Inconsistency in the Application of Glasgow Coma Scale in Pediatric Patients.

IF 2.9 3区医学 Q1 MEDICINE, GENERAL & INTERNAL

Medical Principles and Practice Pub Date : 2024-01-01 Epub Date: 2023-10-27 DOI:10.1159/000534797

Maria Caruana, Sophie Noelle Hackenbruch, Victor Grech, Ruth Farrugia

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引用次数: 0

Abstract

Objective: The Glasgow Coma Scale (GCS) is widely used to objectively describe the extent of patients' impaired consciousness. However, there are known variations in scoring GCS both in adults and children which may impact patient management. The aim of this audit was to assess the application of GCS by medical and nursing staff in pediatric medical patients.

Subject and methods: An online questionnaire was distributed amongst doctors and nurses working in the Department of Child and Adolescent Health at Mater Dei Hospital in Malta. The participants assigned GCS for 8 case scenarios involving children of different ages with varying levels of consciousness. Results were analyzed by calculating percentage agreement and by Cronbach's alpha.

Results: Sixty-six participants were studied, with a response rate of 52%. Performance was poor overall, with Cronbach alpha 0.53. Correlation was better at the upper and lower ends of the scale and the worst performance was for verbal response. Only respondents with 5-10 years of experience achieved acceptable consistency in the application of the GCS (Cronbach alpha 0.78).

Conclusion: There is considerable variation in application of GCS in pediatric patients, highlighting the need for education and training to improve consistency for this commonly used neurological assessment tool.

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格拉斯哥昏迷量表在儿科患者中的应用不一致。

目的：格拉斯哥昏迷量表（GCS）被广泛用于客观描述患者意识受损的程度。然而，成人和儿童的GCS评分存在已知的差异，这可能会影响患者的管理。本审计的目的是评估医护人员在儿科医疗患者中应用GCS的情况。主题和方法：在马耳他Mater Dei医院儿童和青少年健康部的医生和护士中分发了一份在线问卷。参与者将GCS分为8种情况，涉及不同年龄、不同意识水平的儿童。结果通过计算百分比一致性和Cronbachα进行分析。结果：66名参与者接受了研究，有效率为52%。整体表现不佳，Cronbachα为0.53。在量表的上端和下端，相关性更好，表现最差的是言语反应。只有具有5-10年经验的受访者在GCS的应用方面达到了可接受的一致性（Cronbach alpha 0.78）。结论：儿童患者在GCS应用方面存在相当大的差异，这突出了教育和培训的必要性，以提高这一常用神经评估工具的一致性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Medical Principles and Practice 医学-医学：内科

CiteScore

6.10

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： ''Medical Principles and Practice'', as the journal of the Health Sciences Centre, Kuwait University, aims to be a publication of international repute that will be a medium for dissemination and exchange of scientific knowledge in the health sciences.