Browse > Article
http://dx.doi.org/10.7475/kjan.2012.24.6.655

Comparison of Delirium Screening Instruments for the Elderly  

Lee, Young Whee (Department of Nursing, Inha University)
Chang, Sung Ok (College of Nursing, Korea University)
Kong, Eun Suk (Department of Nursing, Jesus University)
Kim, Nam Cho (College of Nursing, The Catholic University of Korea)
Kim, Chun Gill (Division of Nursing, Hallym University)
Kim, Hee Kyung (Department of Nursing, Kongju National University)
Song, Misoon (College of Nursing, Seoul National University)
Ahn, Soo Yeon (Division of Nursing, Hallym University)
Cho, Myung Ok (Department of Nursing, Dong-Eui University)
Choi, Kyung Sook (Red Cross of Nursing, Chung-Ang University)
Publication Information
Korean Journal of Adult Nursing / v.25, no.6, 2013 , pp. 655-664 More about this Journal
Abstract
Purpose: This study was undertaken to identify which delirium screening instrument would be more useful in clinical practice. Methods: Data were collected from 118 nurses from six hospitals in five provinces in Korea. For the delirium screening three instruments were compared: NEECHAM Confusion Scale (NEECHAM), Nursing Delirium Screening Scale (Nu-DESC), Delirium Observation Scale (DOS). The MMSE-K was used for concurrent validity. The nurse subjects were surveyed as to the practical clinical value of each instrument. Cronbach's ${\alpha}$ coefficient and Kuder-Richardson 20 were used to confirm the reliability. Results: The range of three scales reliability was .70~.82 and the range of correlation coefficient was .63~.82 with MMSE-K. For sensitivity of NEECHAM, Nu-DESC and DOS was 1.00, 1.00 and 0.81 respectively and specificity NEECHAM, Nu-DESC and DOS was 0.88, 0.89 and 0.89 respectively. Nurses rated the practical use of the DOS scale as significantly easier to use than the NEECHAM and Nu-DESC. Conclusion: NEECHAM, Nu-DESC and DOS scales were acceptable in terms of reliability, validity, sensitivity and specificity. However, nurses rated the DOS scale as easier scale to use and had more relevance to their practice.
Keywords
Delirium; Aged;
Citations & Related Records
Times Cited By KSCI : 1  (Citation Analysis)
연도 인용수 순위
1 Adamis, D., Sharma, N., Whelan, P. J. P., & Macdonald, A. J. D. (2010). Delirium scales: A review of current evidence. Aging & Mental Health, 14, 543-555. http://dx.doi.org/10.1080/13607860903421011   DOI   ScienceOn
2 Champagne, M. T., Neelon, V. J., McConnel, E. S., & Funk, S. (1987). The NEECHAM Confusion Scale: Assessing acute confusion in hospitalized and nursing home elderly. The Gerontologist, 27, Supplement, 4A   DOI
3 Duppils, G. S. (2011). Predictive value and validation of the NEECHAM confusion scale using DSM-IV criteria for delirium as gold standard. International Journal of Older People Nursing, 6 (2), 133-142. http://dx.doi.org/10.1111/j.1748-3743.2010.00232.x   DOI   ScienceOn
4 Folstein, M. F., Folstein, S. E., & Mchugh, P. R. (1975). Mini-Mental State: A practical method for grading the cognitive state of patient for the clinician. Journal of Psychiatry Research, 12, 189-198. http://dx.doi.org/10.1016/0022-3956(75) 90026-6   DOI   ScienceOn
5 Foreman, M. D., & Zane, D. (1996). Nursing strategies for acute confusion in elders. American Journal of Nursing, 96 (4), 44-52.
6 Gaudreau, J. D., Gagnon, P., Harel, F., Tremblay, A., & Roy, M. A. (2005). Fast, systematic, and continuous delirium assessment in hospitalized patients: The nursing delirium screening scale. Journal of Pain and Symptom Management, 29 (4), 368-375. http://dx.doi.org/10.1016/j.jpainsymman.2004.07.009   DOI   ScienceOn
7 Gemert van, L., & Schuurmans, M. J. (2007). The Neecham confusion scale and the delirium observation screening scale: Capacity to discriminate and ease of use in clinical practice. BMC Nursing, 6 (3), 1-6. http://dx.doi.org/10.1186/1472-6955-6-3   DOI   ScienceOn
8 Grover, S., & Kate, N. (2012). Assessment scales for delirium: A review. World Journal of Psychiatry, 2 (4), 58-70. http://dx.doi.org/10.5498/wjp.v2.i4.58   DOI   ScienceOn
9 Han, M. I. (2004). Clinical approach to delirium in elderly patients. Journal of Korean Geriatric Psychiatry, 8, 96-101.
10 Inouye, S. K. (2003). The confusion assessment method (CAM): Training manual and coding guide. New Haven: Yale University School of Medicine.
