Abstract

Aim.The aim of this study was to modify and validate FOUR coma scale.

Background.Critically ill patients  admitted to the intensive care unit (ICU) have fluctuating levels of consciousness. It is necessary to have a valid scale to provide an appropriate care of these patients. Presently, the Glasgow coma scale (GCS) is widely used but it has some problems. Recently, the FOUR coma scale proposed to determine the level of consciousness and it is gradually gaining wide acceptance.

Method.This study is a methodological research. After translation and modification of FOUR com scale, the final version used for determining validity. For evaluating convergent construct validity, the original and modified FOUR scale compared with the APACHE II in 15 intensive care unit patients and using 40 critical care nurses by 104 pair-wise ratings.

Findings.Correlation of original and modified FOUR Coma scales with APACHE II was 0.02 and -0.04, respectively. Regression of original and modified FOUR scales with APACHE II was 0.03 and 0.3, respectively.

Conclusion.The FOUR scale doesn't have an item for those intubated patients who are not connected to ventilator. It seems that replacing new item in respiratory section of the scale could increase the validity of FOUR scale.