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    ΕΠΙΛΕΓΜΕΝΕΣ ΔΉΜΟΣΙΕΥΣΕΙΣ
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         TRANSLATION AND CULTURAL ADAPTATION OF THE GREEK VERSION OF THE CONFUSION ASSESSMENT METHOD DIAGNOSTIC ALGORITHM AND THE NURSING DELIRIUM SCREENING SCALE AND THEIR INTER-RATER RELIABILITY: A PROSPECTIVE COHORT STUDY
Ntalouka MP1, Bareka M1, Brotis AG2, Chalkias A1, Stamoulis K1, Flossos A1, Tzimas P3, Arnaoutoglou E1 1 Department of Anesthesiology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa
2 Department of Neurosurgery, University Hospital of Larissa Thessaly
3 Department of Anesthesiology and Postoperative Intensive Care, Faculty of Medicine, School of Health Sciences, University of Ioannina, Epirus Greece
   Abstract Aim: The lack of standardized tools limits the diagnosis οf postoperative delirium (POD) in the Greek population. Our aim was the translation and the cultural adaptation of the confusion assessment method (CAM) diagnostic algorithm and the nursing delirium screening scale (nu-DESC) in the Greek surgical population, and the determination of their inter-rater reliability.
Methods: After Ethical approval and registration as a clinical trial (NCT04154176), a prospective cohort study was conducted in the Department of Anesthesiology, University Hospital of Larissa, Greece. Patients at least 60 years old, undergoing elective non-cardiac surgery, under general anesthesia were included.
Results: Data from 60 patients, 180 records in total, were analyzed. There was an “almost perfect agreement” between the raters with the use of CAM (Cohen’s Kappa estimate: 0.960; 95 % CI: 0.905-1.000) and nu-DESC (Cohen’s Kappa estimate: 0.981; 95 % CI: 0.944-1.000). The agreement on each specific question of CAM and nu-DESC ranged from “substantial” to “almost perfect agreement”. Based on the CAM, the sensitivity and specificity of nu-DESC were 0.97 (95 % CI: 0.82-1.00) and 0.99 (95 % CI: 0.96-1.00), respectively. The Greek versions of CAM and nu-DESC showed a high inter-rater agreement.
Conclusion: With the translation, the cultural adaptation, and the determination of their inter-rater agreement, the CAM diagnostic algorithm and the nu-DESC may serve as reliable instruments for the detection of POD in the Greek population. HIPPOKRATIA 2020, 24(1): 8-14.
Keywords: Delirium, diagnosis, neuropsychological tests, confusion assessment method, nursing delirium screening scale, anesthesia, general, reproducibility of results, humans, Greece
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