[Interrater reliability and concurrent validity of 4AT for the detection of postoperative delirium: A prospective cohort study].

IF 0.8 4区医学 Q4 NURSING Pflege Pub Date : 2023-08-01 DOI:10.1024/1012-5302/a000939

Chiara Muzzana, Franco Mantovan, Waltraud Tappeiner, Sarah Niederbacher, Markus Karl Huber, Dietmar Ausserhofer

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Abstract

Interrater reliability and concurrent validity of 4AT for the detection of postoperative delirium: A prospective cohort study Abstract. Background: Numerous tools for detecting postoperative delirium are available. Guidelines recommend the 4 A's Test (4AT). However, there is little evidence on the validity and reliability of the German version of 4AT. Aim: To assess the interrater reliability of the German version of 4AT test for the detection of postoperative delirium in general surgical and orthopedic-traumatological patients, and the concurrent validity with the Delirium Observation Screening Scale (DOS). Methods: The present work is part of a prospective cohort study with a sample of 202 inpatients (≥ 65 years) who underwent surgery. The interrater reliability of the 4AT (intraclass coefficients) was determined with a subsample of 33 subjects who were rated by two nurses. Concurrent validity between the DOS scale and the 4AT was calculated using Pearson's correlation coefficient. Results: Interrater reliability for the 4AT total score and dichotomized total score were 0.92 (95% CI 0.84-0.96) and 0.98 (95% CI 0.95-0.98), respectively. The correlation between DOS and 4AT (Pearson) was 0.54 (p < 0.001). Conclusions: The 4A test can be used by nurses as a screening instrument for the detection of postoperative delirium in older patients on general surgery and orthopedic traumatology wards. In case of positive 4AT results further assessment by nurse experts or physicians is required.

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[4AT检测术后谵妄的信度和并发效度:一项前瞻性队列研究]。

4AT检测术后谵妄的互信度和并发效度:一项前瞻性队列研究背景:有许多检测术后谵妄的工具。指南推荐4a测试(4AT)。然而，在德国版4AT的有效性和可靠性上几乎没有证据。目的:评价德版4AT测验在普外科和骨科创伤患者术后谵妄诊断中的交叉信度，以及与谵妄观察筛查量表(DOS)的并发效度。方法:本研究是一项前瞻性队列研究的一部分，样本为202例接受手术的住院患者(≥65岁)。用由两名护士评定的33名受试者的子样本来确定4AT(类内系数)的互译信度。采用Pearson相关系数计算DOS量表与4AT量表的并发效度。结果:4AT总分和二分总分的判读信度分别为0.92 (95% CI 0.84-0.96)和0.98 (95% CI 0.95-0.98)。DOS与4AT的相关性(Pearson)为0.54 (p < 0.001)。结论:4A试验可作为普通外科及骨科创伤病房老年患者术后谵妄的筛查工具。如果4AT结果呈阳性，则需要护士专家或医生进一步评估。

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来源期刊

Pflege NURSING-

CiteScore

1.40

自引率

20.00%

发文量

审稿时长

>12 weeks

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