Cent Eur J Nurs Midw 2021, 12(3):394-404 | DOI: 10.15452/cejnm.2021.12.0011

The validation of the Czech version of the Delirium Observation Scale and the Nursing Delirium Screening Scale for delirium screening in patients with locomotive apparatus trauma

Blažena Ševčíková1, Hana Matějovská Kubešová2, Lenka Šáteková3, Elena Gurková3
1 Department of Nursing, Faculty of Medicine, University of Ostrava, Czech Republic (student)
2 Department of Nursing, Faculty of Medicine, University of Ostrava, Czech Republic
3 Department of Nursing, Faculty of Health Sciences, Palacký University in Olomouc, Czech Republic

Aim: To validate the Czech version of the Delirium Observation Scale and the Nursing Delirium Screening Scale as screening instruments for detecting of delirium in a traumatology department.

Design: A prospective cohort study.

Methods: The study included 400 patients hospitalized in the traumatology department, University Hospital, Olomouc. The receiver operating characteristics analysis, sensitivity and specificity values and positive and negative predictive values for the screening delirium symptoms were calculated.

Results: The average duration of delirium was 2.78 days. The Delirium Observation Scale (DOS) screening instrument produced the best predictive validity values (sensitivity 97.6%, specificity 96.2%), followed by the Nursing Delirium Screening Scale (Nu-DESC) (sensitivity 92.7%, specificity 96.5%). Both screening instruments have comparable psychometric properties as well as features in the area of the already mentioned feasibility. The largest differences between the psychometric features of the screening instruments were detected in the Nu-DESC instrument in the area of sensitivity.

Conclusion: The benefit of the research lies in obtaining the predictive validity values for the DOS and Nu-DESC screening instruments in patients with locomotive apparatus trauma, having had surgical or conservative treatment. Our results may support a systematic and evidence-based implementation of the screening instruments for detecting of delirium in a clinical setting.

Keywords: delirium, Delirium Observation Scale, nurse, Nursing Delirium Screening Scale, predictive validity, traumatology

Received: November 2, 2020; Revised: December 31, 2020; Accepted: March 3, 2021; Prepublished online: June 24, 2021; Published: September 7, 2021  Show citation

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Ševčíková B, Matějovská Kubešová H, Šáteková L, Gurková E. The validation of the Czech version of the Delirium Observation Scale and the Nursing Delirium Screening Scale for delirium screening in patients with locomotive apparatus trauma. Central European Journal of Nursing and Midwifery. 2021;12(3):394-404. doi: 10.15452/cejnm.2021.12.0011.
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    References

