Nurses' Recognition of Hospitalized Older Patients With Delirium and Cognitive Impairment Using the Delirium Observation Screening Scale A Prospective Comparison Study
Nurses' Recognition of Hospitalized Older Patients With Delirium and Cognitive Impairment Using the Delirium Observation Screening Scale A Prospective Comparison Study
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DOI：
10.3928/00989134-20181018-02
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发表时间：
2018-12-01
影响因子：
1.3
通讯作者：
Kressig, Reto W.
中科院分区：
文献类型：
--
作者：
Hasemann, Wolfgang;Tolson, Debbie;Kressig, Reto W.
本研究的目的是报告有关谵妄检测的结果时，病房护士使用谵妄观察筛选量表（DOSS）与混乱评估方法（CAM）相比，对认知障碍患者进行谵妄筛查。对2010年在瑞士一所高等大学医院收集的研究数据进行了二次分析。在入院后的前5天内，使用DOSS对70岁及以上的认知障碍患者进行谵妄筛查。在患者住院期间，研究助理也每天完成CAM。共有138名最初没有谵妄的患者参加了这项研究。在这些患者中，44例（32%）发生谵妄，中位持续时间为3天（Q1 = 1.25; Q3 = 5.00）。病房护士正确识别谵妄使用DOSS在56%的情况下（敏感性），没有谵妄在92%的情况下（特异性）。虽然DOSS在检测多动性谵妄患者中的正确率为100%，但混合性谵妄亚型患者的识别率降至60%，而少动性谵妄患者的识别率降至38%。使用观察方法进行谵妄筛查可能不够敏感，应辅以正式的注意力测试。
The aim of the current study was to report findings about delirium detection when ward nurses screened for delirium in patients with cognitive impairment using the Delirium Observation Screening Scale (DOSS) in comparison to the Confusion Assessment Method (CAM). A secondary analysis was performed of research data collected in 2010 at a Swiss tertiary university hospital. During the first 5 days after admission, patients 70 and older with cognitive impairment were screened for delirium using the DOSS. Throughout patients' hospital stay, research assistants also completed the CAM on a daily basis. A total of 138 patients who did not have delirium initially participated in the study. Of these patients, 44 (32%) developed delirium with a median duration of 3 days (Q1 = 1.25; Q3 = 5.00). Ward nurses correctly identified delirium using the DOSS in 56% of cases (sensitivity) and no delirium in 92% of cases (specificity). Although the DOSS was 100% correct in detecting patients with hyperactive delirium, the identification rate decreased to 60% for patients with mixed delirium subtype and 38% for patients with hypoactive delirium. Delirium screening using observational methods may be insufficiently sensitive and should be supplemented with a formal attention test.