The validity and reliability of the Portuguese versions of three tools used to diagnose delirium in critically ill patients.

OBJECTIVES: The objectives of this study are to compare the sensitivity and specificity of three diagnostic tools for delirium (the Intensive Care Delirium Screening Checklist, the Confusion Assessment Method for Intensive Care Units and the Confusion Assessment Method for Intensive Care Units Flowsheet) in a mixed population of critically ill patients, and to validate the Brazilian Portuguese Confusion Assessment Method for Intensive Care Units. METHODS: The study was conducted in four intensive care units in Brazil. Patients were screened for delirium by a psychiatrist or neurologist using the Diagnostic and Statistical Manual of Mental Disorders. Patients were subsequently screened by an intensivist using Portuguese translations of the three tools. RESULTS: One hundred and nineteen patients were evaluated and 38.6% were diagnosed with delirium by the reference rater. The Confusion Assessment Method for Intensive Care Units had a sensitivity of 72.5% and a specificity of 96.2%; the Confusion Assessment Method for Intensive Care Units Flowsheet had a sensitivity of 72.5% and a specificity of 96.2%; the Intensive Care Delirium Screening Checklist had a sensitivity of 96.0% and a specificity of 72.4%. There was strong agreement between the Confusion Assessment Method for Intensive Care Units and the Confusion Assessment Method for Intensive Care Units Flowsheet (kappa coefficient = 0.96) CONCLUSION: All three instruments are effective diagnostic tools in critically ill intensive care unit patients. In addition, the Brazilian Portuguese version of the Confusion Assessment Method for Intensive Care Units is a valid and reliable instrument for the assessment of delirium among critically ill patients.

The validity and reliability of the portuguese versions of three tools used to diagnose delirium in critically ill patients

OBJECTIVES: The objectives of this study are to compare the sensitivity and specificity of three diagnostic tools for delirium (the Intensive Care Delirium Screening Checklist, the Confusion Assessment Method for Intensive Care Units and the Confusion Assessment Method for Intensive Care Units Flowsheet) in a mixed population of critically ill patients, and to validate the Brazilian Portuguese Confusion Assessment Method for Intensive Care Units. METHODS: The study was conducted in four intensive care units in Brazil. Patients were screened for delirium by a psychiatrist or neurologist using the Diagnostic and Statistical Manual of Mental Disorders. Patients were subsequently screened by an intensivist using Portuguese translations of the three tools. RESULTS: One hundred and nineteen patients were evaluated and 38.6 percent were diagnosed with delirium by the reference rater. The Confusion Assessment Method for Intensive Care Units had a sensitivity of 72.5 percent and a specificity of 96.2 percent; the Confusion Assessment Method for Intensive Care Units Flowsheet had a sensitivity of 72.5 percent and a specificity of 96.2 percent; the Intensive Care Delirium Screening Checklist had a sensitivity of 96.0 percent and a specificity of 72.4 percent. There was strong agreement between the Confusion Assessment Method for Intensive Care Units and the Confusion Assessment Method for Intensive Care Units Flowsheet (kappa coefficient = 0.96) CONCLUSION: All three instruments are effective diagnostic tools in critically ill intensive care unit patients. In addition, the Brazilian Portuguese version of the Confusion Assessment Method for Intensive Care Units is a valid and reliable instrument for the assessment of delirium among critically ill patients.

Reliability of a questionnaire on substance use among adolescent students, Brazil

OBJETIVO: Analisar a confiabilidade de um questionário auto-aplicável sobre o uso e abuso de substâncias entre adolescentes escolares. MÉTODOS: Foram realizados dois estudos transversais para teste e re-teste do questionário em amostra representativa de alunos de ambos os sexos, de 11 a 19 anos, de escolas públicas e privadas (do curso fundamental e médio) de Salvador, BA, em 2006. Foram aplicados 591 questionários na primeira aplicação e 467 na segunda. Foram calculados a estatística descritiva, o índice kappa, alfa de Cronbach e correlação intraclasse. RESULTADOS: A prevalência do uso/abuso das substâncias foi semelhante em ambas as avaliações. Para as variáveis sociodemográficas o índice kappa indicou concordância "moderada" a "quase perfeita" e a análise do alfa de Cronbach e correlação intraclasse indicaram consistência "satisfatória". A idade de experimentação das substâncias psicoativas (tabaco, álcool e maconha) e idade dos estudantes foram semelhantes nas duas avaliações. A idade de iniciação do consumo e padrões de uso foram considerados indicadores confiáveis. CONCLUSÕES: A confiabilidade do questionário foi satisfatória para a população estudada.

Reliability of a questionnaire on substance use among adolescent students, Brazil.

OBJECTIVE: To analyze reliability of a self-applied questionnaire on substance use and misuse among adolescent students. METHODS: Two cross-sectional studies were carried out for the instrument test-retest. The sample comprised male and female students aged 1119 years from public and private schools (elementary, middle, and high school students) in the city of Salvador, Northeastern Brazil, in 2006. A total of 591 questionnaires were applied in the test and 467 in the retest. Descriptive statistics, the Kappa index, Cronbach's alpha and intraclass correlation were estimated. RESULTS: The prevalence of substance use/misuse was similar in both test and retest. Sociodemographic variables showed a "moderate" to "almost perfect" agreement for the Kappa index, and a "satisfactory" (>0.75) consistency for Cronbach's alpha and intraclass correlation. The age which psychoactive substances (tobacco, alcohol, and cannabis) were first used and chronological age were similar in both studies. Test-retest reliability was found to be a good indicator of students' age of initiation and their patterns of substance use. CONCLUSIONS: The questionnaire reliability was found to be satisfactory in the population studied.