兒童譫妄量表臨床適用性之先驅性研究

黃瓊鶯

doi:10.6342/NTU.2011.01323

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兒童譫妄量表臨床適用性之先驅性研究

The clinical feasibility of Pediatric Delirium Rating Scale-R-98-C (PDRS-R-98-C): A Preliminary Study

黃瓊鶯 , Masters　　Advisor：高碧霞　　

繁體中文 DOI： 10.6342/NTU.2011.01323

兒童加護病房；加護病房症候群；急性譫妄；重症照護； pediatric intensive care unit（PICU）； ICU syndrome ； acute delirium ； critical care

Abstract │ Reference (56) │ Times Cited (1) │ Altmetrics

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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.

Reference ( 56 ) 〈TOP〉

伍雁、毛新春（1998）•學前兒童住院後的行為改變與母親焦慮程度之相關性探討•護理研究，6（3），231-245。
連結：
李季芳、陳文文、劉雪娥（1999）•加護病房症候群的預防及護理•護理雜誌，46（5），22-26。
連結：
李欣南、潘志泉（2003）•譫妄及其治療•台灣醫學雜誌，7（4），611- 617。
連結：
吳麗芬（1995）•護理人員對急性混亂的感知•護理研究，3（1），17-25。
連結：
張因祝、于善潔（1999）•照顧一位發生加護病房症候群患者的護理經驗•國防醫學，28（1），76-83。
連結：

Times Cited (1) 〈TOP〉

朱卉愉(2017)。探討外科加護病房環境改善於預防譫妄及睡眠品質之成效。中山醫學大學護理學系學位論文。2017。1-75。

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