| Content Provider |
World Health Organization (WHO)-Global Index Medicus |
| Author |
Boettger, Soenke Nuñez, David Garcia Meyer, Rafael Richter, André Fernandez, Susana Franco Rudiger, Alain Schubert, Maria Jenewein, Josef |
| Description |
Country affiliation: Switzerland Author Affiliation: Boettger S ( Department of Psychiatry and Psychotherapy,University Hospital of Zurich,University of Zurich,Zurich,Switzerland.); Nuñez DG ( Department of Psychiatry and Psychotherapy,University Hospital of Zurich,University of Zurich,Zurich,Switzerland.); Meyer R ( Institute for Regenerative Medicine,University of Zurich,Schlieren,Switzerland.); Richter A ( Department of Psychiatry and Psychotherapy,University Hospital of Zurich,University of Zurich,Zurich,Switzerland.); Fernandez SF ( Institute of Anaesthesiology,University Hospital Zurich,University of Zurich,Zurich,Switzerland.); Rudiger A ( Institute of Anaesthesiology,University Hospital Zurich,University of Zurich,Zurich,Switzerland.); Schubert M ( Inselspital,University Hospital of Bern,Directorate of Nursing/MTT,Bern,Switzerland.); Jenewein J ( Department of Psychiatry and Psychotherapy,University Hospital of Zurich,University of Zurich,Zurich,Switzerland.) |
| Abstract |
BACKGROUND: In the intensive care setting, delirium is a common occurrence that comes with subsequent adversities. Therefore, several instruments have been developed to screen for and detect delirium. Their validity and psychometric properties, however, remain controversial. METHOD: In this prospective cohort study, the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) and the Intensive Care Delirium Screening Checklist (ICDSC) were evaluated versus the DSM-IV-TR in the diagnosis of delirium with respect to their validity and psychometric properties. RESULTS: Out of some 289 patients, 210 with matching CAM-ICU, ICDSC, and DSM-IV-TR diagnoses were included. Between the scales, the prevalence of delirium ranged from 23.3% with the CAM-ICU, to 30.5% with the ICDSC, to 43.8% with the DSM-IV-TR criteria. The CAM-ICU showed only moderate concurrent validity (Cohen's κ = 0.44) and sensitivity (50%), but high specificity (95%). The ICDSC also reached moderate agreement (Cohen's κ = 0.60) and sensitivity (63%) while being very specific (95%). Between the CAM-ICU and the ICDSC, the concurrent validity was again only moderate (Cohen's κ = 0.56); however, the ICDSC yielded higher sensitivity and specificity (78 and 83%, respectively). SIGNIFICANCE OF RESULTS: In the daily clinical routine, neither the CAM-ICU nor the ICDSC, common tools used in screening and detecting delirium in the intensive care setting, reached sufficient concurrent validity; nor did they outperform the DSM-IV-TR diagnostic criteria with respect to sensitivity or positive prediction, but they were very specific. Thus, the non-prediction by the CAM-ICU or ICDSC did not refute the presence of delirium. Between the CAM-ICU and ICDSC, the ICDSC proved to be the more accurate instrument. |
| File Format |
HTM / HTML |
| ISSN |
14789515 |
| Journal |
Palliative and Supportive Care |
| e-ISSN |
14789523 |
| Language |
English |
| Publisher |
Cambridge University Press |
| Publisher Date |
2017-02-08 |
| Publisher Place |
Great Britain (UK) |
| Access Restriction |
One Nation One Subscription (ONOS) |
| Subject Keyword |
Discipline Palliative Care Discipline Psychology |
| Content Type |
Text |
| Resource Type |
Article |
| Subject |
Nursing Clinical Psychology Psychiatry and Mental Health |
