Valentina Spedale1, Stefania Di Mauro2, Giulia Del Giorno3, Monica Barilaro4, Candida E Villa4, Jean D Gaudreau5, Davide Ausili2. 1. Azienda Socio Sanitaria Territoriale - ASST Monza, Università degli Studi di Milano-Bicocca, Monza, Italy. v.spedale@asst-monza.it. 2. Dipartimento di Scienze della Salute, Università degli Studi di Milano-Bicocca, Monza, Italy. 3. Fondazione Monza e Brianza per il Bambino e la sua Mamma (MBBM), Monza, Italy. 4. Azienda Socio Sanitaria Territoriale - ASST Monza, Università degli Studi di Milano-Bicocca, Monza, Italy. 5. Psychiatrist Laval University, Quebec City, Canada.
Abstract
BACKGROUND: Delirium has a high incidence pathology associated with negative outcomes. Although highly preventable, half the cases are not recognized. One major cause of delirium misdiagnosis is the absence of a versatile instrument to measure it. AIMS: Our objective was to translate the nursing delirium screening scale (Nu-DESC) and evaluate its performance in Italian settings. METHODS: This was a methodological study conducted in two sequential phases. The first was the Italian translation of Nu-DESC through a translation and back-translation process. The second aimed to test the inter-rater reliability, the sensibility and specificity of the instrument on a convenience sample of 101 hospitalized elderly people admitted to relevant wards of the San Gerardo Hospital in Monza. To evaluate the inter-rater reliability, two examiners tested Nu-DESC on 20 patients concurrently without comparison. To measure the sensibility and specificity of Nu-DESC, the confusion assessment method was used as a gold standard measure. RESULTS: The inter-rater reliability (Cohen Kappa) was 0.87-an excellent agreement between examiners. The study of the ROC curve showed an AUC value of 0.9461 suggesting high test accuracy. Using 3 as a cut-off value, Nu-DESC showed 100 % sensibility and 76 % specificity. DISCUSSION AND CONCLUSION: Further research is needed to test Nu-DESC on a larger sample. However, based on our results, Nu-DESC can be used in research and clinical practice in Italian settings because of its very good and similar performances to previous validation studies. The value of 3 appears to be the optimal cut-off in the Italian context.
BACKGROUND:Delirium has a high incidence pathology associated with negative outcomes. Although highly preventable, half the cases are not recognized. One major cause of delirium misdiagnosis is the absence of a versatile instrument to measure it. AIMS: Our objective was to translate the nursing delirium screening scale (Nu-DESC) and evaluate its performance in Italian settings. METHODS: This was a methodological study conducted in two sequential phases. The first was the Italian translation of Nu-DESC through a translation and back-translation process. The second aimed to test the inter-rater reliability, the sensibility and specificity of the instrument on a convenience sample of 101 hospitalized elderly people admitted to relevant wards of the San Gerardo Hospital in Monza. To evaluate the inter-rater reliability, two examiners tested Nu-DESC on 20 patients concurrently without comparison. To measure the sensibility and specificity of Nu-DESC, the confusion assessment method was used as a gold standard measure. RESULTS: The inter-rater reliability (Cohen Kappa) was 0.87-an excellent agreement between examiners. The study of the ROC curve showed an AUC value of 0.9461 suggesting high test accuracy. Using 3 as a cut-off value, Nu-DESC showed 100 % sensibility and 76 % specificity. DISCUSSION AND CONCLUSION: Further research is needed to test Nu-DESC on a larger sample. However, based on our results, Nu-DESC can be used in research and clinical practice in Italian settings because of its very good and similar performances to previous validation studies. The value of 3 appears to be the optimal cut-off in the Italian context.
Authors: Zohreh Amirajam; Elham Asadi-Noran; Behnam Molaei; Vahid Adiban; Mehdi Heidarzadeh; Mohammad Hassanpour-Darghah Journal: Indian J Crit Care Med Date: 2021-06