重症监护谵妄筛查量表在麻醉苏醒期患者中使用的信效度分析  

Reliability and validity of the Chinese version of Intensive Care Delirium Screening Checklist in post-anesthesia care unit

作　　者：刘尚昆[1] 梅伟[1] 张治国[2] 吴震[1] 刘光跃[3,4] Yoanna Skrobik 田玉科[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院麻醉科,湖北武汉430030 [2]华中科技大学同济医学院医药卫生管理学院 [3]四川大学华西临床医学院 [4]四川大学附属华西医院麻醉与重症监护科 [5]Université de Montréal,Hpital Maisonneuve Rosemont

出　　处：《护理学杂志》2010年第10期4-7,共4页

摘　　要：目的检测重症监护谵妄筛查量表(Intensive Care Delirium Screening Checklist,ICDSC)的信度和效度,为测评全麻术后麻醉苏醒期患者的谵妄状态提供有效工具。方法根据ISPOR指南,对国际通用的ICDSC进行编译,制定中文版ICDSC,对228例手术后麻醉恢复室留观患者进行谵妄评估,对中文版ICDSC进行信度和效度分析。结果中文版ICDSC内部一致性Cronbach′sα系数为0.74,评分员间信度为0.90;以DSM-Ⅳ诊断结果为金标准,ICDSC诊断域值≥4分时,敏感度为0.97,特异度为0.83,阳性预测值为0.52,阴性预测值为0.99,ICDSC与DSM-Ⅳ总一致性的Kappa值为0.59(P<0.01)。ROC曲线下面积为0.93。结论中文版ICDSC具有满意的信度和效度,具有较高的诊断效能,可作为麻醉恢复室谵妄筛查工具,但诊断阳性者仍需专科医生进一步鉴别诊断排除其他疾病。Objective To assess the reliability and validity of the Chinese version of Intensive Care Delirium Screening Checklist （ICDSC） in a post-anesthesia care unit. Methods The translation and cultural adaptation of ICDSC was done according to the ISPOR guidelines. Then the Chinese version of ICDSC was used to screen delirium in 228 patients staying in post-anesthesia care unit,and the reliability and validity of the Chinese version ICDSC was calculated. Results The Chinese version ICDSC had high internal consistency,with the Cronbach＇s α coefficient being 0.74; the intraclass correlation coefficient（ICC） for the ICDSC was 0.90. If the results of DSM-Ⅳ screening were taken as the gold standard,with a cut of ICDSC score≥4,the sensitivity of ICDSC was 0.97,the specificity was 0.83,the positive predictive value was 0.52,the negative predictive value was 0.99,and the overall cross-validated Kappa was 0.59（P0.01）. The area under the ROC curve was 0.93. Conclusion The Chinese version of ICDSC has satisfactory reliability and validity,and it can be served as a delirium screening tool in China for postoperative and ICU patients. However,patients with positive screening results still need further differential diagnosis to exclude other diseases.

关 键 词：谵妄 重症监护谵妄筛查量表 信度 效度 麻醉恢复室 

分 类 号：R472.3[医药卫生—护理学] R614.2[医药卫生—临床医学]