ARTICLE INFO

Article Type

Descriptive & Survey Study

Authors

Alemi   A. (1)
Moradi Dolab   Z. (*)
Delshad Noghabi   A. (2)
Hamzei   A. (3)






(*) “Student Research Committee” and “Nursing Department, Nursing & Midwifery Faculty”, Gonabad University of Medical Sciences, Gonabad, Iran
(1) “Social Determinants of Health Research Centre” and “Social Medicine Department, Medicine School”, Gonabad University of Medical Sciences, Gonabad, Iran
(2) Social Development & Health Promotion Research Center, Gonabad University of Medical Science, Gonabad, Iran
(3) Anesthesia & Operating Room Department, Paramedical Faculty, Gonabad University of Medical Sciences, Gonabad, Iran

Correspondence

Address: Deputy of Education & Research, Gonabad University of Medical Sciences, Near Asian Road, Gonabad, Iran
Phone: +985136050376
Fax: +985342222806
zmd445@yahoo.com

Article History

Received:  June  16, 2015
Accepted:  December 23, 2015
ePublished:  March 5, 2016

BRIEF TEXT


… [1-11] Visual Analogue Scales (VAS) is a scale from zero to 10 units [12], which is simple, and is often used as a scale for measuring the pain intensity [13]. Sedation-Agitation Scale (SAS), which was designed by Riker, is one of the most widely used scales, and its reliability and validity in patients with and without mechanical ventilation has been approved in internal ICUs and surgeries [11]. … [14, 15] The use of this scale does not require specialized skills and complicated knowledge [16, 17].

Visual Analogue Scales (VIS) has a high correlation [1, 10, 14, 15]. Reliability and validity of Sedation-Agitation Scale (SAS) has been confirmed [7], and its validity has been, also, investigated in Iran which has been excellent [18].

This study aimed to assess sedation in intensive care unit patients with Sedation-Agitation Scale (SAS) and comparing its results with Visual Analogue Scale (VAS).

This research is a correlation study.

Male and female patients admitted to seven intensive care units (neurology, neurosurgery, ICU, general adult medicine, internal, surgery, and obstetrics) in Ghaem Hospital (a referral hospital in Mashhad) were studied in 2015.

106 patients were selected and investigated by quota sampling method.

A Persian version of Sedation-Agitation Scale (SAS), which has been translated and validated in form of International Quality of Life Assessment (IQOLA) [9-21] in Iran [18], was used to assess the participants` sedation. Visual Analogue Scale (SAS) was used as the criterion scale [1, 10, 15]. In order to determine the formal validity of Persian version of SAS, this scale was presented to four specialists and 16 nurses of intensive care unit. In order to investigate the content validity of the questionnaire quantitatively, Content Validity Index (CVI) was used based on Waltz and Basel content validity index. First, the patient was observed for 30 seconds to determine the level of awareness and alertness as well as openness or closeness of the eyes. If the patients were not awake, the researcher called them with their real name aloud to open their eyes and look at the researcher, and if they did not open their eyes, the researcher repeated this action for three times. If no reaction was observed from the patients, besides calling the patients, the researcher was instigating them by physical touch in form of moving the shoulders at first and then by rubbing the sternum. In order to investigate the patients` moving status, they were asked to do simple tasks such as turning heads, squeezing the fingers of the researcher, and raising the hands. In case of no response from the patient, the patients` sternum was rubbed; and based on patients` moving, a score was given to them. Evaluation was performed within 2 minutes and the patients should not have been taken 10 minutes before the evaluation process under any invasive process such as airway suctioning, and the replacement of vascular catheters, inserted nasogastric tube and changing their position [1, 10, 15, 21, 22]. The researcher was simultaneously giving the score to 10 cm VAS which was considered as a criterion scale in the research. A questionnaire was used to record demographic characteristics of the patients including age, sex, duration of stay in intensive care unit, use or non-use of tranquilizers and analgesic drugs in past 8 hours, the use of drugs as continuous or bolus, diagnosis, etc. For data analysis, SPSS 20 software was used and the mean, standard deviation, median, and percentile quarter (quartile) of SAS data was calculated. In order to determine the correlation between SAS and standard visual test, Spearman correlation coefficient test was used [5]. … [23]

The mean age of patients was 61.58 ± 18.38 years and 57 of the patients were female. 46 patients had been intubated, and 29 of them were using drugs; 27 were using tranquilizers (Table 1). A significant and positive correlation was observed between SAS and Vas (p<0.001; r=0.824). The highest score in SAS scale (6 scores) was equivalent to score 3 in VAS scale, and in general with the increase of score in SAS, the VAS score was, also, increased (Table 2).

The results of this study are similar to the research conducted by Riker et al. on 39 adult patients undergoing cardiac surgery on their arrival at ICU, in three stages and by a trained researcher and another nurse; and an excellent correlation (r= 0.91) has been observed between two scales including SAS and VAS [14]. A significant correlation has been observed between two scales (r= 0.71) [24]. In 192 adult patients in ICU in internal, surgery, heart surgery, heart and nerves departments, a significant correlation has been obtained with Visual Analogue Scale (r= 0.93) [5]. Also, this research had similar results to the studies conducted about sedation scales validity in Iran [9]. In adult patients admitted to the ICU, 120 hospitalized patients at intensive care unit were selected; and there was a high correlation between Ramsay sedation scale and VAS (r=0.978) [1]. In 120 patients admitted to intensive care unit of one hospital in Tehran, a good correlation has been observed with the VAS scale (r= 0.861) [10].

Sedation assessment should be done on the night shift as well.

SAS scale is dependent on vision and hearing of the patients and it is not suitable for patients with such defects.

Sedation-Agitation and Visual Analogue scales are highly correlated in sedation assessment. Therefore, SAS can be used as a valid tool in the healthcare sector.

Intensive care unit staff of Ghaem Hospital of Mashhad is appreciated.

Non-declared

The study was approved by Ethics Committee of Gonabad University of Medical Sciences (Gmu REC 2014).

This study was funded by Council of Graduate Studies and Research Council of Gonabad University of Medical Sciences.

TABLES and CHARTS

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CITIATION LINKS

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