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Cornell Assessment of Pediatric Delirium: Italian cultural validation and preliminary testing
Silvio Simeone1, Teresa Rea2, Gianpaolo Gargiulo3
1Ph.D, RN, Research fellow, Department of Biomedicine and Prevention, University of Rome Tor Vergata.
Insights
The Cornell Assessment of Pediatric Delirium (CAPD) was successfully validated for Italian-speaking pediatric intensive care units. This tool aids in diagnosing pediatric delirium in critically ill children, improving patient outcomes.
Area of Science:
- Pediatric Intensive Care Medicine
- Child Psychology
- Clinical Assessment Tools
Background:
- Pediatric delirium in intensive care units is linked to prolonged hospitalization, post-traumatic stress, and neurocognitive issues.
- Diagnosing delirium in preschool children is challenging due to their developmental stage and pre-verbal communication.
- The Cornell Assessment of Pediatric Delirium (CAPD) is a validated screening tool for critically ill children, including infants.
Purpose of the Study:
- To culturally and linguistically validate the Cornell Assessment of Pediatric Delirium (CAPD) for use in the Italian language.
- To conduct prior testing of the Italian version of the CAPD to ensure its reliability and validity.
Main Methods:
- The Cornell Assessment of Pediatric Delirium (CAPD) was translated and culturally adapted following World Health Organization guidelines.
- Prior testing involved item descriptive analysis, item-total correlation, and Cronbach's alpha on a sample of 42 children aged 0-5 years.
Main Results:
- The cultural-linguistic validation process was completed satisfactorily.
- Prior testing demonstrated normal item distribution, acceptable skewness and kurtosis, and strong item-total correlations (rjx > 0.30).
- The scale achieved excellent reliability with a composite reliability index of 0.94 and Cronbach's alpha of 0.96.
Conclusions:
- The Italian version of the CAPD was developed following international best practices.
- The validation process ensures the CAPD is a reliable instrument for assessing pediatric delirium in Italian-speaking critical care settings.
- The final version received approval from the original instrument's authors.
Introduction:
Paediatric delirium is associated with a longer duration of hospitalization in paediatric intensive care units, the emergence of post-traumatic symptoms and possible neurocognitive dysfunction after discharge. In preschool children, the diagnosis of delirium appears rather challenging: their pre-verbal status and the presence of cognitive skills still in development make accurate diagnosis difficult. Recently, a pediatric delirium screening tool suitable for critical preschool children has also been developed and identified in international literature, with excellent results also in critical infants under 2 years of age: the Cornell Assessment of Pediatric Delirium (CAPD). The CAPD, using a Likert scale, bases the assessment of paediatric delirium within the context of child development. This scale follows the development of the infant by comparing the detection of specific items on the scale as the anchor points that characterize the development of infants by age groups.
Objective:
Culturally and linguistically validation in Italian language and prior testing of the Cornell Assessment of Pediatric Delirium.
Method:
Translation and Cultural Validation of the Cornell Assessment of Pediatric Delirium (CAPD) for the Evaluation/Diagnosis of Pediatric Delirium within Pediatric Intensive Care. The translation and adaptation of this instrument followed the phases of the model proposed by the World Health Organization. Prior testings, such as item descriptive analysis, item-total correlation and Cronbach's alpha, were conducted.
Results:
All phases of the cultural-linguistic validation process were carried out in a satisfactory manner. For the prior testing, the scale was administered to a sample of 42 children, with age ranged 0-5 years old (66.6%), with a higher prevalence of the male gender. All items were normally distributed and there was no excessive Skeweness and Kurtosis. Each item contributed to the scale fairly well and all coefficients of item total correlation (rjx) were higher than the recommended level of 0.30. The composite reliability index was 0.94 and Cronbach's alpha was 0.96.
Conclusions:
The process has meticulously followed the recommendations in international literature. The final version was approved by the authors of the original instrument.
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