Transcultural and linguistic adaptation of the Richmond Agitation-Sedation Scale to Spanish
Introduction: Goal oriented sedation is standard in the management of critically ill patients, but its systematic evaluation is not frequent. The Richmond agitation sedation scale's efficient operative features make it a validated instrument for sedation assessment.
Objectives: To translate and validate the Richmond agitation sedation scale into Spanish.
Method: A cultural and linguistic adaptation study was designed. Translation into Spanish included back-translation and pilot testing. The inter-rater reliability testing was conducted in Clínica Colombia's cardiovascular and general intensive care unit, including 100 patients mechanically ventilated and sedated. Inter-rater reliability was tested using Kappa statistics and Intra-class correlation coefficient. This study was approved by Fundación Universitaria Sanitas Research and Ethics Institute and Clínica Sanitas Research Committee.
Results: 300 assessments using the Spanish version of the Richmond agitation sedation scale were performed by three independent evaluators. The intra-class correlation coefficient was 0.977 (CI 95% 0.968-0.984). The kappa was 0.84 between the first and second evaluators 0.85 between the first and third evaluators and 0.86 between the second and third evaluators.
Conclusion: The product of this study, the Spanish version of the Richmond agitation sedation scale, is conceptually equivalent to the original scale, being reproducible and understandable to physicians whose native language is Spanish.
2. Hughes CG, McGrane S, Pandharipande PP. Sedation in the intensive care setting. Clin Pharmacol. 2012;4:53-63.
3. Tung A, Rosenthal M. Patients requiring sedation. Crit Care Clin. 1995;11:791-802.
4. Godet G, Gossens S, Prayssac P, Daghfous M, Delbrouck D, Aigret D, et al. Infusion of propofol, sufentanil, or midazolam for sedation after aortic surgery: comparison of oxygen consumption and hemodynamic stability. Anesth Analg. 1998;87:272-6.
5. Sánchez-Izquierdo JA, Alted E, Borges M, Sandumiege A. Sedoanalgesia-relajación en la Unidad de Cuidados Intensivos. Situación en España. Med Intensiva. 1998;22:1-6.
6. Cai Y, Li Y, Ji M, Yang H, Zhang Q, Jin Z. The effect of mild sedation on the prognosis and inflammatory markers in critical patients with mechanical ventilation. Zhonghua Jie He He Hu Xi Za Zhi. 2014;37:820-3.
7. Kollef MH, Levy NT, Ahrens TS, Schaiff R, Prentice D, Sherman G. The use of continuous i.v. sedation is associated with prolongation of mechanical ventilation. Chest. 1998;114:541-8.
8. Hodgson C, Bellomo R, Berney S, Bailey M, Buhr H, Denehy L, et al. Early mobilization and recovery in mechanically ventilated patients in the ICU: a bi-national, multi-centre, prospective cohort study. Crit Care. 2015;19:81.
9. Botha J, Le Blanc V. The state of sedation in the nation: results of an Australian survey. Crit Care Resusc. 2005;7:92-6.
10. Thuong M. Sedation and analgesia assessment tools in ICU patients. Ann Fr Anesth Reanim. 2008;27:581-95.
11. Sneyers B, Laterre PF, Perreault MM, Wouters D, Spinewine A. Current practices and barriers impairing physicians' and nurses' adherence to analgo-sedation recommendations in the intensive care unit - a national survey. Crit Care. 2014;18:655-67.
12. Gjersing L, Caplehorn JR, Clausen T. Cross-cultural adaptation of research instruments: language, setting, time and statistical considerations. BMC Med Res Methodol. 2010; 10:13.
13. Ely EW, Truman B, Shintani A, Thomason JW, Wheeler AP, Gordon S, et al Monitoring sedation status over time in ICU patients: reliability and validity of the Richmond Agitation-Sedation Scale (RASS). JAMA. 2003;289:2983-91.
14. Sessler CN, Gosnell MS, Grap MJ, Brophy GM, O'Neal PV, Keane KA, et al. The Richmond Agitation-Sedation Scale: validity and reliability in adult intensive care unit patients. Am J Respir Crit Care Med. 2002;166:1338-44.
15. Chanques G, Jaber S, Barbotte E, Verdier R, Henriette K, Lefrant JY, et al. Validation of the french translated Richmond vigilance-agitation scale. Ann Fr Anesth Reanim. 2006;25:696-701.
16. Almgren M, Lundmark M, Samuelson K. The Richmond Agitation-Sedation Scale: translation and reliability testing in a Swedish intensive care unit. Acta Anaesthesio Scand. 2010;54:729-35.
17. Nassar Junior AP, Pires Neto RC, de Figueiredo WB, Park M. Validity, reliability and applicability of Portuguese versions of sedation-agitation scales among critically ill patients Sao Paulo Med J. 2008;126:215-9.
18. Wild D, Grove A, Martin M, Eremenco S, McElroy S, Verjee-Lorenz A, et al. Principles of Good Practice for the Translation and Cultural Adaptation Process for Patient-Reported Outcomes (PRO) Measures: report of the ISPOR Task Force for Translation and Cultural Adaptation. Value Health. 2005;8:94-104.
19. Ramsay M. El costo biológico de la depresión de la conciencia. Rev Colomb Anestesiol. 2015;43:119-21.
20. Moreno H. No es tan sencillo como «Te pondré a dormir»: una perspectiva neurobiológica sobre la sedación. Rev Colomb Anestesiol. 2015;43:173-5.
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