Construction of the Sophia Observation withdrawal Symptoms-scale (SOS) for critically ill children
Construction of the Sophia Observation withdrawal Symptoms-scale (SOS) for critically ill children
复制标题
DOI：
10.1007/s00134-009-1487-3
复制
发表时间：
2009-06-01
影响因子：
38.9
通讯作者：
Duivenvoorden, Hugo J.
中科院分区：
文献类型：
--
作者：
Ista, Erwin;van Dijk, Monique;Duivenvoorden, Hugo J.
建立一个可靠的和临床实用的仪器监测阿片类药物和苯二氮卓类药物戒断症状的儿科ICU patients.Instrument开发。重症监护病房在学术儿童医院。79例患者高达16岁的静脉咪达唑仑和/或阿片类药物的千分之一日元5天。由85名医生和护士组成的专家小组对戒断症状的临床相关性进行了评估。在药物戒断过程中，使用文献中描述的24种戒断症状的检查表进行了重复观察。对于76名儿童，在减少和/或停用咪达唑仑或阿片类药物后24 h内获得了932个观察结果。最常见的症状是呼吸急促、激越、运动障碍、腹泻、发热、焦虑、睡眠障碍和高血压（14.6-29.6%）。进行多维标度（MDS）以检测症状共现的潜在经验结构。一个专家小组在一个从“肯定是”到“肯定不是”的四分量表上判断每种戒断症状的临床相关性。85-95%的专家认为激动、焦虑、伤心欲绝的哭泣、肌肉紧张度增加、震颤、心动过速和出汗与此相关。根据MDS的结果和专家的意见，15个症状被包括在最终的instrument.We是第一个开发一个评估工具，在儿科ICU患者的基础上，专家认为相关的戒断症状的共同出现的基础经验结构的戒断症状。未来的研究需要确定分界点，并澄清心理测量学问题。
To construct a reliable and clinically practical instrument for monitoring opioids and benzodiazepine withdrawal symptoms in pediatric ICU patients.Instrument development.Intensive care unit in an academic children's hospital.79 patients up to age 16 years on intravenous midazolam and/or opioids for a parts per thousand yen5 days. An expert panel of 85 physicians and nurses rated clinical relevance of withdrawal symptoms.During drug weaning repeated observations were performed with a checklist of 24 withdrawal symptoms described in the literature.For 76 children, 932 observations were obtained within 24 h after decrease and/or discontinuation of midazolam or opioids. Most frequent symptoms were tachypnea, agitation, motor disturbance, diarrhea, fever, anxiety, sleep disturbance and hypertension (14.6-29.6%). Multidimensional scaling (MDS) was performed to detect the underlying empirical structure of co-occurrences of symptoms. An expert panel judged clinical relevance of each withdrawal symptom on a four-point scale ranging from 'definitively so' to 'definitively not'. Agitation, anxiety, inconsolable crying, increased muscle tension, tremors, tachycardia and sweating were considered relevant by 85-95% of the experts. On the basis of the MDS results and the experts' opinions, 15 symptoms were included in the final instrument.We are the first to develop an assessment tool for withdrawal symptoms in pediatric ICU patients on the basis of the underlying empirical structure of co-occurrences of withdrawal symptoms that experts considered relevant. Future studies need to define cut-off points and clarify psychometric issues.