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Yoksunluk Değerlendirme Aracının Türkçe Geçerlilik ve Güvenilirlik Çalışması-1

Yıl 2024, Cilt: 40 Sayı: 3, 345 - 355, 18.12.2024
https://doi.org/10.53490/egehemsire.1267451

Öz

Amaç: Literatürde sedasyon kullanılan çocukların yoksunluk durumunu değerlendiren bir ölçme aracının Türkçe uyarlaması bulunamamıştır. Bu durum Türkiye’de çocukların yoksunluk durumunu değerlendiren bir ölçme aracının literatüre dahil edilmesi ihtiyacını gündeme getirmiştir. Bu çalışma, Yoksunluk Değerlendirme Aracı-1’in Türkçe geçerlik güvenirliğini belirlemek amacıyla yapıldı.
Yöntem: Araştırma metadolojik olarak planlandı. Araştırmanın örneklemini İstanbul’da bulunan bir devlet hastanesinin 16 yataklı Çocuk Yoğun Bakım Ünitesinde yatmakta olan araştırmaya katılmaya gönüllü ve ebeveynlerinden onam alınan 80 çocuk oluşturdu. Veriler “Tanıtıcı Bilgiler Formu”, ‘’Yoksunluk Değerlendirme Aracı-1’’, “Pediatrik Serebral Performans Kategori Ölçeği”, ‘’Pediatrik Genel Performans Kategorisi’’ ve “PRİSİM skoru” ile 25.12.2020-22.08.2021 tarihleri arasında toplandı. Araştırmadan elde edilen veriler SPSS 22.0 ve MedCalc 19.1 istatistik program aracılığıyla değerlendirildi.
Bulgular: Örneklem grubundaki çocukların Yoksunluk Değerlendirme Aracı-1 puanları ile Pediatrik Genel Performans Kategorisi ve Pediatrik Serebral Performans Kategori Ölçeği puanları arasında pozitif (p=0.000<0.05) anlamlı ilişki olduğu saptandı. Çocukların Yoksunluk Değerlendirme Aracı-1 ile yoğun bakımda kalış süresi, ventilasyonda kalış süresi, kümülatif opiate dozu, en yüksek opiate dozu, en yüksek benzodiazepine dozu arasında pozitif (p=<0.05) korelasyon bulundu. Ölçeğin optimum kesim noktası (cutoffdeğeri)>4 olarak belirlendi. Kesme noktasındaki Sensitivity (Duyarlılık) 81.82; Specificity (Özgüllük) 100; Youdenindex J=0.818 (0) göre çocukların %56.2’ sinde yoksunluk geliştiği saptandı.
Sonuç: Elde edilen bulgular sonucunda Yoksunluk Değerlendirme Aracı-1’in farklılıkları ayırt edecek hassas ölçüm yaptığı ve Türkçe geçerli ve güvenilir bir araç olduğu saptandı. Bu sonuçlar ışığında aracın, sedasyon kullanılan çocuklara yönelik yoksunluk durumunun belirlenmesi amacı ile klinik uygulama alanında kullanılması önerilir.

