Turkish Adaptation of the 4AT Delirium Screening Scale: A Validity and Reliability Study

Abstract Background This study aimed to evaluate the psychometric properties, specifically the validity and reliability, of the Turkish version of the 4AT Delirium Screening Tool. Methods This methodological study was conducted in the post-anaesthesia care unit of a public hospital between 1 April and 30 June 2023 with ethics committee approval (2023/025). Data were collected from 188 patients using a demographic form and delirium assessment tools, including the 4AT, CAM-ICU, and DSM-5 criteria. Analyses were performed using SPSS version 27.0. The internal consistency of the 4AT was assessed using KR-20, and its validity was examined using chi-square and ROC analyses. The significance level was set at p < 0.05. Results The 4AT demonstrated strong diagnostic agreement with the CAM-ICU (98.4%) and DSM-5 (98.4%) criteria. Its internal consistency was high (KR-20 = 0.899). In terms of diagnostic performance, the 4AT showed 97.8% sensitivity and 99.3% specificity, with an ROC analysis showing that the 4AT had a high discriminative ability to detect delirium, with an AUC of 0.981. Conclusion These findings indicate that the Turkish version of the 4AT is a valid, reliable, and practical tool for the rapid detection of post-operative delirium in clinical settings. Clinical Trial Registration: NCT06187389