Inter-Rater Reliability and User-Friendliness of the Delirium Observation Screening Scale

Abstract

Background and Purpose: Delirium is a common and often unrecognized complication of hospitalized elderly patients. Currently, there is no evidence for inter-rater reliability studies between registered nurses in the literature. Furthermore, the user-friendliness of the Delirium Observation Screening Scale (DOSS) has not been tested in Austria. Methods: A quantitative cross-sectional design with a convenience sample of 141 patients and 36 nurses in an Austrian hospital. Results: Analysis of rater-agreement and inter-rater reliability on item level, total score as well as category of delirium risk demonstrated very high agreement. In contrast, no or only fair kappa coefficient were determined. The user-friendliness of the scale was partially satisfactory. Conclusions: The very high absolute agreement speaks for the reliability of DOSS although the kappa paradox became obvious. The results of the presented study relate only to the tested setting.