Proje Numarası

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Kaynakça

  • Amigoni, A., Vettore, E., Brugnolaro, V., Brugnaro, L., Gaffo, D., Masola, M., Marzollo, A., & Pettenazzo, A. (2014). High doses of benzodiazepine predict analgesic and sedative drug withdrawal syndrome in paediatric intensive care patients. Acta Pædiatrica. https://doi.org/10.1111/apa.12777
  • Best, K. M., Wypij, D., Asaro, L. A., & Curley, M. A. (2017). Patient, process, and system predictors of iatrogenic withdrawal syndrome in critically ill children. Critical Care Medicine, 45(1), e7–e15. https://doi.org/10.1097/CCM.0000000000001953
  • Burry, L. D., Williamson, D. R., Perreault, M. M., Rose, L., Cook, D. J., Ferguson, N. D., ... Mehta, S. (2014). Analgesic, sedative, antipsychotic, and neuromuscular blocker use in Canadian intensive care units: A prospective, multicentre, observational study. Canadian Journal of Anesthesia, 61(7), 619–630. https://doi.org/10.1007/s12630-014-0174-1
  • Bowe, N. S., Colaianni, C. A., Yamasaki, A., Cummings, B. M., & Hartnick, C. J. (2019). Reevaluating a standardized sedation weaning protocol for pediatric laryngotracheal reconstruction for continuous quality improvement. JAMA Otolaryngology–Head & Neck Surgery, 145(4), 321–327. https://doi.org/10.1001/jamaoto.2018.4348
  • Curley, M. A. Q., Wypij, D., Watson, S., Grant, M. J. C., Asaro, L. A., Cheifetz, I. M., ... Matthay, M. A. (2015). Protocolized sedation vs. usual care in pediatric patients mechanically ventilated for acute respiratory failure: A randomized clinical trial. JAMA, 313(4), 379–389. https://doi.org/10.1001/jama.2014.18399
  • Da Silva, P. S., Reis, M. E., Fonseca, T. S., & Fonseca, M. C. (2016). Opioid and benzodiazepine withdrawal syndrome in PICU patients: Which risk factors matter? Journal of Addiction Medicine, 10(2), 110–116. https://doi.org/10.1097/ADM.0000000000000197
  • Dirican, A. (2021). Tanı testi performanslarının değerlendirilmesi ve kıyaslanması. J Med, 32, 25–30. Erişim adresi: http://www.ctf.istanbul.edu.tr/dergi/online/2001v32/s1/011a4.htm
  • Dokken, M., Rustøen, T., Diep, L. M., Fagermoen, M. S., Huse, R. I., Rosland, G. A., ... Bentsen, G. K. (2021). Iatrogenic withdrawal syndrome frequently occurs in pediatric intensive care without algorithm for tapering of analgosedation. Acta Anaesthesiologica Scandinavica, 65, 928–935. https://doi.org/10.1111/aas.13818
  • Duceppe, M. A., Perreault, M. M., Frenette, A. J., Burry, L. D., Rico, P., Lavoie, A., ... Williamson, D. R. (2019). Frequency, risk factors, and symptomatology of iatrogenic withdrawal from opioids and benzodiazepines in critically ill neonates, children, and adults: A systematic review of clinical studies. Journal of Clinical Pharmacology & Therapeutics, 44(2), 148–156. https://doi.org/10.1111/jcpt.12787
  • Fiser, D. H. (1992). Assessing the outcome of pediatric intensive care. Journal of Pediatrics, 68(1), 68–74. https://doi.org/10.1016/S0022-3476(05)82544-2
  • Franck, L. S., Harris, S. K., Soetenga, D. J., Amling, J. K., & Curley, M. A. Q. (2008). The Withdrawal Assessment Tool–1 (WAT–1): An assessment instrument for monitoring opioid and benzodiazepine withdrawal symptoms in pediatric patients. Pediatric Critical Care Medicine, 9(6). https://doi.org/10.1097/PCC.0b013e31818c8328
  • Franck, L. S., Scoppettuolo, L. A., Wypij, D., & Curley, M. A. Q. (2012). Validity and generalizability of the Withdrawal Assessment Tool-1 (WAT-1) for monitoring iatrogenic withdrawal syndrome in pediatric patients. Pain, 153, 142–147. https://doi.org/10.1016/j.pain.2011.10.003
  • Green, S. M., Roback, M. G., Krauss, B. S., Miner, J. R., Schneider, S., Kivela, P. D., ... Connor, R. E. (2019). Unscheduled procedural sedation: A multidisciplinary consensus practice guideline. Annals of Emergency Medicine, 73, 51. https://doi.org/10.1016/j.annemergmed.2019.02.022
  • Ista, E., Dijk, M., Gamel, C., Tibboel, D., & Hoog, M. (2008). Withdrawal symptoms in critically ill children after long-term administration of sedatives and/or analgesics: A first evaluation. Critical Care Medicine, 36(8), 2427–2432. https://doi.org/10.1097/CCM.0b013e318181600d
  • Özgür, E., Bilgin, C., & Özyurt, B. C. (2018). Turkish validity and reliability of Eustachian tube dysfunction questionnaire-7. Brazilian Journal of Otorhinolaryngology, 84(4), 435–440. https://doi.org/10.1016/j.bjorl.2017.05.001
  • Pollack, M. M., Patel, K. M., & Ruttimann, U. E. (1996). PRISM III: An updated pediatric risk of mortality score. Critical Care Medicine, 24(5), 743–752. https://doi.org/10.1097/00003246-199605000-00004
  • Sanavia, E., Mencía, S., Lafever, S. N., Solana, M. J., & Garcia, M. (2019). Sedative and analgesic drug rotation protocol in critically ill children with prolonged sedation: Evaluation of implementation and efficacy to reduce withdrawal syndrome. Pediatric Critical Care Medicine, 20(12). https://doi.org/10.1097/PCC.0000000000002071
  • Sneyers, B., Duceppe, M. A., Frenette, A. J., Burry, L. D., Rico, P., Lavoie, A., ... Perreault, M. M. (2020). Strategies for the prevention and treatment of iatrogenic withdrawal from opioids and benzodiazepines in critically ill neonates, children, and adults: A systematic review of clinical studies. Drugs, 80, 1211–1223. https://doi.org/10.1007/s40265-020-01338-4
  • Soykök, R., & Kökcü Doğan, A. (2022). Yoksunluk Değerlendirme Aracı-1 (YDA-1)'in Türkçe geçerlik güvenirlik çalışması. (Yüksek Lisans Tezi). İstanbul Medipol Üniversitesi Sağlık Bilimleri Enstitüsü, İstanbul.
  • Şencan, H. (2005). Sosyal ve davranışsal ölçümlerde güvenilirlik ve geçerlik. (s. 787–788). Ankara: Seçkin Yayıncılık. ISBN: 9753478844
  • Volakli, E., Sdougka, M., Mantzafleri, P. E., Tsonidis, C., Kontopoulos, E., & Tsikoulas, I. (2015). Functional outcome following pediatric intensive care: Pediatric Cerebral Performance Category (PCPC) and Pediatric Overall Performance Category (POPC) during a prospective two years follow-up period. The Greek E-Journal of Perioperative Medicine, 13, 2–15.
  • Pena, E. D. (2007). Lost in translation: Methodological considerations in cross-cultural research. Child Development, 78(6), 1255–1264. https://doi.org/10.1111/j.1467-8624.2007.01064.x
  • Sperber, A. D. (2004). Translation and validation of study instruments for cross-cultural research. Gastroenterology, 126, S124–S128. https://doi.org/10.1053/j.gastro.2003.10.016
  • Lawshe, C. H. (1975). A quantitative approach to content validity. Personnel Psychology, 28(4), 563–575. https://doi.org/10.1111/j.1744-6570.1975.tb01393.x

