신경외과 수술 후 노인 환자를 위한 섬망 사정도구의 임상활용 가능성 평가
Evaluation of Clinical Usefulness of Delirium Assessment Tools for Elderly Patients after Neurosurgery
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Purpose: The aim of this study was to evaluate the possibility for clinical use of delirium assessment tools, the Nursing Delirium Screening Scale (Nu-DESC) and the Delirium Observation Screening Scale (DOS), for postoperative neurosurgery patients. Methods: A sample of 100 elderly patients post neurosurgery was recruited from a neurosurgery ward in a university hospital located in Seoul, South Korea. Nurses (n=28) on the neurosurgery ward were asked to assess the participants using the Nu-DESC and the DOS. Based on the diagnosis of delirium made by a neuropsychiatrist, validity of the tools was evaluated. A questionnaire about ease of use of the tool was completed by the nurses. Results: As for the reliability of the tools, Cronbach's ⍺ was .79, and .95 for the Nu-DESC and the DOS, respectively. Both of the tools showed high levels of sensitivity and specificity. As for ease of use in the clinical setting, the Nu-DESC (mean=39.2±4.82) had a higher (t=2.77, p=.01) score than the DOS (mean=37.39±5.97). Conclusion: Findings of this study confirmed that both the Nu-DESC and the DOS were highly reliable and valid tools to detect delirium in postoperative older neurosurgery patients, but the Nu-DESC was easier to use.
Abstract
Purpose: The aim of this study was to evaluate the possibility for clinical use of delirium assessment tools, the Nursing Delirium Screening Scale (Nu-DESC) and the Delirium Observation Screening Scale (DOS), for postoperative neurosurgery patients. Methods: A sample of 100 elderly patients post neurosurgery was recruited from a neurosurgery ward in a university hospital located in Seoul, South Korea. Nurses (n=28) on the neurosurgery ward were asked to assess the participants using the Nu-DESC and the DOS. Based on the diagnosis of delirium made by a neuropsychiatrist, validity of the tools was evaluated. A questionnaire about ease of use of the tool was completed by the nurses. Results: As for the reliability of the tools, Cronbach's ⍺ was .79, and .95 for the Nu-DESC and the DOS, respectively. Both of the tools showed high levels of sensitivity and specificity. As for ease of use in the clinical setting, the Nu-DESC (mean=39.2±4.82) had a higher (t=2.77, p=.01) score than the DOS (mean=37.39±5.97). Conclusion: Findings of this study confirmed that both the Nu-DESC and the DOS were highly reliable and valid tools to detect delirium in postoperative older neurosurgery patients, but the Nu-DESC was easier to use.
참고문헌 (30)
- Torpy JM, "JAMA patients page: delirium", JAMA, 300(24), pp.2936~ (2008)[DOI]
- Farley A, "Delirium part one : clinical features, risk factors and assessment", Nurs Stand, 21(29), pp.35~40 (2007)[DOI]
- Fong TG, "Delirium in elderly adults : diagnosis, prevention and treatment", Nat Rev Neurol, 5, pp.210~220 (2009)[DOI]
- Saxena S, "Delirium in the elderly : a clinical review", Niger Postgrad Med J, 85, pp.405~413 (2009)[DOI]
- Ely EW, "Current opinions regarding the importance, diagnosis, and management of delirium in the intensive care unit : a survey of 912 healthcare professionals", World J Crit Care Med, 32(1), pp.106~112 (2004)[DOI]
- Han MI, "Clinical approach to delirium in elderly patients", J Korean Geriatr Psychiatry, 8, pp.96~101 (2004)
- 양영희, "요양병원과 종합병원 간호사들의 섬망에 대한 인식과 간호지식정도", 한국간호교육학회지, 16(2), pp.312~320 (2010), 한국간호교육학회
- 최은정, "간호사의 섬망사정능력", 노인간호학회지, 13(3), pp.233~241 (2011), 노인간호학회
- Andrew MK, "Incomplete functional recovery after delirium in elderly people", BMC Geriatr, 5, pp.5~ (2005)[DOI]
- 천영훈, "섬망의 조기 발견을 위한 진단 및 평가 방법", 정신신체의학, 19(1), pp.3~14 (2011), 한국정신신체의학회
- Cole MG, "Delirium in elderly patients", Am J Geriatr Psychiatry, 10(5), pp.7~21 (2004)
- 김경남, "한국어판 간호 섬망 선별 도구 개발 및 검증", Journal of Korean Academy of Nursing, 42(3), pp.414~423 (2012), 한국간호과학회
- Siddiqi N, "Interventions for preventing delirium in hospitalised patients", Cochrane Database Syst Rev, 18(2), pp.1~41 (2007)[DOI]
- Devlin JW, "Assessment of delirium in the intensive care unit : nursing practices and perceptions", Am J Crit Care, 17(6), pp.555~566 (2008)
- Park, J, "The effects of delirium education program on delirium knowledge, importance of nursing intervention and nursing practice for intensive care unit nurses", 석사, pp.2008
- Abelha F, "Delirium assessment in postoperative patients : validation of the Portuguese version of the Nursing Delirium Screening Scale in critical care", Braz J Anesthesiol, 63(6), pp.450~455 (2013)[DOI]
- Gaudreau JD, "Fast, systematic, and continuous delirium assessment in hospitalized patients : the nursing delirium screening scale", J Pain Symptom Manage, 29(4), pp.368~375 (2005)[DOI]
- Grover S, "Assessment scales for delirium : a review", World J Psychiatry, 2(4), pp.58~70 (2012)[DOI]
- Hwang HJ, "Effects of nursing intervention to acutely delirious old patients", 석사, pp.2008
- 이영휘, "노인의 섬망 사정을 위한 도구의 임상적 사용 용이성에 관한 연구", 성인간호학회지, 25(6), pp.655~664 (2013), 성인간호학회[DOI]
- Shuurmans MJ, "The delirium observation screening scale : a screening instrument for delirium", Res Theory Nurs Pract, 17(1), pp.31~50 (2003)
- Gemert van LA, "The neecham confusion scale and the delirium observation screening scale : capacity to discriminate and ease of use in clinical practice", BMC Nurs, 6(3), pp.1~6 (2007)[DOI]
- Izabela ZS., "DSM-5 Neurocognitive Disorder : validity, reliability, fairness, and utility in forensic application", Psychol. Inj and Low, 6, pp.299~306 (2013)[DOI]
- Roodbol G., "The Neecham Confusion Scale and the Delirium Observation Screening Scale: capacity to discriminate and ease of use in clinical practice", BMC Nurs, 6(3), pp.1~6 (2007)[DOI]
- Dubois MJ, "Delirium in an intensive care unit : a study of risk factors", J Intensive Care Med, 27(8), pp.1297~1304 (2001)[DOI]
- Ohki T, "An evaluation strategy for the early detection of postoperative delirium", Psychiatry Clin Neurosci, 60(3), pp.277~282 (2006)[DOI]
- Landis JR, "The measurement of observer agreement for categorical data", Biometrics, 33, pp.159~174 (1997)
- Polit D, "Essential of nursing research: Methods, appraisal and utilization", pp.175~178 (2005), Lippincott
- 김성렬, "급성기 신경계 환자에서 낙상 위험 사정 도구의 신뢰도 및 타당도 비교", 성인간호학회지, 25(1), pp.24~32 (2013), 성인간호학회
- Rebecca WR, "The evolving role of the nurse practitioner in neurosurgery", J Neurosurg, 53(6), pp.802~807 (1980)