بررسی اعتبار و پایایی نسخه‌ی فارسی ابزار غربالگری دلیریوم در تشخیص آن در واحدهای مراقبت ویژه

نوع مقاله : مقاله های پژوهشی

نویسندگان

1 دانشجوی کارشناسی ارشد، گروه پرستاری و مامایی، دانشکده‌ی پرستاری و مامایی، دانشگاه علوم پزشکی اراک، اراک، ایران

2 دانشیار، گروه پرستاری و مامایی، دانشکده‌ی پرستاری و مامایی، دانشگاه علوم پزشکی اراک، اراک، ایران

3 استادیار، مرکز تحقیقات سایکوسوماتیک و گروه روان‌پزشکی، دانشکده‌ی پزشکی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

4 دانشیار، مرکز تحقیقات سایکوسوماتیک و گروه روان‌پزشکی، دانشکده‌ی پزشکی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

5 گروه روان‌شناسی بالینی، دانشگاه علوم بهزیستی و توان‌بخشی، تهران، ایران

چکیده

مقدمه: دلیریوم، یک سندرم عصبی- روان‌پزشکی آسیب زننده است. پرسش‌نامه‌ی غربالگری دلیریوم در واحد‌های مراقبت ویژه، یک ابزار مناسب برای تشخیص این بیماری است. این ابزار، به فارسی ترجمه و اعتبارسنجی نشده بود. هدف از انجام این مطالعه، بررسی اعتبار و پایایی نسخه‌ی فارسی ابزار در تشخیص دلیریوم در واحدهای مراقبت ویژه بود.روش‌ها: این مطالعه، از نوع ارزیابی اعتبار و پایایی نسخه‌ی فارسی ابزار بود. نمونه‌ی مورد مطالعه، بیماران بستری در واحدهای مراقبت ویژه ‌در بیمارستان الزهرای (س) اصفهان و کارشناسان پرستاری در سال‌های 94-1393 بودند. در هر مورد، به فاصله‌ی 30 دقیقه از تشخیص‌گذاری توسط روان‌پزشک بر اساس معیارهای Diagnostic and Statistical Manual of Mental Disorders-Forth Version-Text Revision (DSM-IV-TR)، ارزیابی با استفاده از ابزار توسط پرستار صورت می‌گرفت؛ بدون این که از تشخیص مطرح شده توسط روان‌پزشک اطلاع داشته باشد. در نهایت، موارد تشخیص دلیریوم بر اساس نمره‌ی ابزار با تشخیص دلیریوم توسط روان‌پزشک به عنوان مبنا، مقایسه و ویژگی‌های روان‌سنجی ابزار محاسبه شد.یافته‌ها: پس از ترجمه، روایی صوری ابزار تأیید شد. متوسط شاخص اعتبار محتوای ابزار در مربوط بودن 83/0، در واضح بودن 81/0 و در روان بودن 86/0 بود. برای روایی سازه بر اساس تحلیل عاملی، بار عاملی همه‌ی گویه‌ها بالاتر از 5/0 بود. در روایی ملاکی، نقطه‌ی برش نسخه‌ی فارسی ابزار، معادل نمره‌ی 5 بود و در این نقطه‌ی برش، حساسیت ابزار 80 درصد و ویژگی آن 93 درصد بود. ارزش اخباری مثبت و ارزش اخباری منفی در این نقطه‌ی برش، به ترتیب 92 درصد و 88 درصد بود. همبستگی در تشخیص دلیریوم بین دو روش 740/0 (001/0 = P) بود. پایایی ابزار با ﺿﺮﻳﺐ Cronbach's alpha 83/0 و با روش ﺩﻭ ﻧﻴﻤﻪ ﮐﺮﺩﻥ 72/0 بود.نتیجه‌گیری: نسخه‌ی فارسی ابزار غربالگری دلیریوم واحد مراقبت ویژه، از روایی و پایایی بالایی برای تشخیص اختلال دلیریوم برخوردار است. این ابزار، در نقطه‌ی برش 5، با ارزش اخباری مثبت و منفی بالایی موارد مبتلا به اختلال دلیریوم را از افراد سالم تمیز می‌دهد.

کلیدواژه‌ها

عنوان مقاله [English]

Reliability and Validity of the Persian Version of Intensive Care Delirium Screening Checklist in detection of delirium in Intensive Care Units

نویسندگان [English]

  • Mahdieh Torshizi 1
  • Davood Hekmatpou 2
  • Mohammad Reza Sharbafchi 3
  • Hamid Afshar 4
  • Mohammad Mehdi Ayati 5
1 MSc Student, Department of Nursing and Midwifery, School of Nursing and Midwifery, Arak University of Medical Sciences, Arak, Iran
2 Associate Professor, Department of Nursing and Midwifery, School of Nursing and Midwifery, Arak University of Medical Sciences, Arak, Iran
3 Assistant Professor, Psychosomatic Research Center AND Department of Psychiatry, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
4 Associate Professor, Psychosomatic Research Center AND Department of Psychiatry, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
5 Department of Clinical Psychology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
چکیده [English]

Background: Delirium is a dangerous neuro-psychiatric syndrome. Intensive Care Delirium Screening Checklist (ICDSC) is a suitable tool for diagnosis of this disease. This tool has not been translated and validated into Persian language until now. The goal of this study was to determine the reliability and validity of Persian version of this tool in detection of delirium in intensive care units (ICU).Methods: This study is a psychometric study of the Persian version. All samples were selected from hospitalized patients in ICU and nurses in Al-Zahra hospital, Isfahan, Iran, in 2015. In each case, after 30 minutes of making diagnoses based on Diagnostic and Statistical Manual of Mental Disorders-Forth Version-Text Revision (DSM-IV-TR) criteria by a psychiatrist, a nurse makes her diagnoses by using ICDSC without knowing the psychiatrist’ idea. Then all cases of delirium diagnosis according to the tool were compared with delirium diagnosis by psychiatrist and psychometric properties of tool were assessed.Findings: After doing forward and backward translation, the face validity was confirmed. The mean of content validity index (CVI) in relevancy, clarity and simplicity were 0.83, 0.81, and 0.86 respectively. The construct validity based on factor analysis outputs were above 0.5 for all items. In criterion validity measurement, the cut point of five for Persian version of ICDSC is founded. In this cut point the sensitivity and specificity of the tool was calculated 80% and 93%, respectively. The positive predictive value and negative predictive value in this cut off was calculated 92% and 88%, respectively. The correlation between an equivalent criteria with this tool for delirium screening was 0.74 (P = 0.001). Internal Consistency for the tool based on Cronbach’s alpha was 0.83 and the correlation between two split half of the tool for delirium screening was 0.72.Conclusion: The Persian version of ICDSC has a high validity and reliability for delirium screening. This tool in cut point of five can differentiate delirium from normal case with high positive and negative predictive value.

کلیدواژه‌ها [English]

  • Delirium
  • Screening
  • Nurse
  • Intensive Care Unit

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مجله دانشکده پزشکی اصفهان
دوره 34، شماره 383 - شماره پیاپی 383
مرداد و شهریور 1395
صفحه 536-546

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سابقه مقاله

  • تاریخ دریافت: 04 مهر 1394
  • تاریخ بازنگری: 05 اردیبهشت 1403
  • تاریخ پذیرش: 17 فروردین 1401

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