Turkish Validity and Reliability Study Of The Deprivation Assessment Tool-1

Yıl 2024, Cilt: 40 Sayı: 3, 345 - 355, 18.12.2024
https://doi.org/10.53490/egehemsire.1267451

Öz

Objective: No Turkish adaptation of a measurement tool evaluating the withdrawal in sedated children was found in the literature. This situation raised the need for a measuring instrument in the literature that assesses the withdrawal of children in Turkey. This study aimed to determine the Turkish validity and reliability of the Withdrawal Assessment Tool-1.
Methods: It is a methodological study. The sample of the study consisted of 80 children, who were hospitalized in the 16-bed Pediatric Intensive Care Unit of a State hospital in Istanbul, who volunteered to participate in the study, and who had parental consent. The data were collected between 25.12.2020 and 22.08.2021, through “Descriptive Information Form”, “Withdrawal Assessment Tool-1”, “Pediatric Cerebral Performance Category Scale”, and “Pediatric Overall Performance Category” and “PRISM score”. The data obtained from the study were evaluated using SPSS 22.0 and MedCalc 19.1 statistical programs.
Results: A significant positive (p=0.000<0.05) correlation was found between the Withdrawal Assessment Tool-1 scores of the children in the sample group and the Pediatric Overall Performance Category and Pediatric Cerebral Performance Category Scale scores. There was a positive (p=<0.05) correlation between the Withdrawal Assessment Tool-1 of the children and the length of stay in the intensive care unit, ventilation time, cumulative opiate dose, the highest opiate dose, and the highest benzodiazepine dose. The optimum cut-off value of the scale was determined as >4. Cut-off point Sensitivity was 81.82; Specificity was 100; Youden index was J=0.818 (0), it was found that 56.2% of children developed withdrawal.
Conclusions: As a result of the findings, it was determined that the Withdrawal Assessment Tool-1 makes sensitive measurements to distinguish differences and is a valid and reliable tool in Turkish. In the light of these results, it is recommended to be used in clinical practice to determine the withdrawal in children using sedation.

