Matsuishi Yujiro, Hoshino Haruhiko, Enomoto Yuki, Kido Takahiro, Matsuzaki Asaki, Shimojo Nobutake, Mathis Bryan J, Gallagher Joshua, Ista Erwin, Inoue Yoshiaki
Adult and Elderly Nursing, Faculty of Nursing, Tokyo University of Information Science, Chiba, Japan.
Department of Nursing, Faculty of Medical Technology, Teikyo University, Tokyo, Japan.
PLoS One. 2025 Sep 11;20(9):e0322957. doi: 10.1371/journal.pone.0322957. eCollection 2025.
Detecting pediatric delirium in critically ill children is important. The Sophia Observation withdrawal Symptoms and Delirium scale (SOS-PD) is a tool for assessing both pediatric delirium and iatrogenic withdrawal symptoms and contains a question for parents to assist in detecting pediatric delirium.
The aim was to translate the Japanese SOS-PD and to perform a cross-culture validation of the J-SOS-PD pediatric delirium dimension while confirming the accuracy of family assessments of pediatric delirium.
The translation was undertaken with the internationally established forward- backward translation method. Pediatric delirium was simultaneously evaluated and compared between psychiatric diagnoses based on assessment by a pediatric intensivist and the Japanese version of the SOS-PD as evaluated by PICU researchers. We evaluated the criterion validity (sensitivity and specificity), cut-off point using a receiver operating characteristic (ROC) curve, and reliability with Cohen's κ coefficient and intraclass correlation coefficients (ICC).
A total of 125 independent assessments were performed in 67 children with a median age of 15 (IQR 5, 54) months and with a pediatric delirium-positive rate of 30% based on psychiatric evaluation. Based on the ROC curve analysis, the cut-off point of 4 was the most appropriate within the original scale and the Japanese SOS-PD version showed high sensitivity (0.92, 95% CI 0.84-1.00) and specificity (0.97, 95% CI 0.94-1.00) at a cut-off point of 4 and high reliability within the researcher assessments (κ = 0.95). We also verified family assessments of pediatric delirium as showing high sensitivity (0.90) and specificity (0.89) over 36 assessments.
The Japanese version of the SOS-PD shows a high accuracy similar to the original. Moreover, we revealed high accuracy in family perception of pediatric delirium that could promote family presence in PICU settings.
在危重症儿童中检测小儿谵妄很重要。索菲亚观察戒断症状和谵妄量表（SOS-PD）是一种用于评估小儿谵妄和医源性戒断症状的工具，其中包含一个供家长协助检测小儿谵妄的问题。
旨在翻译日语版的SOS-PD，并对J-SOS-PD小儿谵妄维度进行跨文化验证，同时确认家庭对小儿谵妄评估的准确性。
采用国际公认的正向-反向翻译方法进行翻译。由儿科重症监护专家进行评估，同时根据儿科重症监护室研究人员评估的日语版SOS-PD，对基于精神科诊断的小儿谵妄进行评估和比较。我们评估了标准效度（敏感性和特异性）、使用受试者工作特征（ROC）曲线的截断点，以及使用科恩κ系数和组内相关系数（ICC）的信度。
对67名儿童进行了总共125次独立评估，这些儿童的中位年龄为15（四分位间距5，54）个月，根据精神科评估，小儿谵妄阳性率为30%。基于ROC曲线分析，截断点为4在原始量表中是最合适的，日语版SOS-PD在截断点为4时显示出高敏感性（0.92，95%置信区间0.84-1.00）和特异性（0.97，95%置信区间0.94-1.00），并且在研究人员评估中具有高信度（κ = 0.95）。我们还验证了家庭对小儿谵妄的评估，在36次评估中显示出高敏感性（0.90）和特异性（0.89）。
日语版的SOS-PD显示出与原版相似的高准确性。此外，我们揭示了家庭对小儿谵妄认知的高准确性，这可能会促进家长在儿科重症监护室环境中的陪伴。
