title: Appropriateness and reliability testing of the modified Richmond Agitation-Sedation Scale in Spanish patients with advanced cancer.
abstract: BACKGROUND
  A tool to quantify agitation severity and sedation level in patients with advanced cancer is needed.
  
  
  OBJECTIVE
  To test the appropriateness and reliability of the Richmond Agitation-Sedation Scale (RASS) in Spanish patients with advanced cancer.
  
  
  METHODS
  The original RASS was translated into Spanish according to the standard guidelines. Face validity was assessed by members of the palliative care team, and interrater reliability was assessed, using a weighted kappa, from observations of patients admitted to the palliative care unit. The association between scores of the RASS, Ramsay Sedation Scale, and Glasgow Coma Scale was evaluated using Spearman's ρ.
  
  
  RESULTS
  Three hundred twenty-two observations were performed in 156 patients: 116 observations were performed for delirious patients, 76 observations for sedated patients, and 130 observations for patients admitted for other symptom control. The weighted kappa values were practically equal to or greater than 0.90 between nurses and nurses and physicians. The agreement level between observers for each RASS score was roughly 90%. The correlation between the RASS and the Ramsay and Glasgow Scale values was analyzed for 196 observations recorded in 80 patients. The sedation scale of the RASS had a strong correlation with both the Ramsay (Spearman's ρ, -0.89; P < 0.001) and the Glasgow Coma Scales (Spearman's ρ, 0.85; P < 0.001).
  
  
  CONCLUSIONS
  These data support the use of the RASS in Spanish patients with advanced cancer.
authors.affiliation: The Palliative Care Unit, NS Candelaria University Hospital, Tenerife, Spain. mabenros@gmail.com
authors.forename: Miguel Angel
authors.initials: MA
authors.lastname: Benítez-Rosario
authors.forename: Manuel
authors.initials: M
authors.lastname: Castillo-Padrós
authors.forename: Belen
authors.initials: B
authors.lastname: Garrido-Bernet
authors.forename: Toribio
authors.initials: T
authors.lastname: González-Guillermo
authors.forename: Luis Pedro
authors.initials: LP
authors.lastname: Martínez-Castillo
authors.forename: Aceysele
authors.initials: A
authors.lastname: González
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003693:Delirium / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology; D015995:Prevalence; D015203:Reproducibility of Results; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D013030:Spain / Q000453:epidemiology; D011795:Surveys and Questionnaires; D063189:Symptom Assessment / Q000379:methods* / Q000706:statistics & numerical data; D014175:Translating; D016896:Treatment Outcome; D014481:United States