Abstract
BackgroundDelirium is a common problem and associated with poor outcomes in intensive care unit (ICU) patients. Diagnosis of delirium in ICU patients is limited and usually underdiagnosed by physicians. The Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) is one of the most widely used screening methods for detection of ICU delirium. Our goal was to translate and validate the CAM-ICU for use in the Korean ICU setting.MethodsTranslation of the CAM-ICU was done according to the guidelines suggested by the Translation and Cultural Adaptation Group. For validation and interrater reliability assessment of the Korean CAM-ICU, two nurses independently assessed delirium in ICU patients and the results were compared with the reference evaluation, which was done by a psychiatrist using the Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV).ResultsTwenty-two patients were evaluated by two nurses and one psychiatrist expert independently. During the study period, we have continuously educated study nurses. Based on DSM-IV criteria, 16 out of 22 (72.7%) patients developed delirium. The sensitivities of the two nurses' evaluations using the Korean CAM-ICU were 89.80% for nurse 1 and 77.40% for nurse 2. Their specificities were 72.40% and 75.80% and their overall accuracy was 83.33% and 88.37% respectively. The Korean CAM-ICU was done with reasonable interrater reliability between nurse 1 and nurse 2 (κ = 0.81, p < 0.001).ConclusionsThe Korean CAM-ICU showed good validity and could be incorporated into clinical practice in Korean ICUs.Trial registrationISRCTN: ISRCTN50265663
Highlights
Delirium is a common problem and associated with poor outcomes in intensive care unit (ICU) patients
Delirium is defined in the Diagnostic and Statistical Manual of Mental Disorders IV (DSM IV) as a disturbance of consciousness with inattention accompanied by a change in cognition or perceptual disturbance that develops over a short period and fluctuates over time [1]
Delirium is a common problem in patients in the intensive care unit (ICU) because of critical illness, medications, various procedures, and numerous risk factors [2]
Summary
Delirium is a common problem and associated with poor outcomes in intensive care unit (ICU) patients. The Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) is one of the most widely used screening methods for detection of ICU delirium. The Confusion Assessment Method for the ICU (CAMICU) is a valid, reliable tool for detection of ICU delirium and is used in nonverbal mechanically ventilated patients. It is simple, can be assessed by nonpsychiatrists with minimal training and takes only a few minutes [3,4,11]. We attempted to translate and validate the CAM-ICU for practical use in the Korean ICU setting
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