{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T21:05:07Z","timestamp":1791579907010,"version":"4.3.4"},"reference-count":24,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,11,29]],"date-time":"2024-11-29T00:00:00Z","timestamp":1732838400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100010805","name":"Forskningsr\u00e5det i Syd\u00f6stra Sverige","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010805","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Anesthesia"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Emergence delirium is a well\u2010known and common problem in children recovering from anesthesia. The five\u2010item Pediatric Anesthesia Emergence Delirium scale is one of the most commonly used instruments for assessing this condition, but the scale has been questioned regarding its latent structure, i.e., whether its items cover just one underlying construct. It has been suggested that the scale's first three items might identify emergence delirium better than the last two.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>The aim of this study was to evaluate the measurement properties of the Pediatric Anesthesia Emergence Delirium scale with a focus on its latent structure and cutoff scores, using appropriate statistical methods for ordinal data.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 350 children under 7\u2009years of age, undergoing adenoidectomy, with or without additional tonsillotomy or minor procedures like paracentesis, tongue\u2010tie release, or cerumen removal, were enrolled in the study. At the recovery unit, emergence delirium and pain were registered.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The confirmatory factor analyses demonstrated that the two\u2010factor model, including <jats:italic>emergence delirium\u2010specific behaviors<\/jats:italic> (first three items) and <jats:italic>emergence delirium\u2010nonspecific behaviors<\/jats:italic> (last two items), established an excellent model fit according to the <jats:italic>\u03c7<\/jats:italic><jats:sup>2<\/jats:sup> goodness\u2010of\u2010fit statistics, Root Mean Square Error of Approximation, Comparative Fit Index, Tucker\u2010Lewis Index, and Standardized Root Mean Square Residual. The ordinal alpha of 0.98 and the ordinal omega of 0.96 supported the internal consistency reliability of the <jats:italic>emergence delirium\u2010specific behaviors.<\/jats:italic> The convergent validity was supported due to a strong correlation between <jats:italic>emergence delirium\u2010nonspecific behaviors<\/jats:italic> and the Face, Legs, Activity, Cry, and Consolability scale. The receiver\u2010operating characteristic curve analyses resulted in two tentative cutoff scores for <jats:italic>emergence delirium\u2010specific behaviors<\/jats:italic>\u00b8 \u2265\u20096 and \u2265\u20098.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The Pediatric Anesthesia Emergence Delirium scale's first three items are a more valid and reliable measure of emergence delirium than its original five items.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pan.15046","type":"journal-article","created":{"date-parts":[[2024,11,29]],"date-time":"2024-11-29T15:28:46Z","timestamp":1732894126000},"page":"155-162","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Measurement Properties of the Pediatric Anesthesia Emergence Delirium Scale: A Confirmatory Factor Analysis\u2010Based Study"],"prefix":"10.1111","volume":"35","author":[{"given":"Jenny","family":"Ringblom","sequence":"first","affiliation":[{"name":"Center for Social and Affective Neuroscience and Department of Biomedical and Clinical Sciences Link\u00f6ping University  Link\u00f6ping Sweden"},{"name":"Department of Anesthesiology and Intensive Care Region Kalmar County  Kalmar Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ingrid","family":"W\u00e5hlin","sequence":"additional","affiliation":[{"name":"Faculty of Health and Life Sciences Linnaeus University  Kalmar Sweden"},{"name":"Department of Research Region Kalmar County  Kalmar Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie","family":"Proczkowska","sequence":"additional","affiliation":[{"name":"Center for Social and Affective Neuroscience and Department of Biomedical and Clinical Sciences Link\u00f6ping University  Link\u00f6ping Sweden"},{"name":"Child and Adolescent Department Psychiatric Clinic, Helgelandssykehuset  Mo i Rana Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Korhonen","sequence":"additional","affiliation":[{"name":"Center for Social and Affective Neuroscience and Department of Biomedical and Clinical Sciences Link\u00f6ping University  Link\u00f6ping Sweden"},{"name":"Department of Child and Adolescent Psychiatry and Department of Biomedical and Clinical Sciences Link\u00f6ping University  Link\u00f6ping Sweden"},{"name":"Barnafrid Link\u00f6ping University  Link\u00f6ping Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristofer","family":"\u00c5restedt","sequence":"additional","affiliation":[{"name":"Faculty of Health and Life Sciences Linnaeus University  Kalmar Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,11,29]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1460-9592.2011.03646.x"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1213\/01.ANE.0000062522.21048.61"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1460-9592.1999.00415.x"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1213\/01.ane.0000250914.91881.a8"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/scs.13011"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/pan.14259"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/pan.13539"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.3389\/fsurg.2021.754591"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-6576.1998.tb05332.x"},{"key":"e_1_2_12_11_1","article-title":"Effects of Sevoflurane Versus Other General Anaesthesia on Emergence Agitation in Children","volume":"9","author":"Costi D.","year":"2014","journal-title":"Cochrane Database of Systematic Reviews"},{"key":"e_1_2_12_12_1","first-page":"145","article-title":"Does the Child Behavior Checklist Predict Levels of Preoperative Anxiety at Anesthetic Induction and Postoperative Emergence Delirium? 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