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Verifying the Japanese Version of Pediatric Delirium and Withdrawal Syndrome Assessment Scale: SOS-PD Validation
Yujiro Matsuishi1, Haruhiko Hoshino2, Yuki Enomoto3,4
1Adult and Elderly Nursing, Faculty of Nursing, Tokyo University of Information Science, Chiba 265-8501, Japan.
Insights
A new Japanese version of the Sophia Observation withdrawal Symptoms-Paediatric Delirium (SOS-PD) scale effectively assesses iatrogenic withdrawal syndrome (IWS) in Japanese pediatric intensive care units (PICUs). This validated tool aids in early detection and management of IWS in children.
Area of Science:
- Pediatric critical care medicine
- Pharmacology and toxicology
- Clinical nursing and patient monitoring
Background:
- Iatrogenic withdrawal syndrome (IWS) is a significant clinical issue in Japanese pediatric intensive care units (PICUs).
- A validated instrument for assessing IWS in Japanese pediatric patients was previously unavailable.
- The Sophia Observation withdrawal Symptoms-Paediatric Delirium (SOS-PD) scale is a globally recognized tool for IWS evaluation.
Purpose of the Study:
- To validate the Japanese version of the SOS-PD scale for use in Japanese PICUs.
- To establish the criterion validity and inter-rater reliability of the Japanese SOS-PD scale.
Main Methods:
- A prospective, observational cohort study was conducted in a single-center Japanese PICU.
- Participants included neonates to 20-year-olds without pre-existing neurological conditions or coma.
- Criterion validity was assessed by comparing Japanese SOS-PD scores between sedative/opioid tapering (WEAN) and stable medication (MAIN) groups, and correlated with NRSobs.
- Inter-rater reliability was evaluated using kappa statistics and intraclass correlation coefficient (ICC).
Main Results:
- The WEAN group showed significantly higher scores on NRSobs and the IWS component of the Japanese SOS-PD scale compared to the MAIN group (p < 0.001).
- A strong positive correlation was found between the Japanese SOS-PD IWS component and NRSobs (r = 0.91, p < 0.001).
- Excellent inter-rater reliability was demonstrated, with a kappa coefficient of 0.95 and an ICC of 0.98.
Conclusions:
- The Japanese version of the SOS-PD scale is a valid and reliable instrument for assessing IWS in Japanese PICUs.
- This validated scale facilitates early detection and appropriate management of pediatric IWS in Japan.
- Implementation of the Japanese SOS-PD scale has the potential to improve patient care quality in pediatric critical care settings.
Abstract:
Iatrogenic withdrawal syndrome (IWS) poses a significant clinical challenge in pediatric intensive care units (PICUs) within Japan. Despite the existing availability of tools to assess pain and delirium, a validated instrument specifically designed for IWS has been notably absent in Japanese clinical practice. The Sophia Observation withdrawal Symptoms-Paediatric Delirium (SOS-PD) scale is globally recognized as an effective tool for IWS evaluation. To bridge this gap, this study aimed to validate the Japanese version of the SOS-PD scale. Methods: A prospective, cohort, observational study was undertaken in a single-center PICU in Japan. Participants ranged from neonates to children aged 20 years, excluding those with pre-existing neurological conditions or coma. Criterion validity was evaluated by comparing Japanese SOS-PD scale scores between a Weaning Group (WEAN) undergoing sedative/opioid tapering and a Maintenance Group (MAIN) receiving stable medication. Correlation analysis was also conducted against pediatric intensivists' observational NRS (NRSobs). Inter-rater reliability of the Japanese SOS-PD scale was assessed utilizing kappa statistics and intraclass correlation coefficient (ICC). Results: In support of criterion validity, the WEAN group demonstrated significantly higher scores in both NRSobs and the IWS component of the Japanese SOS-PD scale compared to the MAIN group (p < 0.001). A strong correlation was observed between the Japanese SOS-PD IWS component and NRSobs (r = 0.91, p < 0.001). Inter-rater reliability was also robust, with a kappa coefficient of 0.95 and an ICC of 0.98. Conclusions: The Japanese version of the SOS-PD scale exhibits strong validity and inter-rater reliability for IWS assessment within Japanese PICUs. This validated instrument can support the early detection and appropriate management of pediatric IWS in Japan, with the potential to enhance the quality of patient care.
