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. 2019 May 20;132(10):1154-1158.
doi: 10.1097/CM9.0000000000000168.

Translation and validation of the Tibetan confusion assessment method for the intensive care unit

Qu-Zhen Danzeng  1   2 , Na Cui  1   2 , Hao Wang  1 , Wen-Jun Pan  2 , Yun Long  1 , Yang-Zong Deji  2 , Cheng Ze  2 , Zeng Ren  3
Affiliations

Translation and validation of the Tibetan confusion assessment method for the intensive care unit

Qu-Zhen Danzeng et al. Chin Med J (Engl). .

Abstract

Background: At present, there is no available delirium translated assessment method for 3.3 million Tibetans. This study aimed to provide a method for delirium assessment for Tibetan patients speaking this language by validating a translation of the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU).

Methods: The study was conducted between July 2018 and November 2018. Patients were screened for delirium by a neurologist using the Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV). Patients were subsequently screened by two nurses using Tibetan translations of the CAM-ICU. With DSM-IV criterion as the reference standard, the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated to assess the validity of the CAM-ICU criterion. Interrater reliability was determined by comparing the CAM-ICU ratings of nurse 1 vs. nurse 2 using the κ coefficient.

Results: Ninety-six patients were assessed independently by two nurses and one neurologist. According to DSM-IV standard, 42 out of 96 (43.8%) patients developed delirium. The sensitivities of Tibetan CAM-ICU were 90.5% for nurse 1 and 92.9% for nurse 2, respectively. Their specificities were 85.2% and 90.7%, respectively. The PPV were 82.6% for nurse 1 and 88.6% for nurse 2. Their NPV were 92.0% and 94.2%, respectively. The Tibetan CAM-ICU was done with good interrater reliability between nurse 1 and nurse 2 (κ = 0.91, P < 0.001).

Conclusion: The Tibetan CAM-ICU shows good validity and might be incorporated into clinical practice in Tibetan Intensive Care Units. CLINICAL TRAIL REGISTRY:: www.chictr.org.cn (No. ChiCTR1800018231).

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Figures

Figure 1
Figure 1
Patient enrollment and flow. A total of 268 consecutive patients were admitted. One hundred and seventy-two patients were excluded from the study because preexisting psychosis or neurologic disease (n = 101); less than 24 h admission in ICU (n = 25); do not understand Tibetan (n = 43); younger than 18 years old (n = 3). Ninety-six patients who are evaluated by reference standard expert and two study nurses comprised the final study population.
See this image and copyright information in PMC

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