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Logo of bmcpsycBioMed Centralsearchsubmit a manuscriptregisterthis articleBMC Psychiatry
 
BMC Psychiatry. 2011; 11: 94.
Published online May 23, 2011. doi:  10.1186/1471-244X-11-94
PMCID: PMC3118892
Translation and validation of the Korean confusion assessment method for the intensive care unit
Eun Young Heo,1 Byoung-Jo Lee,1 Bong-Jin Hahm,1 Eun Hee Song,1 Han-A Lee,1 Chul-Gyu Yoo,1 Young Whan Kim,1 Sung Koo Han,1 Young-Soo Shim,1 and Sang-Min Leecorresponding author1
1Seoul National University College of Medicine, 103 Daehangno, Jongno-gu, Seoul, 110-744, Republic of Korea
corresponding authorCorresponding author.
Eun Young Heo: eunyoungheo/at/gmail.com; Byoung-Jo Lee: minddoctor/at/naver.com; Bong-Jin Hahm: hahm/at/snu.ac.kr; Eun Hee Song: julie0315/at/hanmail.net; Han-A Lee: hugo0364/at/hanmail.net; Chul-Gyu Yoo: cgyoo/at/snu.ac.kr; Young Whan Kim: ywkim/at/snu.ac.kr; Sung Koo Han: hansk/at/snu.ac.kr; Young-Soo Shim: ysshim/at/snu.ac.kr; Sang-Min Lee: sangmin2/at/snu.ac.kr
Received October 4, 2010; Accepted May 23, 2011.
Abstract
Background
Delirium is a common problem and associated with poor outcomes in intensive care unit (ICU) patients. Diagnosis of delirium in ICU patients is limited and usually underdiagnosed by physicians. The Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) is one of the most widely used screening methods for detection of ICU delirium. Our goal was to translate and validate the CAM-ICU for use in the Korean ICU setting.
Methods
Translation of the CAM-ICU was done according to the guidelines suggested by the Translation and Cultural Adaptation Group. For validation and interrater reliability assessment of the Korean CAM-ICU, two nurses independently assessed delirium in ICU patients and the results were compared with the reference evaluation, which was done by a psychiatrist using the Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV).
Results
Twenty-two patients were evaluated by two nurses and one psychiatrist expert independently. During the study period, we have continuously educated study nurses. Based on DSM-IV criteria, 16 out of 22 (72.7%) patients developed delirium. The sensitivities of the two nurses' evaluations using the Korean CAM-ICU were 89.80% for nurse 1 and 77.40% for nurse 2. Their specificities were 72.40% and 75.80% and their overall accuracy was 83.33% and 88.37% respectively. The Korean CAM-ICU was done with reasonable interrater reliability between nurse 1 and nurse 2 (κ = 0.81, p < 0.001).
Conclusions
The Korean CAM-ICU showed good validity and could be incorporated into clinical practice in Korean ICUs.
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