住院患者谵妄严重度评估工具及临床应用的研究进展

Assessment instruments of delirium severity for inpatients and clinical application:a literature review

目前临床谵妄评估通常将其结果简单地分为阴性或阳性,忽视了对谵妄严重度的评估。然而谵妄严重度的量化分级对于监测住院患者的治疗效果、了解疾病预后及评估其住院期间和出院后的护理负担具有重要意义。该文全面回顾了10种适用于不同临床场景的评估工具,并评述了其构建的方法学质量、结构或预测效度及临床应用接受度等。此综合分析既能满足临床广泛场景,又能同时完成谵妄诊断和严重度评估,临床护士可根据临床需要选择相应的评估工具。我国学者可进一步引进或开发本土化谵妄严重度评估工具,完善对住院患者的筛查和对谵妄的全面评估。

At present,the most common clinical assessment of delirium is to simply classify the results as negative or positive,ignoring the assessment of the delirium severity.However,the quantitative classification of the delirium severity is of great significance for monitoring the treatment effect of inpatients,understanding the prognosis of the disease,and evaluating the burden of care during and after hospitalization.This article reviewed 10 assessment instruments suitable for different clinical settings,and reviewed the methodological quality,structure,validity and acceptance of clinical applications.We comprehensively analyze the instruments that can satisfy a wide range of clinical scenarios and simultaneously complete delirium diagnosis and severity assessment.Clinical nurses can choose appropriate assessment tools according to clinical needs.In the future,Chinese scholars can further develop localized delirium severity instruments to improve the delirium severity assessment.