A psychometric evaluation of the Pediatric Anesthesia Emergence Delirium scale

• Published in: Pediatric anesthesia Vol. 28; no. 4; pp. 332 - 337
• Main Authors: Ringblom, Jenny, Wåhlin, Ingrid, Proczkowska, Marie
• Format: Journal Article
• Language: English
• Published: France Wiley Subscription Services, Inc 01.04.2018
• Subjects: Anesthesia - adverse effects; Anesthesia Recovery Period; Child; Child, Preschool; Delirium; Diagnostic tests; emergence delirium; Emergence Delirium - diagnosis; Emergence Delirium - etiology; Emergence Delirium - psychology; Factor Analysis, Statistical; Female; Health and Caring Sciences; Humans; Hälsovetenskap; Infant; Infant, Newborn; instrument development; Male; Observer Variation; Pediatrics; postoperative behavioral changes; Postoperative Complications - diagnosis; Postoperative Complications - etiology; Postoperative Complications - psychology; Psychometrics; Reproducibility of Results; instrument development; emergence delirium; postoperative behavioral changes; pediatrics
• DOI: 10.1111/pan.13348
• ISSN: 1155-5645; 1460-9592

Summary Background Emergence delirium and emergence agitation have been a subject of interest since the early 1960s. This behavior has been associated with increased risk of injury in children and dissatisfaction with anesthesia care in their parents. The Pediatric Anesthesia Emergence Delirium Scale is a commonly used instrument for codifying and recording this behavior. Aims The aim of this study was to psychometrically evaluate the Pediatric Anesthesia Emergence Delirium scale, focusing on the factor structure, in a sample of children recovering from anesthesia after surgery or diagnostic procedures. The reliability of the Pediatric Anesthesia Emergence Delirium scale was also tested. Methods One hundred and twenty‐two children younger than seven years were observed at postoperative care units during recovery from anesthesia. Two or 3 observers independently assessed the children using the Pediatric Anesthesia Emergence Delirium scale. Results The factor analysis clearly revealed a one‐factor solution, which accounted for 82% of the variation in the data. Internal consistency, calculated with Cronbach′s alpha, was good (0.96). The Intraclass Correlation Coefficient, which was used to assess interrater reliability for the Pediatric Anesthesia Emergence Delirium scale sum score, was 0.97 (P < .001). The weighted kappa statistics were almost perfect in 4 of 5 items, with substantial agreement in the fifth (P < .001). Conclusion The one‐factor solution and the satisfactory reliability in terms of internal consistency and stability support the use of the Pediatric Anesthesia Emergence Delirium scale for assessing emergence delirium in children recovering from anesthesia after surgery or diagnostic procedures. The kappa statistics for the Pediatric Anesthesia Emergence Delirium scale items essentially indicated good agreement between independent raters, supporting interrater reliability.