Validation of Amharic Version of Confusion Assessment Method for Intensive Care Unit (CAM-ICU) among patients admitted to ICU at two centers in Addis Ababa, Ethiopia: A cross-sectional prospective study
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Date
2024-05
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Addis Ababa University
Abstract
Background: Confusion Assessment Method for Intensive Care Unit (CAM-ICU) is a widely
accepted, easily available, and quick tool for assessment of delirium in ICU. Globally, multiple
studies had been conducted to cross culturally translate and validate the tool in order to make it
fit to the local setting. However, to the best of the author knowledge, it has not been cross-
culturally translated and validated into Amharic language. Therefore this study aims to bridge the
gap.
Objective: The study aimed to assess the Validity of Amharic Version of Confusion Assessment
Method for Intensive Care Unit (CAM-ICU) among patients admitted to adult ICU in two
centers in Addis Ababa, Ethiopia.
Method and materials: Institution based prospective cross-sectional study was conducted at the
intensive care unit of Tikur Anbessa specialized hospital and Menelik-II hospital. A total of 132
eligible patients were included in the study. Data were collected by Nurses and resident
physician using Google form from 1-December-2023 to 30-April-2024. Data analysis was done
using to SPSS V.27. Descriptive analyses were done using frequency and percentage for
categorical variables and mean with standard deviation for continuous variables. Reliability,
inter-rater reliability (k), and acceptability of the tool was assessed.
Result: Translation to Amharic version was done by group of experts including
anesthesiologists, psychiatrists, language experts, and the primary investigator ensuring content
and face validity. A total of 132 patients participated in this study with a response rate of
95.65%. The Amharic version of CAM-ICU had high acceptance (100%), good reliability
(Cronbach’s alpha=0.718), and substantial inter-rater agreement (k=0.762). 11(8.3%) and
7(5.3%) patients were diagnosed with delirium by doctors and nurses respectively using CAM-
ICU Amharic. Moreover, 7(5.3%) patients were diagnosed with delirium concurrently by both
physicians and nurses.
Conclusion: Amharic version of CAM-ICU is an acceptable, valid, and reliable tool to assess
delirium in ICU. Utilization of CAM-ICU Amharic in clinical practice after provision of proper
training would enable better detection of delirium in ICU.
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Keywords
Validation, CAM-ICU, Amharic version, Delirium, TASH, Menelik-II, Ethiopia