Hostname: page-component-cd9895bd7-fscjk Total loading time: 0 Render date: 2024-12-29T01:53:42.178Z Has data issue: false hasContentIssue false
  • English
  • Français

Pilot study on the European Portuguese version of the Confusion Assessment Method

Published online by Cambridge University Press:  20 June 2014

Sónia Martins ,
Patrícia Moldes ,
João Pinto-de-Sousa ,
Filipe Conceição ,
José Artur Paiva ,
Mário R. Simões  and
Lia Fernandes Open the ORCID record for Lia Fernandes [Opens in a new window]
Sónia Martins
Affiliation:
Research and Education Unit on Aging, UNIFAI, University of Porto, Portugal
Patrícia Moldes
Affiliation:
Clinic of Psychiatry and Mental Health, CHSJ, Porto, Portugal
João Pinto-de-Sousa
Affiliation:
Department of Surgery, Faculty of Medicine, University of Porto, Portugal
Filipe Conceição
Affiliation:
UCISU, Intensive Medicine Service, CHSJ, Porto, Portugal
José Artur Paiva
Affiliation:
Intensive Care and Emergency Autonomous Management Unit, CHSJ. Faculty of Medicine, University of Porto, Portugal
Mário R. Simões
Affiliation:
Psychological Assessment Laboratory, CINEICC, Faculty of Psychology and Educational Sciences, University of Coimbra, Portugal
Lia Fernandes*
Affiliation:
UNIFAI/CINTESIS Research Unit, Faculty of Medicine, University of Porto. Clinic of Psychiatry and Mental Health, CHSJ, Porto, Portugal
*
Lia Fernandes, Faculty of Medicine, University of Porto, Al. Hernâni Monteiro, 4200–319 Porto, Portugal. Tel: +00351222052525;Fax: +00351225513601 E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective

To present the pilot study on the European Portuguese validation of the Confusion Assessment Method (CAM).

Methods

The translation process was carried out according to International Society Pharmacoeconomics and Outcomes Research guidelines with trained researchers and inter-rater reliability assessment. The study included 50 elderly patients, admitted (≥24 h) to two intermediate care units. Exclusion criteria were: Glasgow Coma Scale (total score ≤11), blindness/deafness, inability to communicate and not able to speak Portuguese. The sensitivity and specificity of CAM were assessed, with DSM-IV-TR criteria of delirium used as a reference standard.

Results

Findings revealed excellent inter-rater reliability (k>0.81), moderate sensitivity (73%) and excellent specificity (95%).

Conclusion

These preliminary results suggested that this version emerges as a promising diagnostic instrument for delirium.

