- 期刊
- OpenAccess
The Revised Hasegawa's Dementia Scale (HDS-R) as a Screening Tool for Delirium
以修訂版長谷川氏失智症量表篩檢譫妄症
摘要
目的：探討修訂版長谷川氏失智症量表（HDS-R, The Revised Hasegawa's Dementia Scale）作為照會精神科醫師於初次會診使用之譫妄篩檢工具之可行性。方法：以69位林口長庚醫院各科照會精神科之個案為對象。個案首先接受精神科照會住院醫師施測HDS-R及簡短智能測驗（Mini-Mental State Examination, MMSE），後由督導照會之精神科專科醫師會談並依照DSM-IV準則診斷。結果：HDS-R內部一致性佳（Cronbach's coefficient α=0.894),且與MMSE相關性高（r=0.972, p＜0.001)。譫妄病人之HDS-R分數介於0到23之間，平均5.8（S.D.=6.5）；非譫妄個案則介4到30之間，平均22.9（S.D.=7.5）（unequal variance t test, t=-9.659, d. f.=45.978, p＜0.001），接收操作特徵曲線（receiver-operating characteristic, ROC）下面積為0.946（95% confident interval 0.875-0.997）。HDS-R篩檢譫妄最佳切分點為16／17。結論：HDS-R可作為照會精神科醫師於初次會診時使用之譫妄篩檢工具。
並列摘要
Objectives: The objective of this study was to examine the feasibility of the Revised Hasegawa's Dementia Scale (HDS-R) in screening delirium for consultant psychiatrists at their first encounter with the patients in clinical medical/surgical settings. The authors also intended to present the sensitivity, specificity, and the cut-off scores of HDS-R scores in detecting delirium. Methods: We recruited 69 patients who have been referred to psychiatric consultation liaison (C-L) service at a medical center in northern Taiwan. HDS-R and Mini Mental State Examination (MMSE) were applied and the diagnoses were made according to DSM-IV criteria. Results: We found that Cronbach's coefficient α HDS-R was 0.894, showing significant correlation with MMSE (r = 0.972, p＜0.001). The HDS-R scores in the delirium group were ranged from 0 to 23, with an average of 5.8 (standard deviation = 6.5). The HDS-R scores in the non-delirium group were ranged from 4 to 30, with an average of 22.9 (S. D. = 7.5, unequal variance t test, t = -9.659, degree of freedom = 45.978, p＜0.001). Area under receiver operating characteristic (ROC) curve was 0.946 (95% confident interval 0.875-0.997). The best cut-off point of HDS-R score for screening delirium was 16/17. Conclusion: HDS-R may serve as a screening tool of delirium for consultant psychiatrists who encounter the patients for the first time in the clinical medical/surgical settings.