Department of Psychiatry, Mackay Memorial Hospital, Taipei, Taiwan.
Department of Medicine, MacKay Medical College, Taiwan.
Asia Pac Psychiatry. 2022 Mar;14(1):e12468. doi: 10.1111/appy.12468. Epub 2021 Apr 12.
Delirium is a common neuropsychiatric condition in the general hospital population. Thus, the goal of the present study is to extend the use of diagnostic tools for delirium by developing and validating a Mandarin version of the Memorial Delirium Assessment Scale (MDAS).
Participants were sampled from two general Mackay Memorial Hospital locations in Taipei and Danshui. Board-certified psychiatrists assessed patients using the MDAS, confusion assessment method (CAM), and Mini-Mental State Examination (MMSE). Another consultation-liaison psychiatrist confirmed the diagnosis of delirium. We assessed the reliability and validity of the MDAS, and the receiver operating characteristic curve was used to determine the optimal cut-off point for identifying delirium.
Of the 61 patients assessed, 29 were diagnosed with delirium. The mean MDAS score was 16.7 for delirium patients and 4.1 for nondelirium patients. The MDAS has good internal consistency, with a Cronbach's alpha coefficient of 0.912. Interrater reliability was 0.996 (95% confidence interval [CI]: 0.992-0.998). The diagnostic cut-off value for the Mandarin version of the MDAS was 9, with a high sensitivity (93.1%) and specificity (96.9%). Factor analysis revealed a two-factor structure; these factors accounted for 58.37% and 14.42% of the variance. A high correlation was found between the MDAS and the CAM scores (r = -0.849, p < .001) as well as the MMSE (r = -0.875, p < .001).
The Mandarin MDAS exhibited good reliability and validity for assessing general hospital patients.
谵妄是普通综合医院人群中常见的神经精神疾病。因此,本研究的目的是通过开发和验证中文版的纪念谵妄评估量表(MDAS)来扩展谵妄诊断工具的使用。
参与者来自台北和淡水的两个马偕纪念医院的两个地点。经过董事会认证的精神科医生使用 MDAS、意识模糊评估方法(CAM)和简易精神状态检查(MMSE)对患者进行评估。另一位联络精神病医生确认了谵妄的诊断。我们评估了 MDAS 的可靠性和有效性,并使用接收者操作特征曲线确定了识别谵妄的最佳截断值。
在评估的 61 名患者中,有 29 名被诊断为谵妄。谵妄患者的 MDAS 平均得分为 16.7,非谵妄患者的 MDAS 平均得分为 4.1。MDAS 具有良好的内部一致性,克朗巴赫 α 系数为 0.912。评分者间信度为 0.996(95%置信区间[CI]:0.992-0.998)。中文 MDAS 的诊断截断值为 9,具有较高的敏感性(93.1%)和特异性(96.9%)。因子分析显示出两因素结构;这些因素占总方差的 58.37%和 14.42%。MDAS 与 CAM 评分(r = -0.849,p < .001)以及 MMSE(r = -0.875,p < .001)之间存在高度相关性。
中文 MDAS 对评估综合医院患者具有良好的可靠性和有效性。