Destekleyen Kurum

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Proje Numarası

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Kaynakça

  • Amigoni, A., Vettore, E., Brugnolaro, V., Brugnaro, L., Gaffo, D., Masola, M., Marzollo, A., & Pettenazzo, A. (2014). High doses of benzodiazepine predict analgesic and sedative drug withdrawal syndrome in paediatric intensive care patients. Acta Pædiatrica. https://doi.org/10.1111/apa.12777
  • Best, K. M., Wypij, D., Asaro, L. A., & Curley, M. A. (2017). Patient, process, and system predictors of iatrogenic withdrawal syndrome in critically ill children. Critical Care Medicine, 45(1), e7–e15. https://doi.org/10.1097/CCM.0000000000001953
  • Burry, L. D., Williamson, D. R., Perreault, M. M., Rose, L., Cook, D. J., Ferguson, N. D., ... Mehta, S. (2014). Analgesic, sedative, antipsychotic, and neuromuscular blocker use in Canadian intensive care units: A prospective, multicentre, observational study. Canadian Journal of Anesthesia, 61(7), 619–630. https://doi.org/10.1007/s12630-014-0174-1
  • Bowe, N. S., Colaianni, C. A., Yamasaki, A., Cummings, B. M., & Hartnick, C. J. (2019). Reevaluating a standardized sedation weaning protocol for pediatric laryngotracheal reconstruction for continuous quality improvement. JAMA Otolaryngology–Head & Neck Surgery, 145(4), 321–327. https://doi.org/10.1001/jamaoto.2018.4348
  • Curley, M. A. Q., Wypij, D., Watson, S., Grant, M. J. C., Asaro, L. A., Cheifetz, I. M., ... Matthay, M. A. (2015). Protocolized sedation vs. usual care in pediatric patients mechanically ventilated for acute respiratory failure: A randomized clinical trial. JAMA, 313(4), 379–389. https://doi.org/10.1001/jama.2014.18399
  • Da Silva, P. S., Reis, M. E., Fonseca, T. S., & Fonseca, M. C. (2016). Opioid and benzodiazepine withdrawal syndrome in PICU patients: Which risk factors matter? Journal of Addiction Medicine, 10(2), 110–116. https://doi.org/10.1097/ADM.0000000000000197
  • Dirican, A. (2021). Tanı testi performanslarının değerlendirilmesi ve kıyaslanması. J Med, 32, 25–30. Erişim adresi: http://www.ctf.istanbul.edu.tr/dergi/online/2001v32/s1/011a4.htm
  • Dokken, M., Rustøen, T., Diep, L. M., Fagermoen, M. S., Huse, R. I., Rosland, G. A., ... Bentsen, G. K. (2021). Iatrogenic withdrawal syndrome frequently occurs in pediatric intensive care without algorithm for tapering of analgosedation. Acta Anaesthesiologica Scandinavica, 65, 928–935. https://doi.org/10.1111/aas.13818
  • Duceppe, M. A., Perreault, M. M., Frenette, A. J., Burry, L. D., Rico, P., Lavoie, A., ... Williamson, D. R. (2019). Frequency, risk factors, and symptomatology of iatrogenic withdrawal from opioids and benzodiazepines in critically ill neonates, children, and adults: A systematic review of clinical studies. Journal of Clinical Pharmacology & Therapeutics, 44(2), 148–156. https://doi.org/10.1111/jcpt.12787
  • Fiser, D. H. (1992). Assessing the outcome of pediatric intensive care. Journal of Pediatrics, 68(1), 68–74. https://doi.org/10.1016/S0022-3476(05)82544-2
  • Franck, L. S., Harris, S. K., Soetenga, D. J., Amling, J. K., & Curley, M. A. Q. (2008). The Withdrawal Assessment Tool–1 (WAT–1): An assessment instrument for monitoring opioid and benzodiazepine withdrawal symptoms in pediatric patients. Pediatric Critical Care Medicine, 9(6). https://doi.org/10.1097/PCC.0b013e31818c8328
  • Franck, L. S., Scoppettuolo, L. A., Wypij, D., & Curley, M. A. Q. (2012). Validity and generalizability of the Withdrawal Assessment Tool-1 (WAT-1) for monitoring iatrogenic withdrawal syndrome in pediatric patients. Pain, 153, 142–147. https://doi.org/10.1016/j.pain.2011.10.003
