Department of Nursing, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, People's Republic of China.
Department of Cardiothoracic Surgery Intensive Care Unit, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, People's Republic of China.
Nurs Crit Care. 2018 Jan;23(1):30-41. doi: 10.1111/nicc.12325. Epub 2017 Nov 12.
This study evaluated the psychometric properties of subjective sedation scales using one psychometric scoring system to identify the appropriate scale that is most suitable for clinical care practice.
A number of published sedation assessment scales for paediatric patients are currently used to attempt to achieve a moderate depth of sedation to avoid the undesirable effects caused by over- or undersedation. However, there has been no systematic review of these scales.
We searched the Cochrane Library, PubMed, EMBASE, the Cumulative Index to Nursing and Allied Health Literature, etc., to obtain relevant articles. The quality of the selected studies was evaluated according to the Consensus-based Standards for the Selection of Health Measurement Instruments checklist.
Articles that had been published or were in press and discussed the psychometric properties of sedation scales were included. The population comprised critically ill infants and non-verbal children ranging in age from 0 to 18 years who underwent sedation in an intensive care unit.
Data were independently extracted by two investigators using a standard data extraction checklist: 43 articles were included in this review, and 13 sedation scales were examined. The quality of the psychometric evidence for the Comfort Scale and Comfort Behaviour Scale was 'very good', with the Comfort Scale having a higher quality (total weighted scores, Comfort Scale = 17·3 and Comfort Behaviour Scale = 15·5).
We suggest that the scales be systematically and comprehensively tested in terms of development method, reliability, validation, feasibility and correlation with clinical outcome. The Comfort Scale and Comfort Behaviour Scale are useful tools for measuring sedation in paediatric patients.
Nursing staff should choose one subjective sedation scale that is suitable for assessing paediatric patients' depth of sedation. We recommend the Comfort Scale and Comfort Behaviour Scale as optimal choices if the clinical environment permits.
本研究使用一种心理计量评分系统评估主观镇静量表的心理计量学特性，以确定最适合临床护理实践的适当量表。
目前有许多已发表的儿科患者镇静评估量表被用于尝试达到适度的镇静深度，以避免过度或不足镇静引起的不良影响。然而，这些量表尚未进行系统评价。
我们检索了 Cochrane 图书馆、PubMed、EMBASE、护理与联合健康文献累积索引等，以获取相关文章。根据共识基础的健康测量仪器选择标准清单评估所选研究的质量。
纳入已发表或即将发表并讨论镇静量表心理计量学特性的文章。研究人群包括在重症监护病房接受镇静治疗的年龄在 0 至 18 岁之间的危重症婴儿和非言语儿童。
两名研究者使用标准数据提取清单独立提取数据：本综述纳入了 43 篇文章，共检查了 13 种镇静量表。舒适量表和舒适行为量表的心理计量学证据质量为“非常好”，舒适量表的质量更高（总加权评分，舒适量表=17.3，舒适行为量表=15.5）。
我们建议系统全面地测试这些量表在开发方法、可靠性、验证、可行性和与临床结果的相关性方面的表现。舒适量表和舒适行为量表是测量儿科患者镇静程度的有用工具。
护理人员应选择一种适合评估儿科患者镇静深度的主观镇静量表。如果临床环境允许，我们建议舒适量表和舒适行为量表作为最佳选择。
