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To assess and identify early sign as well as to follow up the progress or regress of acute confusion are important in nursing care. For this purpose different instruments have been developed and tested psychometrically. One of these instruments is the NEECHAM Confusion Scale. The aim of this article is to describe the development and content of the NEECHAM Confusion Scale and its application in a Swedish sample. This scale is a screening instrument for rapid and non-intrusive assessment and contains nine items organized in three domains; cognitive functions; behavioral measures; physiological control and stability. Possible total score ranging from 0 (minimal responsiveness) to 30 (normal function). A score equal to or less than 24 indicated the presence of confusion. The scale has been psychometrically tested among elderly patients with hip fractures in Sweden. The internal consistency (Cronbach´s alpha coefficient) was satisfactory at two test occasions .73 versus .82 and the construct validity with a three-factor solution accounted for 69% and 73% of the variance. Four months after discharge the predictive value showed a correlation between level of confusion, quality of life, and functional capacity. The study and the literature confirmed that the NEECHAMscale can be helpful both for patients with delirium and those responsible of the care.

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