Validation of the SOS-PD scale for assessment of pediatric delirium: a multicenter study
Validation of the SOS-PD scale for assessment of pediatric delirium: a multicenter study
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DOI：
10.1186/s13054-018-2238-z
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发表时间：
2018-11-20
期刊：
影响因子：
15.1
通讯作者：
van Dijk, Monique
中科院分区：
文献类型：
--
作者：
Ista, Erwin;van Beusekom, Babette;van Dijk, Monique
背景：有报道称危重儿童的精神错乱发生率不断增加，这是值得关注的原因。我们评估了索菲亚戒断症状观察量表(SOS-PD量表)中的儿童妄想成分(PD-Scale)的测量特性。方法：在四家荷兰儿科ICU(PICU)进行的多中心前瞻性观察研究中，年龄<3个月和住院<48 h的患者每天三次使用PD-Scale进行评估。标准效度评估：如果帕金森病量表得分为4分，儿童精神病学家根据《精神障碍诊断和统计手册》(DSM-IV)临床评估帕金森病的存在或不存在。此外，儿童精神病学家对随机选择的一组进行了评估，以确定假阴性率。通过计算PD量表和康奈尔儿童妄想症(CAP-D)评分之间的皮尔逊系数(r(P))来评估其结构效度。结果：纳入485例患者，平均年龄27.0个月(IQR8~102月)，其中48例由儿童精神科医生诊断为妄想症。以4分为界值，PD量表的总体敏感性为92.3%，特异性为96.5%，与精神病学家的诊断结果相比。PD量表与CAP-D的相关系数为0.89(CI 95%，0.82~0.93；P<；0.001)。75对护工观察的ICC为0.99(95%CI，0.98~0.99)。结论：PD量表对危重儿童PD的早期筛查具有良好的信度和效度。护士可以有效、可靠地使用它来达到这一目的。
Backgrounds: Reports of increasing incidence rates of delirium in critically ill children are reason for concern. We evaluated the measurement properties of the pediatric delirium component (PD-scale) of the Sophia Observation Withdrawal Symptoms scale Pediatric Delirium scale (SOS-PD scale).Methods: In a multicenter prospective observational study in four Dutch pediatric ICUs (PICUs), patients aged >= 3 months and admitted for >= 48 h were assessed with the PD-scale thrice daily. Criterion validity was assessed: if the PD-scale score was >= 4, a child psychiatrist clinically assessed the presence or absence of PD according to the Diagnostic and statistical manual of mental disorders (DSM)-IV. In addition, the child psychiatrist assessed a randomly selected group to establish the false-negative rate. The construct validity was assessed by calculating the Pearson coefficient (r(p)) for correlation between the PD-scale and Cornell Assessment Pediatric Delirium (CAP-D) scores. Interrater reliability was determined by comparing paired nurse-researcher PD-scale assessments and calculating the intraclass correlation coefficient (ICC).Results: Four hundred eighty-five patients with a median age of 27.0 months (IQR 8-102) were included, of whom 48 patients were diagnosed with delirium by the child psychiatrist. The PD-scale had overall sensitivity of 92.3% and specificity of 96.5% compared to the psychiatrist diagnosis for a cutoff score >= 4 points. The r(p) between the PD-scale and the CAP-D was 0.89 (CI 95%, 0.82-0.93; p < 0.001). The ICC of 75 paired nurse-researcher observations was 0.99 (95% CI, 0.98-0.99).Conclusions: The PD-scale has good reliability and validity for early screening of PD in critically ill children. It can be validly and reliably used by nurses to this aim.