| Summary: | 碩士 === 國立臺灣大學 === 護理學研究所 === 99 === Background: The occurrence of ICU acute delirium can increase the length of hospital stay, the severity of illness and the medical costs. It has a great impact on physical and mental for children. However, the researches on the ICU delirium in children were insufficient and most of the rating scales were explored the adult and the elder patients; there was no rating useful to children.
Purposes: The purposes of this research are to develop the〝Pediatric Delirium Rating Scale〞and to evaluate its reliability and validity.
Methods: The research utilized a cross-sectional study design. This research is referring to Huang et al. (2009) (Delirium Rating Scale- Revised-98-C). The original delirium rating scale has been amended into “Pediatric Delirium Rating scale” to fit for clinical practice for nursing members to apply on pediatric patients. The data was collected from 24 patients aged among 7-18, who are receiving intensive care in a medical center in northern Taiwan. Repeated surveying has been applied during their stay in ICU, 37 person times all collected data was statistically analyzed with a SPSS 15.0 for windows software, and examined the reliability and validity of the scale, including content validity (CVI), criterion related validity, internal consistency and inter-rater reliability.
Results: This study was recruited 24 illness children, and collected 37 person-time data. These children were aged from 9 to 18 (mean=13.3, SD = 3.05). The intensive care unit stay was between 2 to 26 days (mean=9.83, SD = 6.33). There were 3 children (12.5%) had acute delirium during the admission in the intensive care unit. The content validity index (CVI) of this scale was 0.97; the criterion related validity was measured by the Diagnostic and Statistical Manual of Mental Disorders, fourth edition, (DSM-IV). It showed positive correlation between diagnosis of acute delirium and Pediatric Delirium Rating Scale as the result of Kendall''s tau_b (r＝0.46，P＜0.01). According to Kappa consistency coefficient to evaluate the rater consistency, it showed consistent between the raters of these two groups (κ = 0.79，P＜0.05). The Cronbach’s α was 0.94 also showed adequate internal consistency of this rating scale. The Intra-class correlation, ICC was 0.94.
Conclusion: Study findings suggest that the “Pediatric Delirium Rating Scale Revised-98-C” has good reliability and validity. Hence, the scale can provide a basis for further study about pediatric delirium. Future researches to recruit delirium children in the general wards and to have the longitudinal study design are suggested.
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