신경외과 수술 후 노인 환자를 위한 섬망 사정도구의 임상활용 가능성 평가

Abstract

Purpose: The aim of this study was to evaluate the possibility for clinical use of delirium assessment tools, the Nursing Delirium Screening Scale (Nu-DESC) and the Delirium Observation Screening Scale (DOS), for postoperative neurosurgery patients. Methods: A sample of 100 elderly patients post neurosurgery was recruited from a neurosurgery ward in a university hospital located in Seoul, South Korea. Nurses (n=28) on the neurosurgery ward were asked to assess the participants using the Nu-DESC and the DOS. Based on the diagnosis of delirium made by a neuropsychiatrist, validity of the tools was evaluated. A questionnaire about ease of use of the tool was completed by the nurses. Results: As for the reliability of the tools, Cronbach's ⍺ was .79, and .95 for the Nu-DESC and the DOS, respectively. Both of the tools showed high levels of sensitivity and specificity. As for ease of use in the clinical setting, the Nu-DESC (mean=39.2±4.82) had a higher (t=2.77, p=.01) score than the DOS (mean=37.39±5.97). Conclusion: Findings of this study confirmed that both the Nu-DESC and the DOS were highly reliable and valid tools to detect delirium in postoperative older neurosurgery patients, but the Nu-DESC was easier to use.