Development of a Brief Delirium Knowledge Questionnaire for Intensive Care Nurses: A Validity and Reliability Study

Delirium is a common condition in intensive care unit (ICU) patients, yet no rapid assessment tool currently exists to evaluate ICU nurses' knowledge of key variables essential for screening and managing delirium, despite their critical role in its evaluation and management.

The objective of this study was to develop a brief, valid, and reliable questionnaire that examines the most critical aspects of identification and management of patients with delirium.

Literature relevant to delirium symptoms and management of patients in the ICU was used for initial item generation. The content validity index was assessed by a panel of 5 delirium care experts; item discrimination was assessed with data from 120 ICU nurses. A purposive sample of 318 ICU nurses completed the Delirium Knowledge Questionnaire for ICU nurses (DKQ-I) for principal component analysis, reliability, and construct validity of the final instrument.

The content validity index for the initial 36 items was 0.89, indicating good validity. Item discrimination (range = 3.59-9.55) reduced items to 22; principal component analysis eliminated 5 items. The resulting 17-item DKQ-I had a 4-factor solution, namely, risk factors, signs and symptoms, precipitating factors, and management strategies, which explained 44.08% of the total variance. Cronbach's α for internal consistency was 0.72; 2-week test-retest reliability was good (r = 0.90). Scores on the delirium knowledge questionnaire were significantly associated with level of nursing education.

The newly developed DKQ-I is a reliable, valid, and rapid test that can assess ICU nurses' level of knowledge, which could be used to provide more immediate improvements in delirium care for patients in the ICU.