• Yuji Koga, Ryosuke Tsuruta, Hiroaki Murata, Koji Matsuo, Tatsuhiko Ito, E Wesley Ely, Ayumi Shintani, Hiroya Wakamatsu, Masamitsu Sanui, and Hiroaki Yamase.
• Department of Nursing, Yamaguchi University Hospital, Yamaguchi, Japan. Electronic address: yuji-koga@umin.ac.jp.
• Intensive Crit Care Nurs. 2015 Jun 1; 31 (3): 165-70.

ObjectiveDelirium may lead to adverse outcomes in patients with serious conditions, but is often under-diagnosed due to inadequate screening. The Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) is an established method for assessing delirium in the ICU. The validity and reliability of the Japanese version of the CAM-ICU has not, however, been verified, and we undertook this study to verify these parameters.Research MethodologyCAM-ICU validity and reliability were assessed in two Japanese ICUs. Using the evaluation of the DMS-IV-TR in the psychiatrists group as the standard criteria for delirium diagnosis, we compared the evaluation of the Japanese version of the CAM-ICU between the research nurses group and the staff nurses group.ResultsAccording to DSM-IV-TR criteria, the prevalence of delirium was 22.0%, and according to CAM-ICU delirium was found in 22.0% with Research Nurses and 19.5% with Staff Nurses. CAM-ICU sensitivity ratings were 83% and 78%, while their specificity ratings were 95% and 97%, respectively. The Kappa inter-rater reliability was good (κ=0.85), and Cronbach's alpha coefficient was 0.69 (95% CI: 0.57-0.79). Mean rating time for the CAM-ICU was 2.5-2.8 minutes for Research Nurses and Staff Nurses, respectively.ConclusionThe Japanese version of the CAM-ICU has comparable validity and reliability as a delirium assessment tool in surgical patients in two Japanese ICUs. With training, CAM-ICU can be incorporated into daily clinical practice.Copyright © 2014 Elsevier Ltd. All rights reserved.

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