  • Green, S. M., Roback, M. G., Krauss, B. S., Miner, J. R., Schneider, S., Kivela, P. D., ... Connor, R. E. (2019). Unscheduled procedural sedation: A multidisciplinary consensus practice guideline. Annals of Emergency Medicine, 73, 51. https://doi.org/10.1016/j.annemergmed.2019.02.022
  • Ista, E., Dijk, M., Gamel, C., Tibboel, D., & Hoog, M. (2008). Withdrawal symptoms in critically ill children after long-term administration of sedatives and/or analgesics: A first evaluation. Critical Care Medicine, 36(8), 2427–2432. https://doi.org/10.1097/CCM.0b013e318181600d
  • Özgür, E., Bilgin, C., & Özyurt, B. C. (2018). Turkish validity and reliability of Eustachian tube dysfunction questionnaire-7. Brazilian Journal of Otorhinolaryngology, 84(4), 435–440. https://doi.org/10.1016/j.bjorl.2017.05.001
  • Pollack, M. M., Patel, K. M., & Ruttimann, U. E. (1996). PRISM III: An updated pediatric risk of mortality score. Critical Care Medicine, 24(5), 743–752. https://doi.org/10.1097/00003246-199605000-00004
  • Sanavia, E., Mencía, S., Lafever, S. N., Solana, M. J., & Garcia, M. (2019). Sedative and analgesic drug rotation protocol in critically ill children with prolonged sedation: Evaluation of implementation and efficacy to reduce withdrawal syndrome. Pediatric Critical Care Medicine, 20(12). https://doi.org/10.1097/PCC.0000000000002071
  • Sneyers, B., Duceppe, M. A., Frenette, A. J., Burry, L. D., Rico, P., Lavoie, A., ... Perreault, M. M. (2020). Strategies for the prevention and treatment of iatrogenic withdrawal from opioids and benzodiazepines in critically ill neonates, children, and adults: A systematic review of clinical studies. Drugs, 80, 1211–1223. https://doi.org/10.1007/s40265-020-01338-4
  • Soykök, R., & Kökcü Doğan, A. (2022). Yoksunluk Değerlendirme Aracı-1 (YDA-1)'in Türkçe geçerlik güvenirlik çalışması. (Yüksek Lisans Tezi). İstanbul Medipol Üniversitesi Sağlık Bilimleri Enstitüsü, İstanbul.
  • Şencan, H. (2005). Sosyal ve davranışsal ölçümlerde güvenilirlik ve geçerlik. (s. 787–788). Ankara: Seçkin Yayıncılık. ISBN: 9753478844
  • Volakli, E., Sdougka, M., Mantzafleri, P. E., Tsonidis, C., Kontopoulos, E., & Tsikoulas, I. (2015). Functional outcome following pediatric intensive care: Pediatric Cerebral Performance Category (PCPC) and Pediatric Overall Performance Category (POPC) during a prospective two years follow-up period. The Greek E-Journal of Perioperative Medicine, 13, 2–15.
  • Pena, E. D. (2007). Lost in translation: Methodological considerations in cross-cultural research. Child Development, 78(6), 1255–1264. https://doi.org/10.1111/j.1467-8624.2007.01064.x
  • Sperber, A. D. (2004). Translation and validation of study instruments for cross-cultural research. Gastroenterology, 126, S124–S128. https://doi.org/10.1053/j.gastro.2003.10.016
  • Lawshe, C. H. (1975). A quantitative approach to content validity. Personnel Psychology, 28(4), 563–575. https://doi.org/10.1111/j.1744-6570.1975.tb01393.x
Toplam 24 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm Özgün Araştırma
Yazarlar

Rukiye Soykök Bu kişi benim 0000-0002-1982-024X

Aysel Kökcü Doğan 0000-0003-3312-087X

Proje Numarası .....
Yayımlanma Tarihi 18 Aralık 2024
Gönderilme Tarihi 18 Mart 2023
Kabul Tarihi 22 Şubat 2024
Yayımlandığı Sayı Yıl 2024 Cilt: 40 Sayı: 3

Kaynak Göster

APA Soykök, R., & Kökcü Doğan, A. (2024). Turkish Validity and Reliability Study Of The Deprivation Assessment Tool-1. Ege Üniversitesi Hemşirelik Fakültesi Dergisi, 40(3), 345-355. https://doi.org/10.53490/egehemsire.1267451