Keywords

agedCAMdeliriumPortugalvalidation studies
Type
Rapid Communication
Information
Acta Neuropsychiatrica , Volume 26 , Issue 5 , October 2014 , pp. 321 - 324
Copyright
© Scandinavian College of Neuropsychopharmacology 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Saxena, S, Lawley, D. Delirium in the elderly: a clinical review. Postgrad Med J 2009;85:405–413.Google Scholar
2.Siddiqi, N, House, AO, Holmes, JD. Occurrence and outcome of delirium in medical in-patients: a systematic literature review. Age Ageing 2006;35:350–364.Google Scholar
3.Grover, S, Kate, N. Assessment scales for delirium: a review. World J Psychiatry 2012;2:58–70.Google Scholar
4.Inouye, SK, Van Dyck, CH, Alessi, CA, Balkin, S, Siegal, AP, Horwitz, RI. Clarifying confusion: the confusion assessment method. A new method for detection of delirium. Ann Intern Med 1990;113:941–948.Google Scholar
5.American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. DSM-III-R, 3rd edn. Text Review. Washington: APA, 1987.Google Scholar
6.Wei, LA, Fearing, MA, Sternberg, EJ, Inouye, SK. The Confusion Assessment Method: a systematic review of current usage. J Am Geriatr Soc 2008;56:823–830.Google Scholar
7.Martins, S, Simões, M, Fernandes, L. Elderly delirium assessment tools review. Cur Psychiatr Rev 2012;8:168–174.Google Scholar
8.National Institutefor Health and Clinical Excellence. Delirium: diagnosis, prevention and management, Clinical guideline 103, Nice, 2010. Available at www.nice.org.uk/CG103. Accessed January 9, 2011.Google Scholar
9.Wild, D, Grove, A, Martin, Met al. Principles of good practice for the translation and cultural adaptation process for patient-reported outcomes (PRO) measures: report of the ISPOR Task Force for Translation and Cultural Adaptation. Value Health 2005;8:94–104.Google Scholar
10.Inouye, SK. The Confusion Assessment Method (CAM): Training Manual and Coding Guide. New Haven: Yale University School of Medicine, 2003.Google Scholar
11.Teasdale, G, Jennett, B. Assessment of coma and impaired consciousness. A practical scale. Lancet 1974;2:81–84.Google Scholar
12.American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. DSM-IV-TR, 4th edn. Text Review. Washington: APA, 2000.Google Scholar
13.Folstein, MF, Folstein, SE, Mchugh, PR. Mini-mental state. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975;12:189–198.Google Scholar
14.Wechsler, D. Wechsler Adult Intelligence Scale-III. San Antonio, TX: The Psychological Corporation, 1997.Google Scholar
15.Landis, JR, Koch, GG. The measurement of observer agreement for categorical data. Biometrics 1977;33:159–174.Google Scholar
16.Monette, J, Galbaud, DU, Fort, Get al. Evaluation of the Confusion Assessment Method (CAM) as a screening tool for delirium in the emergency room. Gen Hosp Psychiatry 2001;23:20–25.Google Scholar
17.Fabbri, RM, Moreira, MA, Garrido, R, Almeida, OP. Validity and reliability of the Portuguese version of the Confusion Assessment Method (CAM) for the detection of delirium in the elderly. Arq Neuropsiquiatr 2001;59:175–179.Google Scholar
18.Laurila, JV, Pitkala, KH, Strandberg, TE, Tilvis, RS. Confusion assessment method in the diagnostics of delirium among aged hospital patients: would it serve better in screening than as a diagnostic instrument? Int J Geriatr Psychiatry 2002;17:1112–1119.Google Scholar
19.Gonzalez, M, de Pablo, J, Fuente, Eet al. Instrument for detection of delirium in general hospitals: adaptation of the confusion assessment method. Psychosomatics 2004;45:426–431.Google Scholar
20.Hestermann, U, Backenstrass, M, Gekle, Iet al. Validation of a German version of the Confusion Assessment Method for delirium detection in a sample of acute geriatric patients with a high prevalence of dementia. Psychopathology 2009;42:270–276.CrossRefGoogle Scholar
21.Ryan, K, Leonard, M, Guerin, S, Donnelly, S, Conroy, M, Meagher, D. Validation of the confusion assessment method in the palliative care setting. Palliat Med 2009;23:40–45.Google Scholar
22.Wongpakaran, N, Wongpakaran, T, Bookamana, Pet al. Diagnosing delirium in elderly Thai patients: utilization of the CAM algorithm. BMC Fam Pract 2011;12:65.Google Scholar
23.Ely, EW, Margolin, R, Francis, Jet al. Evaluation of delirium in critically ill patients: validation of the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU). Crit Care Med 2001;29:1370–1379.Google Scholar
24.Salluh, J, Vidal, L. Método de avaliação da confusão mental na UTI. (Confusion Assessment Method in the ICU/CAM-ICU), 2007. Available at http://www.icudelirium.org/docs/CAM_ICU_flowsheet_Portugese_B.pdf. Accessed April 10, 2014.Google Scholar
25.Gusmao-Flores, D, Salluh, JI, Dal-Pizzol, Fet al. The validity and reliability of the Portuguese versions of three tools used to diagnose delirium in critically ill patients. Clinics 2011;66:1917–1922.Google Scholar
26.Gusmao-Flores, D, Salluh, JI, Chalhub, RA, Quarantini, LC. The Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) and Intensive Care Delirium Screening Checklist (ICDSC) for the diagnosis of delirium: a systematic review and meta-analysis of clinical studies. Crit Care 2012;16:1–10.Google Scholar
27.Granja, C, Lopes, A. The Confusion Assessment Method for the Intensive Care Unit (CAM-ICU). Training Manual, 2002. Available at http://www.icudelirium.org/docs/CAM_ICU_training_Portugese.pdf. Accessed September 8, 2013.Google Scholar
28.Martins, S, Fernandes, L. Delirium in elderly people: a review. Front Neurol 2012;3:101.Google Scholar