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Psychometric analysis of subjective sedation scales used for critically ill paediatric patients
Author(s) -
Ge Xiaohua,
Zhang Tingting,
Zhou Lingling
Publication year - 2018
Publication title -
nursing in critical care
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.689
H-Index - 43
eISSN - 1478-5153
pISSN - 1362-1017
DOI - 10.1111/nicc.12325
Subject(s) - sedation , checklist , medicine , scale (ratio) , cochrane library , data extraction , medline , intensive care , psychometrics , population , intensive care medicine , physical therapy , emergency medicine , clinical psychology , psychology , randomized controlled trial , anesthesia , surgery , environmental health , physics , quantum mechanics , political science , law , cognitive psychology
Aims This study evaluated the psychometric properties of subjective sedation scales using one psychometric scoring system to identify the appropriate scale that is most suitable for clinical care practice. Background A number of published sedation assessment scales for paediatric patients are currently used to attempt to achieve a moderate depth of sedation to avoid the undesirable effects caused by over‐ or undersedation. However, there has been no systematic review of these scales. Search strategy We searched the Cochrane Library, PubMed, EMBASE, the Cumulative Index to Nursing and Allied Health Literature, etc., to obtain relevant articles. The quality of the selected studies was evaluated according to the Consensus‐based Standards for the Selection of Health Measurement Instruments checklist. Inclusion criteria Articles that had been published or were in press and discussed the psychometric properties of sedation scales were included. The population comprised critically ill infants and non‐verbal children ranging in age from 0 to 18 years who underwent sedation in an intensive care unit. Findings Data were independently extracted by two investigators using a standard data extraction checklist: 43 articles were included in this review, and 13 sedation scales were examined. The quality of the psychometric evidence for the Comfort Scale and Comfort Behaviour Scale was ‘very good’, with the Comfort Scale having a higher quality (total weighted scores, Comfort Scale = 17·3 and Comfort Behaviour Scale = 15·5). Conclusions We suggest that the scales be systematically and comprehensively tested in terms of development method, reliability, validation, feasibility and correlation with clinical outcome. The Comfort Scale and Comfort Behaviour Scale are useful tools for measuring sedation in paediatric patients. Relevance to clinical practice Nursing staff should choose one subjective sedation scale that is suitable for assessing paediatric patients' depth of sedation. We recommend the Comfort Scale and Comfort Behaviour Scale as optimal choices if the clinical environment permits.