Validity and Reliability of the Memorial Delirium Assessment Scale-Thai Version (MDAS-T) for Assessment of Delirium in Palliative Care Patients

The oncologist

article

Watanachai Klankluang¹  Panate Pukrittayakamee²  Wanlop Atsariyasing²  Arunotai Siriussawakul³  Pratamaporn Chanthong¹  Sasima Tongsai⁵  Supakarn Tayjasanant¹ 

[1] Siriraj Palliative Care Center, Mahidol University;Department Psychiatry, Mahidol University;Department Anesthesiology, Mahidol University;Department Integrated Perioperative Geriatric Excellent Research Center, Mahidol University;Department Office for Research and Development, Faculty of Medicine, Siriraj Hospital, Mahidol University

关键词: Delirium;    MDAS;    Palliative care;    Validity and reliability;    Screening;    Sensitivity and specificity;   

DOI  :  10.1634/theoncologist.2019-0399

学科分类：地质学

来源: AlphaMed Press Incorporated

【 摘 要 】

Background Delirium, a neuropsychiatric syndrome that occurs throughout medical illness trajectories, is frequently misdiagnosed. The Memorial Delirium Assessment Scale (MDAS) is a commonly used tool in palliative care (PC) settings. Our objective was to establish and validate the Memorial Delirium Assessment Scale-Thai version (MDAS-T) in PC patients. Materials and Methods The MDAS was translated into Thai. Content validity, inter-rater reliability, and internal consistency were explored. The construct validity of the MDAS-T was analyzed using exploratory factor analysis. Instrument testing of the MDAS-T, the Thai version of the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU-T), and the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition as the gold standard was performed. The receiver operating characteristic (ROC) curve was used to determine the optimal cutoff score. The duration of each assessment was recorded. Results The study enrolled 194 patients. The content validity index was 0.97. The intraclass correlation coefficient and Cronbach's α coefficient were 0.98 and 0.96, respectively. A principal component analysis indicated a homogeneous, one-factor structure. The area under the ROC curve was 0.96 (95% confidence interval [CI], 0.93–0.99). The best combination of sensitivity and specificity (95% CI) of the MDAS-T were 0.92 (0.85–0.96) and 0.90 (0.82–0.94), respectively, with a cutoff score of 9, whereas the CAM-ICU-T yielded 0.58 (0.48–0.67) and 0.98 (0.93–0.99), respectively. The median MDAS-T assessment time was 5 minutes. Conclusion This study established and validated the MDAS-T as a good and feasible tool for delirium screening and severity rating in PC settings. Implications for Practice Delirium is prevalent in palliative care (PC) settings and causes distress to patients and families, thereby making delirium screening necessary. This study found that the MDAS-T is a highly objective and feasible test for delirium screening and severity monitoring in PC settings and can greatly improve the quality of care for this population.

【 授权许可】

CC BY|CC BY-NC