TY - JOUR
T1 - Prospective validation of Sophia observation withdrawal symptoms
T2 - A paediatric delirium scale in critically ill children in Denmark
AU - Stenkjaer, Rikke Louise
AU - Egerod, Ingrid
AU - Moszkowicz, Mala
AU - Ista, Erwin
AU - Greisen, Gorm
AU - Weis, Janne
AU - Pagsberg, Anne Katrine
AU - Herling, Suzanne Forsyth
N1 - Copyright © 2023 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.
PY - 2024
Y1 - 2024
N2 - BACKGROUND: Paediatric delirium (PD) is increasingly recognised as a common disorder in critically ill children with a reported prevalence ranging from 9% to 66%. We validated the PD component of the Sophia Observation withdrawal Symptoms-Paediatric Delirium (SOS-PD) scale in a Danish setting to provide increased awareness and reliable identification of this critical condition, thereby paving the way for improved pathways to targeted delirium care.OBJECTIVE: The objectives of this study were to criterion validate the PD component of the SOS-PD screening tool by comparing blinded psychiatric and nurse assessments and to estimate the prevalence of delirium in critically ill children in a Danish context.METHODS: A prospective observational study was performed on critically ill children aged between 3 m and 18 y, admitted to an intensive care unit, with a hospital stay of 48 h or more. Assessments took place on a fixed weekday over an 18-month period. To test accuracy and criterion validity, bedside nurses' SOS-PD assessments were compared to the reference standard, a diagnostic assessment performed by a child psychiatrist according to the Diagnostic and Statistical Manual-V criteria by use of the Vanderbilt Assessment of Delirium in Infants and Children.RESULTS: We included 141 children in the study, 30 (21%) of whom were diagnosed with delirium by the child psychiatrist. The accuracy of the delirium diagnosis was 93.6% (95% confidence interval [CI]: 88.3-97.1) among the nurses' SOS-PD assessments compared to the reference standard. The SOS-PD demonstrated a high sensitivity of 83.3% (95% CI: 65.3-94.4) and a high specificity of 96.4% (95% CI: 91.0-99.0) with five false-negative and four false-positive cases.CONCLUSION: The PD component of the SOS-PD tool has good accuracy and validity for assessments performed by nurses compared to a child psychiatrist's diagnosis in critically ill children in a Danish setting. We recommend the use of the SOS-PD instrument in clinical practice.
AB - BACKGROUND: Paediatric delirium (PD) is increasingly recognised as a common disorder in critically ill children with a reported prevalence ranging from 9% to 66%. We validated the PD component of the Sophia Observation withdrawal Symptoms-Paediatric Delirium (SOS-PD) scale in a Danish setting to provide increased awareness and reliable identification of this critical condition, thereby paving the way for improved pathways to targeted delirium care.OBJECTIVE: The objectives of this study were to criterion validate the PD component of the SOS-PD screening tool by comparing blinded psychiatric and nurse assessments and to estimate the prevalence of delirium in critically ill children in a Danish context.METHODS: A prospective observational study was performed on critically ill children aged between 3 m and 18 y, admitted to an intensive care unit, with a hospital stay of 48 h or more. Assessments took place on a fixed weekday over an 18-month period. To test accuracy and criterion validity, bedside nurses' SOS-PD assessments were compared to the reference standard, a diagnostic assessment performed by a child psychiatrist according to the Diagnostic and Statistical Manual-V criteria by use of the Vanderbilt Assessment of Delirium in Infants and Children.RESULTS: We included 141 children in the study, 30 (21%) of whom were diagnosed with delirium by the child psychiatrist. The accuracy of the delirium diagnosis was 93.6% (95% confidence interval [CI]: 88.3-97.1) among the nurses' SOS-PD assessments compared to the reference standard. The SOS-PD demonstrated a high sensitivity of 83.3% (95% CI: 65.3-94.4) and a high specificity of 96.4% (95% CI: 91.0-99.0) with five false-negative and four false-positive cases.CONCLUSION: The PD component of the SOS-PD tool has good accuracy and validity for assessments performed by nurses compared to a child psychiatrist's diagnosis in critically ill children in a Danish setting. We recommend the use of the SOS-PD instrument in clinical practice.
KW - Assessment tool
KW - Delirium screening tool
KW - Nursing assessment
KW - Paediatric delirium
KW - Paediatric intensive care unit
KW - Prevalence
KW - Sophia observation withdrawal symptoms-paediatric Delirium
KW - Validation
KW - Intensive Care Units
KW - Reproducibility of Results
KW - Delirium/epidemiology
KW - Humans
KW - Child, Preschool
KW - Critical Illness
KW - Infant
KW - Substance Withdrawal Syndrome
KW - Sensitivity and Specificity
KW - Denmark
KW - Child
UR - http://www.scopus.com/inward/record.url?scp=85158067232&partnerID=8YFLogxK
U2 - 10.1016/j.aucc.2023.04.001
DO - 10.1016/j.aucc.2023.04.001
M3 - Journal article
C2 - 37164889
SN - 1036-7314
VL - 37
SP - 400
EP - 406
JO - Australian critical care : official journal of the Confederation of Australian Critical Care Nurses
JF - Australian critical care : official journal of the Confederation of Australian Critical Care Nurses
IS - 3
ER -