Sophia Observation withdrawal Symptoms-Paediatric Delirium scale: A tool for early screening of delirium in the PICU

Ista, Erwin; Beest, Harma te; Rosmalen, Joost van; Hoog, Matthijs de; Tibboel, Dick; Beusekom, Babette van; Dijk, Monique van

doi:10.1016/j.aucc.2017.07.006

Cited by 37 publications

(51 citation statements)

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“…The PD-scale consists of 17 items that represent symptoms of PD and an item that reflects the perspective of the child’s parents (“parents do not recognize their child’s behavior as normal”) (Fig. 1 ) [ 21 ]. Presence of a symptom is scored as “yes” if it was observed at any moment during the previous 4 h. If the items “hallucinations” or “parents do not recognize their child’s behavior” were positive, a score of 4 points was assigned.…”

Section: Methodsmentioning

confidence: 99%

“…The maximum sum score of the PD-scale is 17 points. In our pilot study, the sensitivity was 96.8% (95% CI, 80.4–99.5%) and the specificity was 92.0% (95% CI, 59.7–98.9%) for the cutoff point ≥4 [ 21 ]. The intraclass correlation coefficient (ICC) from 16 paired nurse-researcher observations was 0.90 (95% CI, 82.7–99.4) [ 21 ].…”

Section: Methodsmentioning

confidence: 99%

“…In our pilot study, the sensitivity was 96.8% (95% CI, 80.4–99.5%) and the specificity was 92.0% (95% CI, 59.7–98.9%) for the cutoff point ≥4 [ 21 ]. The intraclass correlation coefficient (ICC) from 16 paired nurse-researcher observations was 0.90 (95% CI, 82.7–99.4) [ 21 ]. Given the lack of data on false-negatives and the small sample size of the pilot study, the validity should be reproduced in a large multicenter study.…”

Section: Methodsmentioning

confidence: 99%

“…As IWS is a possible cause of delirium, symptoms of both conditions overlap [ 19 , 20 ]. From a pilot study we concluded that the SOS scale, extended with a pediatric delirium (PD) component (SOS-PD scale), had promising validity and reliability [ 21 ]. We aimed to determine the measurement properties of the PD part of the SOS-PD scale for use by nurses, in terms of construct validity, criterion validity, and interrater reliability.…”

Section: Introductionmentioning

confidence: 99%

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Validation of the SOS-PD scale for assessment of pediatric delirium: a multicenter study

et al. 2018

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BackgroundsReports of increasing incidence rates of delirium in critically ill children are reason for concern. We evaluated the measurement properties of the pediatric delirium component (PD-scale) of the Sophia Observation Withdrawal Symptoms scale Pediatric Delirium scale (SOS-PD scale).MethodsIn a multicenter prospective observational study in four Dutch pediatric ICUs (PICUs), patients aged ≥ 3 months and admitted for ≥ 48 h were assessed with the PD-scale thrice daily. Criterion validity was assessed: if the PD-scale score was ≥ 4, a child psychiatrist clinically assessed the presence or absence of PD according to the Diagnostic and statistical manual of mental disorders (DSM)-IV. In addition, the child psychiatrist assessed a randomly selected group to establish the false-negative rate. The construct validity was assessed by calculating the Pearson coefficient (rp) for correlation between the PD-scale and Cornell Assessment Pediatric Delirium (CAP-D) scores. Interrater reliability was determined by comparing paired nurse-researcher PD-scale assessments and calculating the intraclass correlation coefficient (ICC).ResultsFour hundred eighty-five patients with a median age of 27.0 months (IQR 8–102) were included, of whom 48 patients were diagnosed with delirium by the child psychiatrist. The PD-scale had overall sensitivity of 92.3% and specificity of 96.5% compared to the psychiatrist diagnosis for a cutoff score ≥4 points. The rp between the PD-scale and the CAP-D was 0.89 (CI 95%, 0.82–0.93; p < 0.001). The ICC of 75 paired nurse-researcher observations was 0.99 (95% CI, 0.98–0.99).ConclusionsThe PD-scale has good reliability and validity for early screening of PD in critically ill children. It can be validly and reliably used by nurses to this aim.Electronic supplementary materialThe online version of this article (10.1186/s13054-018-2238-z) contains supplementary material, which is available to authorized users.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Validation of the SOS-PD scale for assessment of pediatric delirium: a multicenter study

et al. 2018

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“…Some tools for the diagnosis of delirium in the pediatric ICU have been validated and described in the literature, including the Pediatric Anesthesia Emergence Delirium (PAED), ( 13 ) the Cornell Assessment of Pediatric Delirium (CAPD), ( 12 ) the Sophia Observation Withdrawal Symptoms-Pediatric Delirium Scale (SOS-PD), ( 14 ) the Pediatric Confusion Assessment Method for the Intensive Care Unit (pCAM-ICU), ( 7 ) and the PreSchool Confusion Assessment Method for the ICU (psCAM-ICU). ( 15 )…”

