）和镇静重症监护评分（10.5）。新谢菲尔德镇静量表（8.5）和观察者评估警觉/镇静量表（3.7）显示“非常低”的发表特性。
根据现有文献并使用预定的心理测量评分系统，Richmond 躁动-镇静量表和镇静-躁动量表是用于重症成年患者最有效和可靠的主观镇静量表。
