Yang Eun Jung, Hahm Bong-Jin, Shim Eun-Jung
Department of Psychology, Pusan National University, Busan, Korea.
Department of Psychiatry and Behavioral Sciences, Seoul National University College of Medicine, Seoul, Korea.
J Hosp Palliat Care. 2021 Dec 1;24(4):214-225. doi: 10.14475/jhpc.2021.24.4.214.
This study reviewed screening and assessment tools that are used to measure delirium in patients with cancer in hospice and palliative care settings and examined their psychometric properties.
Four databases were searched for studies using related search terms (delirium, tools, palliative care, cancer, and others). The inclusion criteria were a) studies that included screening/assessment tools for measuring delirium in cancer patients receiving hospice/palliative care, and b) studies published in English or Korean. The exclusion criteria were a) studies that were conducted in an intensive care setting, and b) case studies, qualitative studies, systematic reviews, or meta-analyses.
Out of the 81 studies identified, only 10 examined the psychometric properties of tools for measuring delirium, and 8 tools were ultimately identified. The psychometric properties of the Memorial Delirium Assessment Scale (MDAS) were the most frequently examined (n=5), and the MDAS showed good reliability, concurrent validity, and diagnostic accuracy. The Delirium Rating Scale had good reliability and diagnostic accuracy. The Delirium Rating Scale-Revised 98 also showed good reliability and structural validity, but its diagnostic performance was not examined in hospice/palliative care settings. The Nursing Delirium Screening Scale showed relatively low diagnostic accuracy.
The MDAS showed evidence of being a valid assessment tool for assessing delirium in patients with cancer in palliative care. Few studies examined the diagnostic performance of delirium tools. Therefore, further studies are needed to examine the diagnostic performance of screening/assessment tools for the optimal detection of delirium in patients with cancer in hospice/palliative care.
本研究回顾了用于测量临终关怀和姑息治疗环境中癌症患者谵妄的筛查和评估工具，并考察了它们的心理测量特性。
使用相关检索词（谵妄、工具、姑息治疗、癌症等）在四个数据库中检索研究。纳入标准为：a）包括用于测量接受临终关怀/姑息治疗的癌症患者谵妄的筛查/评估工具的研究；b）以英文或韩文发表的研究。排除标准为：a）在重症监护环境中进行的研究；b）案例研究、定性研究、系统评价或荟萃分析。
在识别出的81项研究中，只有10项考察了测量谵妄工具的心理测量特性，最终确定了8种工具。纪念谵妄评估量表（MDAS）的心理测量特性被考察得最为频繁（n = 5），MDAS显示出良好的信度、同时效度和诊断准确性。谵妄评定量表具有良好的信度和诊断准确性。修订版谵妄评定量表98也显示出良好的信度和结构效度，但未在临终关怀/姑息治疗环境中考察其诊断性能。护理谵妄筛查量表显示出相对较低的诊断准确性。
MDAS显示出是评估姑息治疗中癌症患者谵妄的有效评估工具的证据。很少有研究考察谵妄工具的诊断性能。因此，需要进一步研究以考察筛查/评估工具在临终关怀/姑息治疗环境中对癌症患者谵妄进行最佳检测的诊断性能。
