Detroyer Elke, Timmermans Annick, Segers Dana, Meyfroidt Geert, Dubois Jasperina, Van Assche Aimé, Joosten Etienne, Milisen Koen
1Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Kapucijnenvoer 35 - PB 7001/4, B-3000 Leuven, Belgium.
2Department of Geriatrics, University Hospitals Leuven, Leuven, Belgium.
BMC Nurs. 2020 Apr 10;19:21. doi: 10.1186/s12912-020-00415-z. eCollection 2020.
The Intensive Care Delirium Screening Checklist (ICDSC) demonstrates good psychometric characteristics in research settings. However, evidence about these characteristics in pragmatic ICU settings is inconsistent. This study evaluated psychometric properties and user-friendliness of the ICDSC when administered by ICU nurses in daily practice.
This prospective study included 77 patients from a surgical intensive care unit. To examine the psychometric characteristics, the scores on the ICDSC (performed by bedside nurses) were compared with the scores on the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) (performed by researchers as gold standard). The user-friendliness was evaluated by 34 ICU nurses with a 20-item questionnaire.
The ICDSC had an area under the curve of 0.843. It showed a good diagnostic accuracy with a sensitivity of 81.0%, a specificity of 87.7%, and a 53.1% positive and 96.4% negative predictive value. The overall Cronbach's alpha coefficient for all ICDSC scores was high (0.839). Overall, ICU nurses experienced the ICDSC as easy-to-use. The scale was usable in most surgical ICU patients. Yet, some nurses (11.8%) had problems to score the items 'inappropriate speech' and 'symptom fluctuation' in intubated patients.
The ICDSC is a valid and user-friendly tool for delirium screening in daily ICU nursing practice. Yet, some problems were reported in intubated patients. Therefore, validation studies with specific focus on intubated patients are needed.
重症监护谵妄筛查检查表（ICDSC）在研究环境中显示出良好的心理测量学特征。然而，在实际的重症监护病房（ICU）环境中，关于这些特征的证据并不一致。本研究评估了ICU护士在日常实践中使用ICDSC时的心理测量学特性和用户友好性。
这项前瞻性研究纳入了来自外科重症监护病房的77名患者。为了检查心理测量学特征，将ICDSC（由床边护士执行）的得分与重症监护病房意识模糊评估方法（CAM-ICU）（由研究人员作为金标准执行）的得分进行比较。通过34名ICU护士使用一份包含20个条目的问卷来评估用户友好性。
ICDSC的曲线下面积为0.843。它显示出良好的诊断准确性，敏感性为81.0%，特异性为87.7%，阳性预测值为53.1%，阴性预测值为96.4%。所有ICDSC得分的总体克朗巴赫α系数较高（0.839）。总体而言，ICU护士认为ICDSC易于使用。该量表在大多数外科ICU患者中可用。然而，一些护士（11.8%）在对插管患者的“言语不当”和“症状波动”项目进行评分时遇到问题。
ICDSC是ICU日常护理实践中用于谵妄筛查的有效且用户友好的工具。然而，插管患者中报告了一些问题。因此，需要针对插管患者进行专门的验证研究。