    1. Adamis, D., Sharma, N., Whelan, P. J. P., & Macdonald, A. J. D. (2010). Delirium scales: a review of current evidence. Aging & Mental Health, 14(5), 543-555. https://doi.org/10.1080/13607860903421011 Go to original source... Go to PubMed...
    2. Ambler, Z. (2009). Neurologické poruchy a základní principy farmakoterapie staršího věku [Neurological disorders and basic principles of pharmacotherapy of older age]. Interní medicína pro praxi, 11(4), 182-185.
    3. Diagnostic and statistical manual of mental disorders DSM-5tm. (2013, 5th ed.). American Psychiatric Publishing.
    4. Agar, M., Draper, B., Phillips, P. A., Phillips, J., Collier, A., Harlum, J., & Currow, D. (2012). Making decisions about delirium: a qualitative comparison of decision making between nurses working in palliative care, aged care, aged care psychiatry, and oncology. Palliative Medicine, 26(7), 887-896. https://doi.org/10.1177/0269216311419884 Go to original source... Go to PubMed...
    5. Bellelli, B., Morandi, A., Davis, D. H. J., Mazzala, P., Turco, R., Gentile, S., Ryan, T., Cash, H., Guerini, F., Torpilliesi, T., Del Santo, F., Trabucchi, M., Annoni, G., & Maclullich, A. M. J. (2014). Validation of the 4AT, a new instrument for rapid delirium screening: a study in 234 hospitalised older people. Age and Ageing, 43(4), 496-502. https://doi.org/10.1093/ageing/afu021 Go to original source... Go to PubMed...
    6. Balková, M., & Tomagová, M. (2018). Use of measurement tools for screening of postoperative delirium in nursing practice. Central European Journal of Nursing and Midwifery, 9(3), 897-904. https://doi.org/10.15452/CEJNM.2018.09.0021 Go to original source...
    7. Bucerius, J., Gummert, J. F., Borger, M. A., Walther, T., Doll, N., Falk, V., Schmitt, D. V., & Mohr, F. V. (2004). Predictors of delirium after cardiac surgery delirium: effect of beating-heart (off-pump) surgery. Cardiopulmonary Support and Physiology, 127(1), 57-64. https://doi.org/10.1016/s0022-5223(03)01281-9 Go to original source... Go to PubMed...
    8. De, J., Wand, A. P. F., Smerdely, P. I., & Hunt, G. E. (2017). Validating the 4Aʼs test in screening for delirium in a culturally diverse geriatric inpatient population. International Journal of Geriatric Psychiatry, 32(12), 1322-1329. https://doi.org/10.1002/gps.4615 Go to original source... Go to PubMed...
    9. Detroyer, E., Clement, P. M., Baeten, N., Pennemans, M., Decruyenaere, M., Vandenberghe, J., Menten, J., Joosten, E., & Milisen, K. (2014). Detection of delirium in palliative care unit patients: a prospective descriptive study of the Delirium Observation Screening Scale administered by bedside nurses. Palliative Medicine, 28(1), 79-86. https://doi.org/10.1177/0269216313492187 Go to original source... Go to PubMed...
    10. Eeles, E. M. P., Hubbard, R. E., White, S. V., OʼMahony, M. S., Savva, G. M., & Bayer, A. M. (2010). Hospital use, institutionalisation and mortality associated with delirium. Age and Ageing, 39(4), 470-475. https://doi.org/10.1093/ageing/afq052 Go to original source... Go to PubMed...
    11. Folstein M. F, Folstein S. E., & McHugh, P. R. (1975). Mini-mental state. A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12(3), 189-198. https://doi.org/10.1016/0022-3956(75)90026-6 Go to original source... Go to PubMed...
    12. Franco, K., Litaker, D., Locala, J., & Bronson, D. (2001). The cost of delirium in the surgical patient. Psychosomatics, 42(1), 68-73. https://doi.org/10.1176/appi.psy.42.1.68 Go to original source... Go to PubMed...
    13. Gaudreau, J. D., Gagnon, P., Harel, F., Tremblay, A., & Roy, M. A. (2005). Fast, systematic, and continuous delirium assessment in hospitalized patients: the Nursing Delirium Screening Scale. Journal of Pain and Symptom Management, 29(4), 368-375. https://doi.org/10.1016/j.jpainsymman.2004.07.009 Go to original source... Go to PubMed...
    14. Gavinski, K., Carnahan, R., & Weckmann, M. (2016). Validation of the delirium observation screening scale in a hospitalized older population. Journal of Hospital Medicine, 11(7), 494-497. https://doi.org/10.1002/jhm.2580 Go to original source... Go to PubMed...
    15. Godfrey M., Smith, J., Green, J., Cheater, F., Inouye, S. K., & Young, J. B. (2013). Developing and implementing an integrated delirium prevention system of care: a theory driven, participatory research study. BMS Health Services Research, 13, 341. https://doi.org/10.1186/1472-6963-13-341 Go to original source... Go to PubMed...
    16. Grover, S., & Kate, N. (2012). Assessment scale for delirium: a review. World Journal of Psychiatry, 2(4), 58-70. https://doi.org/10.5498/wjp.v2.i4.58 Go to original source... Go to PubMed...
    17. Inouye, S. K. (2006). Delirium in older persons. New England Journal of Medicine, 354(12), 1157-1165. https://doi.org/10.1056/NEJMra052321 Go to original source... Go to PubMed...