Section: Introductionmentioning

confidence: 99%

Translation and cross-cultural adaptation of the Pediatric Confusion Assessment Method for the Intensive Care Unit into Brazilian Portuguese for the detection of delirium in pediatric intensive care units

Molon¹,

Castro²,

Foronda³

et al. 2018

Revista Brasileira De Terapia Intensiva

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ObjectiveTo undertake the translation and cross-cultural adaption into Brazilian Portuguese of the Pediatric Confusion Assessment Method for the Intensive Care Unit for the detection of delirium in pediatric intensive care units, including the algorithm and instructions.MethodsA universalist approach for the translation and cross-cultural adaptation of health measurement instruments was used. A group of pediatric critical care specialists assessed conceptual and item equivalences. Semantic equivalence was evaluated by means of a translation from English to Portuguese by two independent translators; reconciliation into a single version; back-translation by a native English speaker; and consensus among six experts with respect to language and content understanding by means of Likert scale responses and the Content Validity Index. Finally, operational equivalence was assessed by applying a pre-test to 30 patients.ResultsThe back-translation was approved by the original authors. The medians of the expert consensus responses varied between good and excellent, except for the feature "acute onset" of the instructions. Items with a low Content Validity Index for the features "acute onset" and "disorganized thinking" were adapted. In the pre-test, the expression "signal with your head" was modified into "nod your head" for better understanding. No further adjustments were necessary, resulting in the final version for Brazilian Portuguese.ConclusionThe Brazilian version of the Pediatric Confusion Assessment Method for the Intensive Care Unit was generated in agreement with the international recommendations and can be used in Brazil for the diagnosis of delirium in critically ill children 5 years of age or above and with no developmental cognitive disabilities.

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State of the science in pediatric ICU delirium: An integrative review

Kalvas

Harrison

2020

Research in Nursing & Health

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Delirium is a complication of critical illness associated with poor outcomes. Although widely studied in adults, comparatively little is understood about delirium in pediatric intensive care units (ICUs). The purpose of this integrative review is to determine the extent and nature of current evidence, identify gaps in the literature, and outline future areas for investigation of pediatric ICU delirium. Eligible articles included research reports of delirium in pediatric ICU samples published in English since 2009. After an extensive literature search and consideration for inclusion/exclusion criteria, 22 articles were chosen for review. Delirium was highly prevalent in the ICU. Delirium episodes developed early in hospitalization, lasted several days, and consisted of hypoactive or mixed motor subtypes. Frequently identified independent risk factors included young age, developmental delay, mechanical ventilation, and benzodiazepine exposure. Pediatric delirium was independently associated with increased length of stay, costs, and mortality. The long‐term cognitive, psychological, and functional morbidities associated with pediatric delirium remain largely unknown. Few researchers have implemented interventions to prevent or manage delirium. There was little evidence for the efficacy or safety of pharmacological management. Multicomponent delirium bundles may significantly decrease delirium incidence. Key quality issues among studies included variation in delirium screening, low levels of evidence (i.e., observational studies), and limited ability to determine intervention efficacy in quasi‐experimental designs. Although the quantity and quality of pediatric delirium research has rapidly increased, further studies are needed to understand the long‐term effects of pediatric delirium and determine the efficacy and safety of interventions for prevention and management.

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Sophia Observation withdrawal Symptoms-Paediatric Delirium scale: A tool for early screening of delirium in the PICU

Cited by 37 publications

References 30 publications

Validation of the SOS-PD scale for assessment of pediatric delirium: a multicenter study

Validation of the SOS-PD scale for assessment of pediatric delirium: a multicenter study

Translation and cross-cultural adaptation of the Pediatric Confusion Assessment Method for the Intensive Care Unit into Brazilian Portuguese for the detection of delirium in pediatric intensive care units

State of the science in pediatric ICU delirium: An integrative review

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