Psychometric Analysis of Glasgow Coma Scale Modified by Palma and Cook among Patients Hospitalized in Intensive Care Unit by Untrained Evaluators

Under sedation and over sedation cause several problems for critical care patients. There are no truly validated instruments for monitoring intensive care unit sedation. The purpose of this study was to determine the validity and reliability of Glasgow Coma Scale Modified by Palma and Cook in adult patients hospitalized in intensive care unit by untrained evaluators. The study is analytical. After translating the English version of (GCSC) into persian through international Quality of life assessment method, eight surveyors (principle investigator (PI), six nurses and one resident anesthesiologist), 70 patients hospitalized in Critical Care Unit were selected through purposeful sampling. PI and all investigators evaluated the patients independently and recorded a GCSC score. In addition, the PI marked a 10cm Visual Analog Scale and recorded Richmond sedation agitation score in order to determine of validity GCSC. Evaluators had not received training about Glasgow Coma Scale Modified by Palma and Cook. Interclass correlation coefficient between inter-rater in untrained group for Glasgow Coma Scale Modified by Palma and Cook showed 0.898 and the weighted kappa score for interrater agreement was 0.894with, P>0.001. Also positive and significant (P<0.001) correlations between GCSC score with visual analog scale (r=0.91), with Richmond sedation agitation scale (r=0.897) and with Glasgow Coma (r= 0.897) were observed. Validity and reliability of Glasgow Coma Scale Modified by Palma and Cook for assessing the level of sedation in adult patients hospitalized in intensive care can be approved even by untrained evaluators.