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Nam and Park: Development of Korean Intensive Care Delirium Screening Tool (KICDST)
Original Article

Journal of Korean Academy of Nursing 2016; 46(1): 149-158.

Published online: 29 February 2016

DOI: https://doi.org/10.4040/jkan.2016.46.1.149

Development of Korean Intensive Care Delirium Screening Tool (KICDST)

Ae-Ri-Na Nam1, Jee-Won Park2

1Department of Nursing, Ajou University Medical Center·Nursing Research Institute, Ajou University, Suwon, Korea.

2College of Nursing·Nursing Research Institute, Ajou University, Suwon, Korea.

Address reprint requests to: Nam, Ae-Ri-Na. Department of Nursing, Ajou Medical Center, 164 Worldcup-ro, Yeongtong-gu, Suwon 16499, Korea. Tel: +82-31-219-4436, Fax: +82-31-219-5520, rina@aumc.ac.kr

Received 8 August 2015       Revised 24 August 2015       Accepted 12 November 2015

© 2016 Korean Society of Nursing Science

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution NoDerivs License. (http://creativecommons.org/licenses/by-nd/4.0/) If the original work is properly cited and retained without any modification or reproduction, it can be used and re-distributed in any format and medium.

Abstract

Purpose

This study was done to develop of the Korean intensive care delirium screening tool (KICDST).

Methods

The KICDST was developed in 5 steps: Configuration of conceptual frame, development of preliminary tool, pilot study, reliability and validity test, development of final KICDST. Reliability tests were done using degree of agreement between evaluators and internal consistency. For validity tests, CVI (Content Validity Index), ROC (Receiver Operating Characteristics) analysis, known group technique and factor analysis were used.

Results

In the reliability test, the degree of agreement between evaluators showed .80~1.00 and the internal consistency was KR-20=.84. The CVI was .83~1.00. In ROC analysis, the AUC (Area Under the ROC Curve) was .98. Assessment score was 4 points. The values for sensitivity, specificity, correct classification rate, positive predictive value, and negative predictive value were found to be 95.0%, 93.7%, 94.4%, 95.0% and 93.7%, respectively. In the known group technique, the average delirium screening tool score of the non-delirium group was 1.25±0.99 while that of delirium group was 5.07±1.89 (t= - 16.33, p <.001). The factors were classified into 3 factors (cognitive change, symptom fluctuation, psychomotor retardation), which explained 67.4% of total variance.

Conclusion

Findings show that the KICDST has high sensitivity and specificity. Therefore, this screening tool is recommended for early identification of delirium in intensive care patients.

Keywords: Intensive Care, Delirium, Screening, Reliability, Validity

Figures and Tables

Table 1

General and Disease Related Characteristics of the Participants (N =180)

jkan-46-149-i001

APACHE II=Acute physiologic and chronic health evaluation; ICU=Intensive care unit; HTN=Hypertension; DM=Diabetes mellitus; CVA=Cerebrovascular accident.

Table 2

Sensitivity, Specificity, Correct Classification Rate, Predictability Value and Correlation of KICDST with CAM-ICU (N =180)

jkan-46-149-i002

KICDST=Korean Intensive Care Delirium Screening Tool; CAM-ICU=Confusion Assessment Method for the Intensive Care Unit.

Table 3

Comparison of Delirium Occurrence by KICDST Score (N =180)

jkan-46-149-i003

KICDST=Korean Intensive Care Delirium Screening Tool; CAM-ICU=Confusion Assessment Method for the Intensive Care Unit.

Table 4

Factor Analysis of KICDST

jkan-46-149-i004

Kaiser-Meyer-Olkin test=0.84; Bartlett's test of sphericity p <.001; KICDST=Korean Intensive Care Delirium Screening Tool.

Table 5

Items and Measuring Methods and Criteria of KICDST

jkan-46-149-i005

KICDST=Korean Intensive Care Delirium Screening Tool.

Notes

This manuscript is a revision of the first author's doctoral dissertation from Ajou University.

CONFLICTS OF INTEREST The authors declared no conflict of interest.

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