摘要目的 翻译和修订中文版3分钟谵妄诊断量表(3D-CAM)谵妄量表,并验证其在老年患者中的信度和效度. 方法 对中文版3D-CAM谵妄量表进行编译和文化调试.将其在230例65岁以上老年患者中进行验证,测定评定者一致性信度以及效标效度(诊断效度),计算3D-CAM的敏感度、特异度、阳性预测值、阴性预测值. 结果 各条目与条目总分相关分析显示:相关系数均达到显著性水平,相关系数为0.290～0.724 (P＜0.01).评分员间总体一致性kappa为0.78(P＜0.001).以美国精神病学会《诊断与统计手册:精神障碍第五版》(DSM-Ⅴ)为金标准做对比,中文版3D-CAM量表评估230例老年患者谵妄发生的敏感性为94.73％,特异性为97.92％,阳性预测值为90.00％,阴性预测值为98.95％. 结论 中文版3D-CAM应用于国内的内外科病房具有满意的信度和效度,且简单易行,操作方便,可作为评估内外科老年患者谵妄的一种有效工具.

abstractsObjective To translate the 3-minute diagnostic confusion assessment method(3D-CAM)into Chinese,to revise it,and to test its reliability and validity in elderly patients.Methods We translated and culturally adapted 3D-CAM into Chinese.The sample was formed by 230 elderly patients over 65 years of age.We tested inter-assessors reliability and criterion validity (diagnostic validity)and then computed the sensitivity,specificity,positive predictive value,and negative predictive value of the Chinese version of 3D-CAM.Results Correlation analyses between each item and its total score showed that the correlation coefficients ranged between 0.290 and 0.724,all reaching statistical significance(P＜0.01).Inter-assessor reliability in a sample size of 30 patients resulted in a kappa value of 0.78 (P ＜ 0.001).Compared with the gold standard,the diagnostic and statistical manual of mental disorders(DSM-5)by American Psychiatric Association(APA),the sensitivity of the Chinese version of 3D-CAM was 94.73％,the specificity was 97.92％,the positive predictive value was 90.00％,and the negative predictive value was 98.95％.Conclusions The Chinese version of 3D-CAM has achieved satisfactory reliability and validity through pilot runs in surgery and internal medicine inpatients,proved to be easy and convenient to administer,and can be used as an assessment tool for delirium in elderly surgery and internal medicine patients.