133 - Translation, cultural adaptation and testing of the Cornell Assessment of Pediatric delirium in Swedish conditions

Poster Number: 133
Publication Number: 133.3187

Background: Pediatric delirium is an acute and sudden failure of brain function and can lead to poorer outcomes for the child with longer hospitalization, increased costs and increased suffering for the child and its parents. Although delirium in children is a common complication in intensive care and leads to several adverse effects, only one of the four pediatric intensive care units in Sweden uses a validated instrument to identify children with delirium. This is due to the lack of validated, translated and easy-to-use instruments for this purpose.

Objective: The aim of this study was to translate, culturally adapt and test the Cornell Assessment of Pediatric Delirium (CAPD) in Swedish conditions.

Design/Methods: The ISPOR Task Force for Translation and Cultural Adaptation report was used to translate and culturally adapt the CAPD to Swedish conditions. Inter-rater reliability was also tested using intraclass correlation (ICC). This study has been approved by the Swedish Ethical Review Authority.

Results: The cultural adaptation provided valuable insight into the problems and weaknesses of the translated version of the instrument. These problems were related to instructions, education and wording. Problems with wording resulted in words being changed to increase or ensure correct interpretation. In addition, education was extended and improved to ensure the best possible conditions for the users of the instrument. Regarding problems with instructions, the physical appearance of the instrument was slightly changed and some instructions were added to increase clarity and usability. The inter-rater reliability was tested and calculated with interclass correlation. The reliability turned out to be good with an ICC at 0.857 (CI: 0.708-0.930). A Bland-Altman plot was also done to visualize score differences against score averages. Logistic regression was then performed on the Bland-Altman plot showing no significance (P=0.555), indicating there are no proportional biases.

Conclusion(s): This study has translated and culturally adapted the CAPD to Swedish conditions and the reliability is good. Therefore, it should be used in pediatric intensive care units in Sweden to assess the prevalence of delirium in children. This would benefit the children by potentially reducing the risk of delirium and thus the adverse effects associated with delirium.