Hoshino Haruhiko, Sakuramoto Hideaki, Matsuishi Yujiro, Shimojo Nobutake, Enomoto Yuki, Ohto Tatsuyuki, Kido Takahiro, Ouchi Akira, Sumitani Masahiko, Kawano Satoru, Inoue Yoshiaki
Department of Emergency and Critical Care Medicine Faculty of Medicine University of Tsukuba Tsukuba Ibaraki Japan.
Pediatric intensive care unit University of Tsukuba Hospital Tsukuba Ibaraki Japan.
Acute Med Surg. 2018 Dec 21;6(2):101-108. doi: 10.1002/ams2.379. eCollection 2019 Apr.
The State Behavioral Scale (SBS) was developed to assess sedation states, including agitation, in pediatric patients on mechanical ventilation. The purpose of this study was to determine the reliability and validity of a back-translated Japanese version of the SBS.
Translation was done by the back-translation method followed by a prospective study in a Japanese intensive care unit. For reliability, a nurse/researcher pair evaluated SBS along eight dimensions (respiratory drive, response to ventilation, coughing, best response to stimulation, attentiveness to care provider, tolerance to care, consolability, and movement after consoled). For validity, SBS scores were compared to the Richmond Agitation-Sedation Scale and a visual analog scale (VAS).
The original author approved the back-translated SBS. Thirty-one patients aged 0 weeks to 8 years were evaluated from 59 total critical pediatric patient encounters. The researcher and nurse SBS scores demonstrated excellent inter-rater reliability (weighted κ = 0.96, 95% CI 0.92-0.99). In addition, there was a very strong correlation between the researcher and nurse VAS scores (ρ = 0.80, < 0.001). Weighted kappa coefficients for the eight dimensions ranged from 0.71 (95% confidence interval, 0.55-0.88; consolability) to 0.89 (95% confidence interval, 0.80-0.98; best response to stimulation). In validity testing, nurse SBS and nurse VAS scores were strongly correlated (ρ = 0.80, < 0.001) with the researcher SBS and researcher Richmond Agitation-Sedation Scale scores (ρ = 0.91, < 0.001).
This study suggests that our Japanese version of the SBS is valid and reliable for evaluating sedation for critically ill children.
制定国家行为量表（SBS）以评估接受机械通气的儿科患者的镇静状态，包括躁动情况。本研究的目的是确定反向翻译后的日语版SBS的信度和效度。
采用反向翻译法进行翻译，随后在一家日本重症监护病房进行前瞻性研究。为评估信度，由护士/研究人员对沿着八个维度（呼吸驱动力、对通气的反应、咳嗽、对刺激的最佳反应、对护理人员的注意力、对护理的耐受性、安抚性、安抚后的活动）对SBS进行评估。为评估效度，将SBS评分与里士满躁动-镇静量表及视觉模拟量表（VAS）进行比较。
原作者认可反向翻译后的SBS。在总共59次儿科危重症患者诊疗中，对31例年龄从0周至8岁的患者进行了评估。研究人员和护士的SBS评分显示出极好的评分者间信度（加权κ = 0.96，95%可信区间0.92 - 0.99）。此外，研究人员和护士的VAS评分之间存在非常强的相关性（ρ = 0.80，< 0.001）。八个维度的加权kappa系数范围从0.71（95%可信区间，0.55 - 0.88；安抚性）到0.89（95%可信区间，0.80 - 0.98；对刺激的最佳反应）。在效度测试中，护士的SBS和护士的VAS评分与研究人员的SBS及研究人员的里士满躁动-镇静量表评分之间存在强相关性（ρ = 0.80，< 0.001）（ρ = 0.91，< 0.001）。
本研究表明，我们的日语版SBS在评估危重症儿童的镇静方面是有效且可靠的。
