한국어판 Cornell Assessment of Pediatric Delirium 소아 섬망 사정 도구의 검증
Study on Systematization of Advanced Practice Nursing in Korea
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목적: 본 연구는 소아 중환자실에서 한국어판 Cornell Assessment Pediatric Delirium (CAPD) 소아 섬망 도구의 신뢰도, 타당도를 검증하고자 함이다. 방법: 한국어판 CAPD의 관찰자 간 일치도를 통한 신뢰도 검증을 위해 3명의 간호사가 독립적으로 소아 중환자실에 입원한 환아의 섬망을 사정하였다. 준거타당도 검증을 위해 한국어판 CAPD의 결과와 협진을 통해 소아정신과 전문의가 DSM-V의 진단 기준에 따라 섬망 여부를 진단하는 것을 비교하였다. ROC 분석을 통해 도구의 민감도와 특이도를 산출하였다. 결과: 한국어판 CAPD의 관찰자간 일치도를 통한 신뢰도는 .98(95% CI .96∼.99)이었다. 8문항의 내적 일관성 신뢰도인 Cronbach’s α는 .91로 나타났다. 한국어판 CAPD와 소아정신과 전문의의 진단의 일치도는 90.0%이었다. 도구의 절단점은 9점 이상, 민감도는 93.8%, 특이도는 75.0%로 나타났다. ROC 분석을 통한 AUC는 .88로 나타났다. 결론: 본 연구를 통해 한국어판 CAPD는 신뢰도와 타당도가 우수하게 나타났다. 이를 토대로 한국어판 CAPD 도구는 국내 소아 중환자실에서 소아 섬망의 선별과 관리에 유용하게 사용될 것이다.
Abstract
Purpose: This study was to examine the reliability and validity of the Korean version of the Cornell Assessment of Pediatric Delirium (CAPD). Methods: For testing the reliability of the Korean version of the CAPD, this study calculated the internal consistency (Cronbach's ⍺) and the Interrater Correlation Coefficient (ICC) by comparing the independent assessment results of three nurses in Pediatric Intensive Care Unit (PICU). For testing the validity of the Korean version of the CAPD, the assessment result of the Korean version of the CAPD compared with that of the Diagnostic and Statistical Manual of Mental Disorders V (DSM-V). Receiver Operating Characteristics (ROC) analysis was used for measuring sensitivity and specificity. Results: Overall interrater reliability of the Korean version of the CAPD, ICC was .98 (95% CI .96~.99). Cronbach's ⍺ was .91 for eight items. The concordance between the Korean version of the CAPD and psychiatrist’s diagnosis was 90.0%. When the Korean version of the CAPD has the cut point of 9, sensitivity was 93.8%, and specificity was 75.0%. The area under the curve indicated by the ROC analysis was .88. Conclusion: The Korean version of the CAPD showed good reliability and validity. This tool will be useful for pediatric delirium screening and management in Korean PICU.
