Abelha Fernando, Veiga Dalila, Norton Maria, Santos Cristina, Gaudreau Jean-David
Anesthesiology and Perioperative Care Unit, Surgical Department, School of Medicine, University of Porto, Porto, Portugal; Department of Anesthesiology, Centro Hospitalar de São João, Porto, Portugal.
Department of Anesthesiology, Centro Hospitalar de São João, Porto, Portugal.
Braz J Anesthesiol. 2013 Nov-Dec;63(6):450-5. doi: 10.1016/j.bjane.2012.09.003. Epub 2013 Dec 5.
The aim of this study was to validate the Portuguese version of the Nursing Delirium Screening Scale (Nu-DESC) for use in critical care settings.
We simultaneously and independently evaluated all postoperative patients admitted to a surgical Intensive Care Unit (SICU) over a 1-month period for delirium, using the Portuguese versions of both the Nu-DESC and the Intensive Care Delirium Screening Checklist (ICDSC) within 24 hours of admission by both the research staff physician and one bedside nurse. We determined the diagnostic accuracy of the Nu-DESC using sensitivity, specificity and ROC curve analyses. We assessed reliability between nurses and the research staff physician for Nu-DESC by intraclass correlation coefficient (ICC). We assessed agreement and reliability between Nu-DESC and ICDSC by overall and specific proportions of agreement and by kappa statistics.
Based on the ICDSC, we diagnosed delirium in 12 of the 78 patients. Reliability between nurses and the staff physician for total Nu-DESC score was high. Agreement between nurses and staff physician in the delirium diagnosis was perfect. The proportion of overall agreement between Nu-DESC and ICDSC in the delirium diagnosis was 0.88 and the kappa ranged from 0.79 to 0.93. Nu-DESC Sensitivity was 100 and specificity was 86%.
The Portuguese version of the Nu-DESC appears to be an accurate and reliable assessment and monitoring instrument for delirium in critical care settings.
本研究旨在验证葡萄牙语版的护理谵妄筛查量表（Nu-DESC）在重症监护环境中的应用。
我们在1个月的时间内，由研究人员医生和一名床边护士在患者入院24小时内，同时且独立地使用葡萄牙语版的Nu-DESC和重症监护谵妄筛查清单（ICDSC）对所有入住外科重症监护病房（SICU）的术后患者进行谵妄评估。我们通过敏感性、特异性和ROC曲线分析来确定Nu-DESC的诊断准确性。我们通过组内相关系数（ICC）评估护士与研究人员医生之间对Nu-DESC的可靠性。我们通过总体和特定一致性比例以及kappa统计量评估Nu-DESC与ICDSC之间的一致性和可靠性。
基于ICDSC，我们在78例患者中的12例中诊断出谵妄。护士与医生之间对Nu-DESC总分的可靠性较高。护士与医生在谵妄诊断方面的一致性极佳。Nu-DESC与ICDSC在谵妄诊断方面的总体一致性比例为0.88，kappa值在0.79至0.93之间。Nu-DESC的敏感性为100%，特异性为86%。
葡萄牙语版的Nu-DESC似乎是一种用于重症监护环境中谵妄的准确且可靠的评估和监测工具。
