Psychometric Properties of Nursing Delirium Screening Scale in Patients Admitted to Intensive Care Units
Zohreh Amirajam, Elham Asadi-Noran, Behnam Molaei, Vahid Adiban, Mehdi Heidarzadeh, Mohammad Hassanpour-Darghah
Delirium, Intensive care, Validity
Citation Information :
Amirajam Z, Asadi-Noran E, Molaei B, Adiban V, Heidarzadeh M, Hassanpour-Darghah M. Psychometric Properties of Nursing Delirium Screening Scale in Patients Admitted to Intensive Care Units. Indian J Crit Care Med 2021; 25 (6):680-684.
Background: Nursing Delirium Screening Scale (Nu-DESC) is a new instrument for determining delirium by nurses. The study aimed to investigate the psychometric properties of Nu-DESC and determined the sensitivity and specificity of it.
Methods: Two evaluators assessed delirium by Nu-DESC in nonintubated patients admitted to intensive care unit (ICU) wards of Ardabil educational and medical centers. For determining psychometric properties of the instrument, the methods of determining content validity, structural validity, criterion validity (the DSM-5 criteria was used as a standard tool), internal consistency, and inter-rater reliability were used.
Results: Ninety-six participants were assessed two times using the Nu-DESC. The mean age of the participants was 58.84, and 51 (53.1%) of them were male. Due to the high correlation of the Nu-DESC with the study criterion (DSM-5), the criterion validity of the instrument is confirmed. By using DSM-5 instrument, the cutoff score of 2 shows the best sensitivity and specificity. The kappa and alpha coefficients were obtained as r = 0.96 and α = 0.86, which indicate a good agreement between the evaluators and acceptable consistency.
Conclusion: Nu-DESC can be used as an efficient and reliable instrument by nurses in the ICU. It was also found that taking medical history can help nurses to better interpret the Nu-DESC score at diagnosing delirium.
Hsieh SJ, Soto GJ, Hope AA, Ponea A, Gong MN. The association between acute respiratory distress syndrome, delirium, and in-hospital mortality in intensive care unit patients. Am J Respir Crit Care Med 2015;191(1):71–78. DOI: 10.1164/rccm.201409-1690OC.
American Psychiatric Association. Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Pub; 2013.
Ely EW, Shintani A, Truman B, Speroff T, Gordon SM, Harrell FE Jr. Delirium as a predictor of mortality in mechanically ventilated patients in the intensive care unit. JAMA 2004;291(14):1753–1762. DOI: 10.1001/jama.291.14.1753.
Ebert AD, Walzer TA, Huth C, Herrmann M. Early neurobehavioral disorders after cardiac surgery: a comparative analysis of coronary artery bypass graft surgery and valve replacement. J Cardiothorac Vasc Anesth 2001;15(1):15–19. DOI: 10.1053/jcan.2001.20211.
George C, Nair JS, Ebenezer JA, Gangadharan A, Christudas A, Gnanaseelan LK. Validation of the Intensive Care Delirium Screening Checklist in nonintubated intensive care unit patients in a resource-poor medical intensive care setting in South India. J Crit Care 2011;26(2):138–143. DOI: 10.1016/j.jcrc.2010.11.002.
Gaudreau JD, Gagnon P, Harel F, Tremblay A, Roy MA. Fast, systematic, and continuous delirium assessment in hospitalized patients: the nursing delirium screening scale. J Pain Symptom Manage 2005;29(4):368–375. DOI: 10.1016/j.jpainsymman.2004.07.009.
Hargrave A, Bastiaens J, Bourgeois JA, Neuhaus J, Josephson SA, Chinn J, et al. Validation of a nurse-based delirium-screening tool for hospitalized patients. Psychosomatics 2017;58(6):594–603. DOI: 10.1016/j.psym.2017.05.005.
L eung Jl, Leung Vc, Leung CM, Pan PC. Clinical utility and validation of two instruments (the Confusion Assessment Method Algorithm and the Chinese version of Nursing Delirium Screening Scale) to detect delirium in geriatric inpatients. Gen Hosp Psychiatry 2008;30(2):171–176. DOI: 10.1016/j.genhosppsych.2007.12.007.
Spedale V, Di Mauro S, Del Giorno G, Barilaro M, Villa CE, Gaudreau JD, et al. Delirium assessment in hospitalized elderly patients: Italian translation and validation of the nursing delirium screening scale. Aging Clin Exp Res 2017;29(4):675–683. DOI: 10.1007/s40520-016-0621-7.
Wild D, Grove A, Martin M, Eremenco S, McElroy S, Verjee-Lorenz A, et al. Principles of good practice for the translation and cultural adaptation process for patient-reported outcomes (PRO) measures: report of the ISPOR task force for translation and cultural adaptation. Value Health 2005;8(2):94–104. DOI: 10.1111/j.1524-4733.2005.04054.x.
Polit DF, Beck CT, Owen SV. Is the CVI an acceptable indicator of content validity? Appraisal and recommendations. Res Nurs Health 2007;30(4):459–467. DOI: 10.1002/nur.20199.
Brown TA. Confirmatory factor analysis for applied research.Guilford Publications; 2015.
Abelha F, Veiga D, Norton M, Santos C, Gaudreau JD. Delirium assessment in postoperative patients: validation of the Portuguese version of the Nursing Delirium Screening Scale in critical care. Braz J Anesthesiol (English Edition) 2013;63(6):450–455. DOI: 10.1016/j.bjane.2012.09.003.
Marino PL. Marino's the ICU Book, Vol. 1. Bukupedia: Wolters Kluwer Health; 2014.