seyyed davood tadrisi
nasrin bahari
abass ebadi
seyyed jalal madani

Aims: in order to review and determine the level of orientation , a standard scale is needed that shows ability the best type level of orientation. According to that in Iran, there are so far no measures the level of orientation Four Score made native. The aim of this study was to confirm the validity and reliability of Four Score scale in adult patients hospitalized in critical care units of Iran. Methods: This study is methodological. After translating the English version of Four Score scale to Persian, ۱۵۵ patients in two trained and untrained evaluators group (۱۲۰ patients in trained evaluators group and ۳۵ patients in untrained group ) hospitalized in critical care units of two hospitals of Tehran city were selected by no probable accessible purposeful sampling method. Six evaluators ( main researcher , four nurse and anesthesia resident) independently and at the same time evaluated the patients. Main researcher and other investigators recorded the level of orientation with Four Score and Glasgow Coma scores. Results: Inter-rater reliability for Four score was "excellent". Interclass correlation coefficient in trained and untrained group was (۰.۹۹۸, ۰/۹۹۳) and the weighted kappa score for inter-rater agreement was (۰.۹۸۱, ۰/۹۸۶). Validity tests showed a high correlation between Four Score with Glasgow Coma scale. (r=۰.۹۸۰, ۰/۹۲۵) (p<; ۰.۰۰۱) Conclusion: Validity and Reliability of Coma Scale (Four Score) are confirmed for assessing in Adult Patient Hospitalized in Critical Care Units in Iran.