참고문헌 (29)
- Balas MC, "Delirium in older patients in surgical intensive care units", Journal of Nursing Scholarship, 39(2), pp.147~154 (2007)[DOI]
- Girard TD, "Delirium in the intensive care unit", Critical Care, 12(Suppl 3), pp.S3~ (2008)[DOI]
- Traube C, "Cornell assessment of pediatric delirium: A valid, rapid, observational tool for screening delirium in the PICU", Critical Care Medicine, 42(3), pp.656~663 (2014)[DOI]
- Silver G, "Delirium screening anchored in child development: The Cornell assessment for pediatric delirium", Palliative and Supportive Care, 13(4), pp.1005~1011 (2015)[DOI]
- 김효진, "소아중환자실 입원 아동의 섬망 발생 관련 요인", Child Health Nursing Research, 25(2), pp.103~111 (2019), 한국아동간호학회[DOI]
- Silver G, "Pediatric delirium and associated risk factors: A single-center prospective observational study", Pediatric Critical Care Medicine, 16(4), pp.303~309 (2015)[DOI]
- Silver G, "Detecting pediatric delirium: Development of a rapid observational assessment tool", Intensive Care Medicine, 38(6), pp.1025~1031 (2012)[DOI]
- Traube C, "Delirium in critically ill children: An international point prevalence study", Critical Care Medicine, 45(4), pp.584~590 (2017)[DOI]
- Traube C, "Delirium and mortality in critically ill children: epidemiology and outcomes of pediatric delirium", Critical Care Medicine, 45(5), pp.891~898 (2017)[DOI]
- Leentjens AF, "A comparison of the phenomenology of pediatric, adult, and geriatric delirium", Journal of Psychosomatic Research, 64(2), pp.219~223 (2008)[DOI]
- Smith HA, "Pediatric critical care perceptions on analgesia, sedation, and delirium", Seminars in Respiratory and Critical Care Medicine, 34(2), pp.244~261 (2013)[DOI]
- Kim MY, "Development and validation of a delirium prediction scoring system for major general surgery: Presented at the 6th World Nursing and Healthcare Conference, August 15-17, 2016 London, UK", Journal of Nursing & Care, 5(4, Suppl) (2016)[DOI]
- Sikich N, "Development and psychometric evaluation of the pediatric anesthesia emergence delirium scale", Anesthesiology, 100(5), pp.1138~1145 (2004)
- Schieveld JN, "Delirium in the pediatric patient:On the growing awareness of its clinical interdisciplinary importance", JAMA Pediatrics, 168(7), pp.595~596 (2014)[DOI]
- Harris J, "Clinical recommendations for pain, sedation, withdrawal and delirium assessment in critically ill infants and children: An ESPNIC position statement for healthcare professionals", Intensive Care Medicine, 42(6), pp.972~986 (2016)[DOI]
- Barbosa M, "Translation and cross-cultural adaptation of the Cornell Assessment of Pediatric Delirium scale for the Portuguese language", Revista Brasileira de Terapia Intensiva, 30(2), pp.195~200 (2018)
- Hoshino H, "The validity and reliability of the Japanese version of the Cornell Assessment of Pediatric Delirium", Pediatric Critical Care Medicine, 21(5), pp.e267~e273 (2020)[DOI]
- Simeone S, "Cornell Assessment of Pediatric Delirium:Italian cultural validation and preliminary testing", Professioni Infermieristiche, 72(1), pp.25~33 (2019)
- Simonsen BY, "The Cornell Assessment of Pediatric Delirium: Translation and inter-rater reliability in a Danish pediatric intensive care unit", Acta Anaesthesiologica Scandinavica, 63(7), pp.900~904 (2019)[DOI]
- American Psychiatric Association, "Diagnostic and statistical manual of mental disorders" (2013), American Psychiatric Association
- Heo EY, "Translation and validation of the Korean confusion assessment method for the intensive care unit", BMC Psychiatry, 11, pp.94~ (2011)[DOI]
- Sessler CN, "The Richmond Agitation-Sedation Scale: validity and reliability in adult intensive care unit patients", American Journal of Respiratory and Critical Care Medicine, 166(10), pp.1338~1344 (2002)[DOI]
- Bujang MA, "A simplified guide to determination of sample size requirements for estimating the value of intraclass correlation coefficient: A review", Archives of Orofacial Sciences, 12(1), pp.1~11 (2017)
- European Delirium Association, "The DSM-5 criteria, level of arousal and delirium diagnosis:Inclusiveness is safer", BMC Medicine, 12, pp.141~ (2014)[DOI]
- Nunnally JC, "Psychometric theory" (1994), MaGraw-Hill
- Schisterman EF, "Optimal cut-point and its corresponding Youden index to discriminate individuals using pooled blood samples", Epidemiology, 16(1), pp.73~81 (2005)[DOI]
- Swets JA, "Measuring the accuracy of diagnostic systems", Science, 240(4857), pp.1285~1293 (1988)[DOI]
- Steis MR, "Are nurses recognizing delirium? A systematic review", Journal of Gerontological Nursing, 34(9), pp.40~48 (2008)[DOI]
- Inouye SK, "Nurses' recognition of delirium and its symptoms: Comparison of nurse and researcher ratings", Archives of Internal Medicine, 161(20), pp.2467~2473 (2001)[DOI]