Hasemann Wolfgang, Tolson Debbie, Godwin Jon, Spirig Rebecca, Frei Irena Anna, Kressig Reto W
J Gerontol Nurs. 2018 Dec 1;44(12):35-43. doi: 10.3928/00989134-20181018-02.
The aim of the current study was to report findings about delirium detection when ward nurses screened for delirium in patients with cognitive impairment using the Delirium Observation Screening Scale (DOSS) in comparison to the Confusion Assessment Method (CAM). A secondary analysis was performed of research data collected in 2010 at a Swiss tertiary university hospital. During the first 5 days after admission, patients 70 and older with cognitive impairment were screened for delirium using the DOSS. Throughout patients' hospital stay, research assistants also completed the CAM on a daily basis. A total of 138 patients who did not have delirium initially participated in the study. Of these patients, 44 (32%) developed delirium with a median duration of 3 days (Q1 = 1.25; Q3 = 5.00). Ward nurses correctly identified delirium using the DOSS in 56% of cases (sensitivity) and no delirium in 92% of cases (specificity). Although the DOSS was 100% correct in detecting patients with hyperactive delirium, the identification rate decreased to 60% for patients with mixed delirium subtype and 38% for patients with hypoactive delirium. Delirium screening using observational methods may be insufficiently sensitive and should be supplemented with a formal attention test. [Journal of Gerontological Nursing, 44(12), 35-43.].
本研究的目的是报告当病房护士使用谵妄观察筛查量表（DOSS）对认知障碍患者进行谵妄筛查时与使用混乱评估法（CAM）相比的谵妄检测结果。对2010年在瑞士一家三级大学医院收集的研究数据进行了二次分析。在入院后的前5天，使用DOSS对70岁及以上的认知障碍患者进行谵妄筛查。在患者住院期间，研究助理也每天完成CAM评估。共有138名最初没有谵妄的患者参与了研究。在这些患者中，44名（32%）出现了谵妄，中位持续时间为3天（Q1 = 1.25；Q3 = 5.00）。病房护士使用DOSS正确识别谵妄的病例占56%（敏感性），正确识别无谵妄的病例占92%（特异性）。虽然DOSS在检测躁动性谵妄患者时100%正确，但对于混合型谵妄亚型患者，识别率降至60%，对于安静型谵妄患者，识别率降至38%。使用观察法进行谵妄筛查可能敏感性不足，应辅以正式的注意力测试。[《老年护理杂志》，44(12)，35 - 43。]