    18. Inouye, S. K., Van Dyck, C. H., Alessi C. A., Balkin, S., Siegal, A. P., & Horvitz, R. I. (1990). Clarifying confusion: the Confusion Assessment Method. A new method for detection of delirium. Annals of Internal Medicine, 113(12), 941-948. https://doi.org/10.7326/0003-4819-113-12-941 Go to original source... Go to PubMed...
    19. Jorgensen, M. S., Carnahan, R. M., & Weckmann, T. M. (2017). Validity of the Delirium Observation Screening Scale in identifying delirium in home hospice patients. American Journals of Hospice and Palliative Medicine, 34(8), 744-747. Go to original source... Go to PubMed...
    20. Koster, S., Hensens, A. G., Oosterveld, F. G., Wijma, A., & Van Der Palen, J. (2009) The delirium observation screening scale recognizes delirium early after cardiac surgery. European Journal of Cardiovascular Nursing, 8(4), 309-314. https://doi.org/10.1016/j.ejcnurse.2009.02.006 Go to original source... Go to PubMed...
    21. Lingehall, H. C., Smutler, N., Engström, K. G., Gustavson, Y., & Olofsson, B. (2013). Validation of the Swedish version of the Nursing Delirium Screening Scale used in patients 70 years and older undergoing cardiac surgery. Journal of Clinical Nursing, 22(19-20), 2858-2866. https://doi.org/10.1111/j.1365-2702.2012.04102.x Go to original source... Go to PubMed...
    22. Luetz, A., Heymann, A., Radtke, F. M., Chenitir, C., Neuhaus, U., Nachtigall, I., von Dossow, W., Marz, S., Eggers, V., Heinz, A., Wernecke, K. D., & Spies, C. D. (2010). Different assessment tools for intensive care unit delirium: Which score to use? Critical Care Medicine, 38(2), 409-418. https://doi.org/10.1097/CCM.0b013e3181cabb42 Go to original source... Go to PubMed...
    23. Numan, T., van den Boogaard, M., Kamper, A. M., Rood, P. J. T., Peelen, L. M., & Slooter, A. J. C. (2017). Recognition of delirium in postoperative elderly patients: a multicenter study. Journal of the American Geriatrics Society, 65(9), 1932-1938. https://doi.org/10.1111/jgs.14933 Go to original source... Go to PubMed...
    24. Pandharipande, P., Cotton, B. A., Shintani, A., Thompson, J., Pun, B. T., Morris, J. A. Jr., Dittus, R., & Ely, E. W. (2008). Prevalence and risk factors for development of delirium in surgical and trauma intensive care unit patients. Journal of Trauma and Acute Care Surgery, 65(1), 34-41. https://doi.org/10.1097/TA.0b013e31814b2c4d Go to original source... Go to PubMed...
    25. Poikajärvi, S., Salantera, S., Katajisto, J., & Junttila, K. (2017). Validation of Finnish Neecham Confusion Scale and Nursing Delirium Screening Scale using Confusion Assessment Method algorithm as a comparison scale. BMC Nursing, 16, 7. https://doi.org/10.1186/s12912-016-0199-6 Go to original source... Go to PubMed...
    26. Radtke, M. F., Franck, M., Schust, S., Boehme, L., Pascher, A., Bail, H. J., Seeling, M., Luetz, A., Wernecke, K. D., Heinz, A., & Spies, C. D. (2010). A comparison of three scores to screen for delirium on the surgical ward. World Journal of Surgery, 34(3), 487-494. https://doi.org/10.1007/s00268-009-0376-9 Go to original source... Go to PubMed...
    27. Schubert, M., Schürch, R., Boettger S., Garcia Nuñez, D., Schwarz, U., Bettex, D., Jenewein, J., Bogdanovic, J., Staehli, M. L., Spirig, R., & Rudiger, A. (2018). A hospital-wide evaluation of delirium prevalence and outcomes in acute care patients - a cohort study. BMC Health Services Research, 18, 550. https://doi.org/10.1186/s12913-018-3345-x Go to original source... Go to PubMed...
    28. Schuurmans, M. J., Shortridge-Baggett, L. M., & Duursma, S. A. (2003). The Delirium Observation Screening Scale: a screening instrument for delirium. Research and Theory for Nursing Practice, 17(1), 31-50. https://doi.org/10.1891/rtnp.17.1.31.53169 Go to original source... Go to PubMed...
    29. Van de Steeg, L., Ijkema, R., Langelaan, M., & Wagner C. (2014). Can an e-learning course improve nursing care for older people at risk of delirium: a stepped wedge cluster randomised trial. BMC Geriatrics, 14, 69. https://doi.org/10.1186/1471-2318-14-69 Go to original source... Go to PubMed...
    30. Van Velthuijsen, E. L., Zwakhalen, S. M. G., Warnier, R. M., Mulder, W. J., Verhey, F. R., & Kempen, G. I. (2016). Psychometric properties and feasibility of instruments for the detection of delirium in older hospitalized patients: a systematic review. International Journal of Geriatric Psychiatry, 31(9), 974-989. https://doi.org/10.1002/gps.4441 Go to original source... Go to PubMed...
    31. Williams, J. B. W. (1988). A structured interview guide for the Hamilton Depression Rating Scale. Archives of General Psychiatry, 45(8), 742-747. https://doi.org/10.1001/archpsyc.1988.01800320058007 Go to original source... Go to PubMed...
    32. Wong, C. L., Holroyd-Leduc, J., Simel, D. L., & Straus, S. E. (2010). Does this patient have delirium? Value of bedside instruments. JAMA, 304(7), 779-786. https://doi.org/10.1001/jama.2010.1182 Go to original source... Go to PubMed...

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