J Korean Acad Nurs.  2012 Jun;42(3):414-423. 10.4040/jkan.2012.42.3.414.

Development and validation of the Korean Nursing Delirium Scale

Affiliations
  • 1Department of Nursing, Seoul National University Bundang Hospital, Bundang, South Korea.
  • 2Geriatric Center, Seoul National University Bundang Hospital & Department of Internal Medicine, Seoul National University College of Medicine, Bundang, South Korea.
  • 3Geriatric Center, Seoul National University Bundang Hospital, Bundang, South Korea.
  • 4College of Nursing & The Research Institute of Nurisng Science, Seoul National University, Seoul, South Korea. hanipyh@snu.ac.kr

Abstract

PURPOSE
The aims of this study were to develop and test the validity of the Korean Nursing Delirium Scale (Nu-DESC) for older patients in hospital.
METHODS
The Korean Nu-DESC was developed based on the Nu-DESC (Gaudreau, 2005), and revised according to nursing records related to signs and symptoms of older patients with delirium (n=361) and the results of a pilot study (n=42) in one general hospital. To test the validity of the Korean Nu-DESC, 75 older patients whom nurses suspected of delirium from 731 older patients from 12 nursing units were assessed by bedside nurses using the Korean Nu-DESC. A Receiver Operating Characteristic Curve of the Korean Nu-DESC was constructed with an accompanying Area Under the Curve (AUC).
RESULTS
Specific examples such as irritable, kidding, sleeping tendency, which were observed by bedside nurses in Korea, were identified in the five features of signs and symptoms of delirium in the instrument. The Korean Nu-DESC was psycho-metrically valid and had a sensitivity and specificity of .81-.76 and .97-.73, respectively. The AUC were .89, .74.
CONCLUSION
Results of this study indicate that the Korean Nu-DESC is well-suited for widespread clinical use in busy inpatients settings and shows promise as a research instrument.

Keyword

Delirium; Screening; Aged; Nursing

MeSH Terms

Aged
Aged, 80 and over
Area Under Curve
Behavior
Communication
Confusion
Delirium/diagnosis/*nursing
Female
Hallucinations
Hospitals, General
Humans
Illusions
Male
Pilot Projects
*Program Development
Psychomotor Performance
Questionnaires
ROC Curve
Republic of Korea
Translating

Figure

  • Figure 1 Korean Nursing Delirium Screening Scale (Nu-DESC).

  • Figure 2 Receiver Operating Characteristic (ROC) curves of the power of two methods to discriminate between delirium screening according to Korean Nu-DESC.


