Hasegawa Tadashi, Seo Tomomi, Kubota Yoko, Sudo Tomoko, Yokota Kumi, Miyazaki Nao, Muranaka Akira, Hirano Shigeki, Yamauchi Atsushi, Nagashima Kengo, Iyo Masaomi, Sakai Ikuko
Department of Psychiatry, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuou-ku, Chiba-shi, Chiba 260-8670, Japan.
Department of Nursing, Chiba University Hospital, 1-8-1 Inohana, Chuou-ku, Chiba-shi, Chiba 260-8670, Japan.
Asian J Psychiatr. 2022 Jan;67:102918. doi: 10.1016/j.ajp.2021.102918. Epub 2021 Nov 6.
Although many screening tools for delirium are available, delirium is still occasionally overlooked or misdiagnosed. One of the reasons for this is the lack of brief screening tools that do not require specialized training to use. The 4 'A's test (the 4AT) is a validated screening tool for delirium that can be administered in a very short time without specialized training. Herein, we evaluated the reliability and validity of the Japanese version of the 4AT (the 4AT-J). A total of 150 patients aged ≥ 65 years were enrolled. Their demographics and clinical characteristics were obtained within 24 hr of their hospitalization. On each patient's high-risk day of developing delirium, the 4AT-J was administered by a nurse, and the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-Ⅴ) and the Japanese version of Delirium Rating Scale-Revised-98 (DRS-98-J) were administered by a psychiatrist. Our analyses revealed that when a cut-off score of 4, the 4AT-J showed high sensitivity and specificity. The Cronbach's α-coefficient was similar to that of the original version. A receiver operating curve analysis showed sufficient power of the 4AT-J to discriminate delirium. The 4AT-J showed adequate reliability and validity for delirium screening in elderly patients.
尽管有许多用于谵妄的筛查工具，但谵妄仍偶尔被忽视或误诊。其原因之一是缺乏无需专门培训即可使用的简短筛查工具。4“A”测试（4AT）是一种经过验证的谵妄筛查工具，无需专门培训即可在很短时间内完成。在此，我们评估了日语版4AT（4AT-J）的可靠性和有效性。共纳入150名年龄≥65岁的患者。在他们住院24小时内获取其人口统计学和临床特征。在每位患者发生谵妄的高危日，由护士进行4AT-J测试，由精神科医生进行《精神疾病诊断与统计手册》第5版（DSM-Ⅴ）和日语版谵妄评定量表修订版98（DRS-98-J）评估。我们的分析显示，当临界值为4时，4AT-J具有较高的敏感性和特异性。克朗巴哈α系数与原版相似。受试者工作特征曲线分析显示4AT-J有足够的能力鉴别谵妄。4AT-J在老年患者谵妄筛查中显示出足够的可靠性和有效性。
