Psychometric Properties of Nursing Delirium Screening Scale in Patients Admitted to Intensive Care Units.

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. HOW TO CITE THIS ARTICLE: Amirajam Z, Noran EA, Molaei B, Adiban V, Heidarzadeh M, Darghah MH. Psychometric Properties of Nursing Delirium Screening Scale in Patients Admitted to Intensive Care Units. Indian J Crit Care Med 2021;25(6):680-684.

The Critical care Pain Observation Tool is reliable in non-agitated but not in agitated intubated patients.

OBJECTIVE: The Critical-Care Pain. OBSERVATION: Tool is one of the instruments developed to assess pain in patients who are unable to communicate verbally. The study aimed to survey the psychometric properties of Critical-Care Pain. OBSERVATION: Tool in four groups of non-verbal patients according to their Richmond Agitation Sedation Score (RASS). STUDY DESIGN AND METHODOLOGY: 65 critically ill patients (medical, surgical, trauma) were assessed using the critical care pain observation tool on six occasions (before, during and after nociceptive and non-nociceptive procedures). Patients were divided into four groups according to their RASS score: 1. All patients (RASS -3 to +2), 2. Sedated patients (RASS -3 to -1), 3. Restless patients (RASS +1), 4. Agitated patients (RASS +2). RESULTS: Discriminant and criterion validity, confirmatory factor analysis and internal reliability showed good validity and reliability in the critical care pain observation tool in all groups except agitated patients. The results showed that, in general, the CPOT has good version of the critical care pain observation tool has good psychometric properties to evaluate pain in non-verbal patients admitted to intensive care units who have a RASS score ranging from -3 to +1, but it is not a good tool to evaluate pain in patients who are agitated according to RASS.