11 Inouye, S. K., Foreman, M. D., Mion, L. C., Katz, K. H., & Cooney, L. M. Jr. (2001). Nurses' recognition of delirium and its symptoms: comparison of nurse and researcher ratings. Archives of Internal Medicine, 161, 2467-3473. http://dx.doi.org/doi:10.1001/archinte.161.20.2467   DOI   ScienceOn
12 Kim, E. J., & Park, Y. K. (2000). SPSS statistical analysis 8. Seoul: 21Saegi Co.
13 Kim, K. N., Kim, C. H., Kim, K. I., Yoo, H. J., Park, S. Y., & Park, Y. H. (2012). Development and validation of the Korean nursing delirium scale. Journal of Korean Academy of Nursing, 42, 414-423. http://dx.doi.org/10.4040/jkan.2012. 42.3.414   DOI   ScienceOn
14 Matarese, M., Generoso, S., Ivziku, D., Pedone, C., & Marinis, M. G. (2012). Delirium in older patients: A diagnostic study of Neecham confusion scale in surgical intensive care unit. Journal of Clinical Nursing, Nov. 22 on-line published, 1-9. http://dx.doi.org/10.1111/j.1365-2702.2012.04300.x   DOI   ScienceOn
15 Kwon, Y. C., & Park, J. H. (1989). Korean version of Mini-Mental State Examination (MMSE-K) Part I: Development of the test for the elderly. Journal of Korean Neuropsychiatric Association, 28, 125-135.
16 Lee, E. H., Jung, Y. H., Kim, J. S., Song, R. Y., & Hwang, K. Y. (2002). Statistical methods for health care research. Seoul: Kunja Publishing.
17 Lee, Y. W., Kim, C. G., Kong, E. S., Kim, K. B., Kim, N. C., Kim, H. K., et al. (2007) A study of nurses' knowledge level and assessment experience of delirium. Journal of Korean Academy of Adult Nursing, 19, 35-44.
18 McCarthy, M. (2003). Detecting acute confusion in older adults: Comparing clinical reasoning of nurses working in acute, long-term, and community health care environments. Research in Nursing and Health, 26, 203-212. http://dx.doi.org/10.1002/nur.10081   DOI   ScienceOn
19 Neelon, V. J., Champagne, M. T., Carlson, J. R., & Funk, S. G. (1996). The NEECHAM Confusion Scale: Construction, validation, and clinical testing. Nursing Research, 45, 324-330.   DOI   ScienceOn
20 Park, J. H., & Kwon, Y. C. (1989). Standardization of Korean version of the Mini-Mental State Examination (MMSE-K) for use in the elderly. Part II. Diagnostic validity. Journal of Korean Neuropsychiatric Association, 28, 508-513.
21 Polit, D., Beck, C., & Hungler, B. (2001). Essential of nursing research: methods, appraisal and utilization. Philadelphia: Lippincott.
22 Shuurmans, M. J., Shortridge-Baggett, L. M., & Duursma, S. A. (2003). The Delirium Observation Screening Scale: A screening instrument for delirium. Research and Theory for Nursing Practice, 17 (1), 31-50.   DOI
23 Rapp, C. G., Wakerfield, B., Kundarat, M., Mentes, J. C., Tripp-Reimer, T., Culp, K., et al. (2000). Acute confusion assessment instruments: clinical versus research utility. Applied Nursing Research, 13, 37-45. http://dx.doi.org/10.1016/S0897-1897(00)80017-8   DOI   ScienceOn
24 Rompaey, B, V., Schuurmans, M. J., Shortridge-Baggett, L. M., Truijen, S., Elseviers, M., & Bossaert, L. (2008). A comparison of the CAM-ICU and the NEECHAM confusion scale in intensive care delirium assessement: An observational study in non-intubated patients. Critical Care, 12, 1-7. http://dx.doi.org/10.1186/cc6790   DOI
25 Shuurmans, M. J., Donders, R. T., Shortridge-Baggett, L. M., & Duursma, S. A. (2002). Delirium case finding: Pilot testing of a new screening scale for nurses. Journal of the American Geriatric Society, 50 (4), S3.   DOI   ScienceOn
26 Trzepacz, P. T., Meagher, D. J., & Wise, M. G. (2002). Neuropsychiatric aspects of delirium. In S. C. Yudofsky & R. E. Hales (ed.), Textbook of neuropsychiatry and clinical neurosciences (pp. 534-564). Washington DC: American Psychiatric Publishing Inc.
27 Wakerfield, B., J. (2002). Risk for acute confusion on hospital admission. Clinical Nursing Research, 11, 153-172. http://dx.doi.org/10.1177/10547738020110205   DOI
28 Yu, M. Y., Park, J. W., Hyun, M. S., & Lee, Y. J. (2008). Factors related to delirium occurrence among the patients in the intensive care units. Journal of Korean Clinical Nursing Research, 14, 151-160.