An online delirium detection tool: Cross-cultural adaptation of a Chinese version of the Family Confusion Assessment Method

Huanmin Xing; Shichao Zhu; Shiqing Liu; Ming Xia; Shuaihong Tong; Long Li; Liming Li

doi:10.1016/j.aucc.2024.01.010

An online delirium detection tool: Cross-cultural adaptation of a Chinese version of the Family Confusion Assessment Method

Aust Crit Care. 2024 Apr 4:S1036-7314(24)00026-2. doi: 10.1016/j.aucc.2024.01.010. Online ahead of print.

Authors

Huanmin Xing¹, Shichao Zhu¹, Shiqing Liu², Ming Xia¹, Shuaihong Tong¹, Long Li¹, Liming Li³

Affiliations

¹ Intensive Care Unit, Henan Provincial People's Hospital, Henan Province, China; Henan Provincial Key Medicine Laboratory of Nursing, Henan Province, China; Intensive Care Unit, People's Hospital of Zhengzhou University, Henan Province, China; Intensive Care Unit, People's Hospital of Henan University, Henan Province, China.
² Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Zhengzhou University, Henan Province, China. Electronic address: 1484454764@qq.com.
³ Henan Provincial Key Medicine Laboratory of Nursing, Henan Province, China; Nursing Department, Henan Provincial People's Hospital, Henan Province, China. Electronic address: 15638202286@126.com.

PMID: 38580485
DOI: 10.1016/j.aucc.2024.01.010

Abstract

Background: Intensive care unit (ICU) delirium is a common complication in older critically ill patients that has a significant impact. The Family Confusion Assessment Method (FAM-CAM) is a vital tool for assisting family members in identifying delirium; however, no study has yet been reported on the Chinese version of the scale.

Objectives: The objective of this study was to translate the FAM-CAM into a Chinese version and to verify its effectiveness for delirium detection in an online patient visit setting.

Methods: This was a cross-sectional study. The FAM-CAM was translated to Chinese according to the International Society for Pharmacoeconomics and Outcomes Research guidelines. Patients and family members were recruited to participate in delirium assessments in three ICUs of one hospital. Family members then used the Chinese version of the FAM-CAM to assess for delirium via online visitation, and ICU nurses assessed patients for delirium using the Intensive Care Delirium Screening Checklist (ICDSC). Results were then compared between family members' and nurses' assessments.

Results: Overall, 190 critically ill patients and 190 family members were included, of whom 117 (61.6%) were assessed for delirium using the Intensive Care Delirium Screening Checklist. The Cohen's kappa coefficient between the Intensive Care Delirium Screening Checklist and FAM-CAM was 0.759 (P < 0.01). The sensitivity of the Chinese version of the FAM-CAM was 0.880, specificity was 0.890, positive predictive value was 0.928, negative predictive value was 0.823, and area under the receiver operating characteristic curve was 0.881 (95% confidence interval: 0.872-0.935, P < 0.01).

Conclusion: The Chinese version of the FAM-CAM was shown to effectively help families detect delirium and was suggested as a crucial tool for assisting ICU nurses in the early identification of delirium. This tool may effectively be used to assess delirium during online visits.

Keywords: Delirium; Family Confusion Assessment Method (FAM-CAM); Intensive care unit (ICU); Nursing.