title: Validity of the Delirium Observation Screening Scale in Identifying Delirium in Home Hospice Patients.
abstract: BACKGROUND
  Delirium is common in home hospice patients and conveys significant morbidity to both patients and caregivers. The Delirium Observation Screening Scale (DOS) was developed to improve delirium recognition but has yet to be validated in the home hospice setting.
  
  
  OBJECTIVE
  This pilot study aimed to explore the accuracy of the DOS for identifying delirium in home hospice patients.
  
  
  METHODS
  Prospective delirium evaluation using a convenience sample.
  
  
  METHODS
  Community hospice patients were approached for study inclusion.
  
  
  METHODS
  Participants were assessed using the Delirium Rating Scale-Revised-98 (DRS-R-98), with results being categorized as "delirium" or "no delirium." The Delirium Observation Screening Scale scores, completed by hospice nurses during weekly patient assessment visits, were compared to the DRS-R-98 results.
  
  
  RESULTS
  Within this population, 30/78 (38%) assessments were categorized as delirious. In the majority of assessments, 69/75 (92%), the DRS-R-98 and DOS provided congruent results. There were 5 false positives and 1 false negative, demonstrating the DOS to be a clinically useful tool with a sensitivity of 0.97 and specificity of 0.89.
  
  
  CONCLUSIONS
  The DOS appears to be an accurate way to screen for delirium in home hospice patients. Validation of the DOS may help to improve delirium recognition and treatment and has the potential to increase quality of life in this vulnerable population. This input will also be taken into consideration in the development of a systematic screening procedure for delirium diagnosis at our local hospice, which we hope will be generalizable to other hospice agencies.
authors.affiliation: 1 University of Iowa Carver College of Medicine, Iowa City, IA, USA.
authors.forename: Shea M
authors.initials: SM
authors.lastname: Jorgensen
authors.affiliation: 2 University of Iowa College of Public Health, Iowa City, IA, USA.
authors.forename: Ryan M
authors.initials: RM
authors.lastname: Carnahan
authors.affiliation: 3 Department of Family Medicine, University of Iowa Carver College of Medicine, Iowa City, IA, USA.
authors.forename: Michelle T
authors.initials: MT
authors.lastname: Weckmann
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003693:Delirium / Q000175:diagnosis*; D005260:Female; D017051:Hospice Care / Q000379:methods* / Q000592:standards; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests / Q000592:standards*; D010865:Pilot Projects; D011446:Prospective Studies; D011788:Quality of Life; D015203:Reproducibility of Results
keywords: delirium screening; home hospice