Colombian translation and cultural adaptation of the Pediatric Anesthesia Emergence Delirium scale

Introduction: Emergence delirium is a state of mental dissociation which occurs in children as they emerge from anesthesia. Its incidence ranges between 10% and 80% and is associated with neurotoxicity, prolonged hospital stay, self-harm and heteroaggressiveness. To date, the Pediatric Anesthesia Emergence Delirium (PAED) scale is the best studied tool for diagnosing this condition. Objective: Given the lack of a similar tool for the Colombian context, the aim of this study was to translate and culturally adapt the PAED scale in Spanish. Methods: Prospective study with a mixed (quantitative and qualitative) methodology approach consisting of three phases. Phase 1 comprised the translation into Spanish of the PAED tool and its cultural adaptation to the Colombian context. Phase 2 consisted of expert validations. Phase 3 consisted of a pilot test using the final version of the scale, during which two trained observers used the tools during the consecutive assessment of 49 pediatric patients in a hospital post-anesthetic care unit. Parametric statistics were used to analyze the information. Results: With moderate to near-perfect agreement, the translation and cultural adaptation process was validated by expert judgement in order to obtain the final Spanish version of the PAED scale. In the pilot test, inter-observer agreement ranged from acceptable to near-perfect (Cohen’s k 0.29-0.95; p: 0.001) for the tool’s assessment categories. Absolute agreement obtained for the diagnosis of emergence delirium based on the adapted PAED scale was excellent, with an ICCA (absolute agreement) of 0.82 (0.69–0.90) to 0.92 (0.846–0.96). Conclusion: A Spanish version of the PAED scale culturally adapted to the Colombian context was validated by expert judgement and shown to be useful in the clinical setting.