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Reference

1. Balas MC, Deutschman CS, Sullivan-Marx EM, Strumpf NE, Alston RP, Richmond TS. Delirium in older patients in surgical intensive care units. Journal of Nursing Scholarship. 2007. 39:147–154. http://dx.doi.org/10.1111/j.1547-5069.2007.00160.x.
2. Ely EW, Shintani A, Truman B, Speroff T, Gordon SM, Harrell FE jr, et al. Delirium as a predictor of mortality in mechanically ventilated patients in the intensive care unit. Journal of the American Medical Association. 2004. 291:1753–1762. http://dx.doi.org/10.1001/jama.291.14.1753.
3. Forsgren LM, Eriksson M. Delirium-awareness, observations in intensive care units: A national survey of Swedish ICU head nurses. Intensive and Critical Care Nursing. 2010. 26:296–303. http://dx.doi.org/10.1016/j.iccn.2010.07.003.
4. Gaudreau JD, Gagnon P, Harel F, Tremblay A, Roy MA. Fast, systematic, and continuous delirium assessment in hospitalized patients: The nursing delirium screening scale. Journal of Pain and Symptom Management. 2005. 29:368–375. http://dx.doi.org/10.1016/j.jpainsymman.2004.07.009.
5. Inouye SK. Predisposing and precipitating factors for delirium in hospitalized older patients. Dementia and Geriatric Cognitive Disorder. 1999. 10:393–400. http://dx.doi.org/10.1159/000017177.
6. Inouye SK, Foreman MD, Mion LC, Katz KH, Cooney LM Jr. Nurses' recognition of delirium and its symptoms: Comparison of nurse and researcher ratings. Archives of Internal Medicine. 2001. 161:2467–2473. http://dx.doi.org/10.1001/archinte.161.20.2467.
7. Kiely DK, Marcantonio ER, Inouye SK, Shaffer ML, Bergmann MA, Yang FM, et al. Persistent delirium predicts greater mortality. Journal of the American Geriatrics Society. 2009. 57:55–61. http://dx.doi.org/10.1111/j.1532-5415.2008.02092.x.
8. Kim AL. Delirium among elderly patients in the intensive care units. 2010. Seoul: Ewha Womans University;Unpublished master's thesis.
9. Kim KH, Kho DH, Shin JY, Choi JY, Kim ES, Kim DH. Risk factors of postoperative delirium in elderly patients with hip fractures. Journal of the Korean Fracture Society. 2008. 21:189–194.
10. Lemiengre J, Nelis T, Joosten E, Braes T, Foreman M, Gastmans C, et al. Detection of delirium by bedside nurses using the confusion assessment method. Journal of the American Geriatrics Society. 2006. 54:685–689. http://dx.doi.org/10.1111/j.1532-5415.2006.00667.x.
11. Leung JM, Leung VW, Leung CM, Pan PC. Clinical utility and validation of two instruments (the Confusion Assessment Method Algorithm and the Chinese version of Nursing Delirium Screening Scale) to detect delirium in geriatric inpatients. General Hospital Psychiatry. 2008. 30:171–176. http://dx.doi.org/10.1016/j.genhosppsych.2007.12.007.
12. McCusker J, Cole MG, Voyer P, Monette J, Champoux N, Ciampi A, et al. Use of nurse-observed symptoms of delirium in long-term care: Effects on prevalence and outcomes of delirium. International Psychogeriatrics. 2011. 23:602–608. http://dx.doi.org/10.1017/S1041610210001900.
13. Micek ST, Anand NJ, Laible BR, Shannon WD, Kollef MH. Delirium as detected by the CAM-ICU predicts restraint use among mechanically ventilated medical patients. Critical Care Medicine. 2005. 33:1260–1265. http://dx.doi.org/10.1097/01.CCM.0000 164540.58515.BF.
14. Milisen K, Steeman E, Foreman MD. Early detection and prevention of delirium in older patients with cancer. European Journal of Cancer Care. 2004. 13:494–500. http://dx.doi.org/10.1111/j.1365-2354.2004.00545.x.
15. Morandi A, Jackson JC, Ely EW. Delirium in the intensive care unit. International Review of Psychiatry. 2009. 21:43–58. http://dx.doi.org/10.1080/09540260802675296.
16. Ouimet S, Kavanagh BP, Gottfried SB, Skrobik Y. Incidence, risk factors and consequences of ICU delirium. Intensive Care Medicine. 2007. 33:66–73. http://dx.doi.org/10.1007/s00134-006-0399-8.
17. Peterson JF, Pun BT, Dittus RS, Thomason JW, Jackson JC, Shintani AK, et al. Delirium and its motoric subtypes: A study of 614 critically ill patients. Journal of the American Geriatrics Society. 2006. 54:479–484. http://dx.doi.org/10.1111/j.1532-5415.2005.00621.x.
18. Pisani MA, Murphy TE, Araujo KL, Slattum P, Van Ness PH, Inouye SK. Benzodiazepine and opioid use and the duration of intensive care unit delirium in an older population. Critical Care Medicine. 2009. 37:177–183. http://dx.doi.org/10.1097/CCM.0b013e318 192fcf9.
19. Pitkälä KH, Laurila JV, Strandberg TE, Tilvis RS. Multicomponent geriatric intervention for elderly inpatients with delirium: A randomized, controlled trial. The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences. 2006. 61:176–181.
20. Schreier AM. Nursing care, delirium, and pain management for the hospitalized older adult. Pain Management Nursing. 2010. 11:177–185. http://dx.doi.org/10.1016/j.pmn.2009.07.002.
21. Schuurmans MJ, Duursma SA, Shortridge-Baggett LM. Early recognition of delirium: Review of the literature. Journal of Clinical Nursing. 2001. 10:721–729. http://dx.doi.org/10.1111/j.1365-2702.2001.00548.x.
22. Souder E, O'Sullivan PS. Nursing documentation versus standardized assessment of cognitive status in hospitalized medical patients. Applied Nursing Research. 2000. 13:29–36. http://dx.doi.org/10.1016/S0897-1897(00)80016-6.
23. Steis MR, Fick DM. Are nurses recognizing delirium? A systematic review. Journal of Gerontological Nursing. 2008. 34:40–48.
24. Swets JA. Measuring the accuracy of diagnostic systems. Science. 1988. 240:1285–1293. http://dx.doi.org/10.1126/science.3287615.
25. Trzepacz PT, Mittal D, Torres R, Kanary K, Norton J, Jimerson N. Validation of the delirium rating scale-revised-98: Comparison with the delirium rating scale and the cognitive test for delirium. The Journal of Neuropsychiatry and Clinical Neurosciences. 2001. 13:229–242. http://dx.doi.org/10.1176/appi.neuropsych.13.2.229.
26. Voyer P, Richard S, Doucet L, Danjou C, Carmichael PH. Detection of delirium by nurses among long-term care residents with dementia. BMC Nursing. 2008. 7:4. http://dx.doi.org/10.1186/1472-6955-7-4.
27. Wei LA, Fearing MA, Sternberg EJ, Inouye SK. The confusion assessment method: A systematic review of current usage. Journal of the American Geriatrics Society. 2008. 56:823–830. http://dx.doi.org/10.1111/j.1532-5415.2008.01674.x.
28. Yang YH. Comprehension and knowledge about delirium in nurses working at long-term care hospitals or general hospitals. Journal of Korean Academic Society of Nursing Education. 2010. 16:312–320.
29. Yu KD, Lee TJ, Suh YW, Chung SH, Kim EY, Kim HY, et al. Delirium in acute elderly care unit: Prevalence, clinical characteristics, risk factors and prognostic significance. Journal of the Korean Geriatrics Society. 2005. 9:182–189.
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