title: Delirium assessment using Confusion Assessment Method for the Intensive Care Unit in Chinese critically ill patients.
abstract: OBJECTIVE
  The aim of this study was to provide a method for delirium evaluation in simplified Chinese for patients speaking this language via validation of a translation of the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU).
  
  
  METHODS
  Two phases were conducted including initial reliability testing (phase I) of the Attention Screening Exam (ASE) followed by reliability and validity testing of the CAM-ICU (phase II). To analyze the reliability of the ASE, each patient was assessed sequentially by ASE Visual and ASE Auditory. The patients were assessed by 2 nurse investigators using CAM-ICU and 1 neurologist using Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition separately within 2 hours in the second phase.
  
  
  RESULTS
  We found that the agreement between ASE Visual and ASE Auditory was high (κ = 0.83, P < .01, respectively). The educational level of the patients influenced the results of the inattention assessment, with the lower educational level of the patient yielding lower agreement on ASE. Even still, the κ consistencies were all above 0.61. The sensitivities of CAM-ICU were 91.8% and 93.4%, and the specificities were 90.8%and 87.7%, respectively. The interrater reliability of 2 nurse investigators was very high, with κ coefficient of 0.92 (P < .001).
  
  
  CONCLUSIONS
  This study affirmed the validity and reliability against reference raters using the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition of a brief nursing-conducted method of diagnosing delirium in ICU patients who speak simplified Chinese using the CAM-ICU.
authors.affiliation: School of Nursing, Capital Medical University, Feng-tai, Beijing, PR China. chuliwang2008@163.com
authors.forename: Chunli
authors.initials: C
authors.lastname: Wang
authors.forename: Ying
authors.initials: Y
authors.lastname: Wu
authors.forename: Peng
authors.initials: P
authors.lastname: Yue
authors.forename: E Wesley
authors.initials: EW
authors.lastname: Ely
authors.forename: Jie
authors.initials: J
authors.lastname: Huang
authors.forename: Xin
authors.initials: X
authors.lastname: Yang
authors.forename: Yisi
authors.initials: Y
authors.lastname: Liu
mesh_terms: D018806:APACHE; D000203:Activities of Daily Living; D000368:Aged; D016009:Chi-Square Distribution; D002681:China; D003221:Confusion / Q000175:diagnosis*; D016638:Critical Illness; D003693:Delirium / Q000175:diagnosis*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014177:Translations