Evidence map›Paper›PMID 38508739›Full record

Observational studyNursing in critical care2025

Inter-rater reliability in the assessment of consciousness in patients receiving palliative care in intensive care: A prospective cross sectional observational study.

Dilek Yildirim, Arzu Kavala, Seda Değirmenci Öz, Esra Sezer, Emre Kuğu, Zeynep Coşkun

Abstract readObservational Study
In one paragraph

Observational study in Nursing in critical care, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Dilek YildirimFaculty of Health Sciences, Department of Nursing, Istanbul Aydın University, Istanbul, Turkey.ORCID https://orcid.org/0000-0002-6228-0007
Arzu KavalaFaculty of Health Sciences, Department of Nursing, Istanbul Aydın University, Istanbul, Turkey.ORCID https://orcid.org/0000-0001-8817-0511
Seda Değirmenci ÖzFaculty of Health Sciences, Department of Nursing Administration, Zonguldak Bülent Ecevit University, Zonguldak, Turkey.ORCID https://orcid.org/0000-0002-4790-9639
Esra SezerFaculty of Health Sciences, Department of Nursing, Acibadem University, Istanbul, Turkey.ORCID https://orcid.org/0000-0002-5310-2575
Emre KuğuVocational School of Health Services, Department of Medical Services and Techniques, Anesthesia Programme, Fenerbahçe University, Istanbul, Turkey.ORCID https://orcid.org/0000-0002-9345-4727
Zeynep CoşkunMedical Park Florya Hospital, Istanbul Aydin University, Istanbul, Turkey.ORCID https://orcid.org/0000-0002-7398-3111

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe Glasgow Coma Scale (GCS) is one of the methods that has validity for evaluating the consciousness levels of patients in the literature and is accepted by health authorities.

aimThe purpose of this study was to evaluate the inter-rater reliability of GCS in intensive care patients receiving palliative care. STUDY

designA prospective cross sectional observational study. The study was conducted in a general intensive care unit with 20 beds with patients receiving palliative care. In the unit, 18 nurses worked in two shifts, day and night. Each patient's primary palliative care nurse and two additional researchers were given one minute to independently record the patient's GCS total and subscale scores. All observations were completed within 5 min as there could be significant changes in the patient's GCS score during observations.

resultsA total of 258 assessments were completed. For the GCS total scoring, a moderate agreement was found between palliative care nurses and the first researcher-observer (49.0%) and also between palliative care nurses and the second researcher-observer (47.7%). In addition, there was a substantial agreement between the first and second researchers (78.9%) and also between all observers (61.5%) (all p = .001).

conclusionsAlthough there was a near-perfect agreement between the two researcher-observers, we found only moderate agreement among all observers (palliative care nurses and two researcher-observers) in the evaluation of GCS total and subscale scores. RELEVANCE TO CLINICAL PRACTICE: We found that lack of knowledge and training on the standardized use of GCS is still a problem for palliative and intensive care units. Because of the diversity of patients requiring GCS assessment in palliative care units, refresher training programs and hands-on workshops on consciousness assessment should be organized regularly for more experienced nurses.

Indexed as

ConsciousnessCritical CareGlasgow Coma ScalePalliative CareAdultAgedCritical Care NursingCross-Sectional StudiesFemaleHumansIntensive Care UnitsMaleMiddle AgedObserver VariationProspective StudiesReproducibility of Resultscare managementconsciousnessGlasgow Coma Scaleintensive carepalliative care

Identifiers

PMID38508739
PMCPMC12305481

What Socratic holds

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.