Recognition of delirium in ICU patients: A diagnostic study of the NEECHAM confusion scale in ICU patients

被引：50

作者：

Immers H.E.M. ^{[1
,2
]}

Schuurmans M.J. ^{[3
,4
]}

Van De Bijl J.J. ^{[3
]}

机构：

[1] Intensive Care Unit, Reinier de Graaf Group, 2625 AD Delft

[2] CC Department, Haga Hospital, Leyenburg, 2545 CH The Hague

[3] Nursing Sciences, Julius Center, University Medical Center Utrecht, 3584 CX Utrecht

[4] Faculty of Health Care, University of Professional Education, 3484 CJ Utrecht

来源：

BMC Nursing | / 4卷 / 1期

关键词：

Intensive Care Unit; Intensive Care Unit Patient; Concurrent Validity; Intubate Patient; Regular Care;

D O I：

10.1186/1472-6955-4-7

中图分类号：

学科分类号：

摘要：

Background: A delirium, is a serious, high-frequency complication in intensive care unit (ICU) patients. The consequences of this complication range from high morbidity and mortality to greater need for nursing care. Despite these, delirium is often not recognized and there for not treated. In this study a nursing screening instrument, the NEECHAM confusion scale, was studied for early recognition of delirium ICU patients. This scale proved valid and reliable in several studies in the general hospital population. Methods: In this study validity and reliability were tested in a prospective cohort of 105 patients. Gold standard for delirium was an independent DSM-IV diagnosis. User friendliness was tested by structured evaluation of nurses' experiences working with the scale. Results: The NEECHAM confusion scale showed high internal consistency (Cronbach's alpha 0.88) and an interrater reliability of Cohen's Kappa 0.60. The concurrent validity with the DSM-IVcriteria showed a strong link (chi-square 67.52, p [less than or equal to] 0.001). Sensitivity was high, 97% and specificity was good 83%. ICU nurses completed the NEECHAM confusion rating in 3.69, ± 1.21 minutes average. In general the nurses were positive about the NEECHAM confusion scale. They were able to collect data during regular care, but experienced problems in rating the scale in intubated patients. The items in themselves were clear, the content validity, measured by the language used was rated good. Conclusion: The psychometric characteristics of the NEECHAM confusion scale of this ICU study are generally consistent with validity research previously reported for the general hospital population. The psychometric characteristics and the ease of use of the NEECHAM confusion scale enables ICU nurses to early recognize delirium. Further study, especially in intubed patients is recommended. © 2005 Immers et al; licensee BioMed Central Ltd.

引用

页数：6

共 22 条

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