Cross-cultural Adaption of the Indonesian Version of the Withdrawal Assessment Tool Version-1

Abstract

Background Sedative and analgesic medications are commonly administered in the Pediatric Intensive Care Unit (PICU) but can cause complications, such as Iatrogenic Withdrawal Syndrome (IWS). The Withdrawal Assessment Tool Version-1 (WAT-1) questionnaire is a validated and reliable diagnostic tool for IWS, but it is not yet available in the Indonesian language. Methods This observational cross-sectional study was conducted in two phases at Ciptomangukusumo Hospital, Jakarta, Indonesia. The initial phase involved translating the WAT-1 and State Behavioral Scale (SBS) instrument into Indonesian. Subsequently, the validity and reliability of the Indonesian version of WAT-1 were tested on 30 patients who received sedative and analgesic medications for at least five consecutive days in the PICU. Evaluations were performed by two groups of nurses: PICU nurses and training nurses. Results The Indonesian version of WAT-1 was found to be valid and reliable. The validity showed correlations ranging from good to very strong (r = 0.490 to 0.836) among PICU nurses and strong correlations (r = 0.634 to 0.808) among trained nurses. The WAT-1 questionnaire demonstrated reliability with Cronbach's alpha values of 0.791 for PICU nurses and 0.785 for trained nurses. The Intraclass Correlation Coefficient (ICC) for WAT-1 indicated very good to excellent consistency in assessments, and the ICC for SBS indicated excellent consistency. Conclusion The Indonesian version of WAT-1 and SBS is a valid and reliable diagnostic tool for detecting Iatrogenic Withdrawal Syndrome in Children.