Reliability and validity assessment of the Japanese version of the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU)

• Published in: Intensive & critical care nursing Vol. 31; no. 3; pp. 165 - 170
• Main Authors: Koga, Yuji, Tsuruta, Ryosuke, Murata, Hiroaki, Matsuo, Koji, Ito, Tatsuhiko, Ely, E. Wesley, Shintani, Ayumi, Wakamatsu, Hiroya, Sanui, Masamitsu, Yamase, Hiroaki
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.06.2015; Elsevier Limited
• Subjects: Aged; Analgesics; Anesthesia; CAM-ICU; Confidence intervals; Confusion - diagnosis; Confusion - nursing; Consciousness; Delirium; Female; Geriatric Assessment; Humans; ICU; Illnesses; Intensive care; Intensive Care Units; Intubation; Japan; Male; Mental disorders; Mortality; Neuropsychological Tests; Nurses; Nursing; Nursing Diagnosis; Psychiatrists; Reliability; Reproducibility of Results; Studies; Surgery; Thoracic surgery; Translations; Validity; Japan; Delirium; Validity; CAM-ICU; ICU; Reliability; Japan
• ISSN: 0964-3397; 1532-4036
• DOI: 10.1016/j.iccn.2014.10.002

Delirium may lead to adverse outcomes in patients with serious conditions, but is often under-diagnosed due to inadequate screening. The Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) is an established method for assessing delirium in the ICU. The validity and reliability of the Japanese version of the CAM-ICU has not, however, been verified, and we undertook this study to verify these parameters. CAM-ICU validity and reliability were assessed in two Japanese ICUs. Using the evaluation of the DMS-IV-TR in the psychiatrists group as the standard criteria for delirium diagnosis, we compared the evaluation of the Japanese version of the CAM-ICU between the research nurses group and the staff nurses group. According to DSM-IV-TR criteria, the prevalence of delirium was 22.0%, and according to CAM-ICU delirium was found in 22.0% with Research Nurses and 19.5% with Staff Nurses. CAM-ICU sensitivity ratings were 83% and 78%, while their specificity ratings were 95% and 97%, respectively. The Kappa inter-rater reliability was good (κ=0.85), and Cronbach's alpha coefficient was 0.69 (95% CI: 0.57–0.79). Mean rating time for the CAM-ICU was 2.5–2.8minutes for Research Nurses and Staff Nurses, respectively. The Japanese version of the CAM-ICU has comparable validity and reliability as a delirium assessment tool in surgical patients in two Japanese ICUs. With training, CAM-ICU can be incorporated into daily clinical practice.