Translation, Cultural Adaption and Validation of the Indonesian Version of Withdrawal Assessment Tool Version-1 as a Diagnostic Tool for Iatrogenic Withdrawal Syndrome in Children

Abstract Background Sedative and analgesic medications are commonly administered in the treatment of critically ill children in the Pediatric Intensive Care Unit (PICU). However, their use may result in complications such as Iatrogenic Withdrawal Syndrome (IWS), which poses challenges for diagnosis. The Withdrawal Assessment Tool Version-1 (WAT-1) questionnaire has been proven to be a valid and reliable diagnostic tool for IWS, however it is not yet available in the Indonesian language. Objective To validate and assess the reliability of the Withdrawal Assessment Tool Version-1 questionnaire in the Indonesian language. Methods This study is a prospective observational cross-sectional study that was done in two phases. The initial phase of the study involved translating the WAT-1 instrument into Indonesian. The validity and reliability of the Indonesian version of WAT-1 were tested on 30 patients who received sedative and analgesic medications for at least 5 consecutive days in the PICU Ciptomangunkusumo Hospital, Jakarta, Indonesia. Results The Indonesian version of WAT-1 was proven to be a valid and reliable assessment tool, with an r value in the training nurse above 0.361, and Cronbach's alpha values of 0.708 and 0.716 for assessments by PICU nurses and nurses trained in WAT-1, respectively. The Intraclass Correlation Coefficient (ICC) used to measure the consistency of assessments showed very good (trained nurse group, r = 0.878, 95% CI 0.743–0.942) to excellent (PICU nurse group, r = 0.956, 95% CI 0.886–0.974) values. Conclusion The Indonesian version of WAT-1 is a valid and reliable diagnostic tool.