Pressure ulcer prevention: Development and psychometric validation of a knowledge assessment instrument

Beeckman, D.; Vanderwee, K.; Demarré, L.; Paquay, L.; Van Hecke, A.; Defloor, T.

doi:10.1016/j.ijnurstu.2009.08.010

« Previous Next »International Journal of Nursing Studies
Volume 47, Issue 4 , Pages 399-410, April 2010

Pressure ulcer prevention: Development and psychometric validation of a knowledge assessment instrument

D. Beeckman
- Nursing Science, Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
- Department of Bachelor in Nursing, University College Arteveldehogeschool Ghent, Ghent, Belgium
- Corresponding author at: Nursing Science, Ghent University, U.Z. Block A 2nd floor, De Pintelaan 185, B-9000 Ghent, Belgium. Tel.: +32 9 332 36 19; fax: +32 9 332 50 02.
K. Vanderwee
- Nursing Science, Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
L. Demarré
- Nursing Science, Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
L. Paquay
- Wit-Gele Kruis van Vlaanderen, Brussels, Belgium
- Academic Centre for General Practice, KULeuven, Leuven, Belgium
A. Van Hecke
- Nursing Science, Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
T. Defloor
- Nursing Science, Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium

Received 29 April 2009; received in revised form 12 August 2009; accepted 30 August 2009.

Abstract

Background

Profound knowledge of pressure ulcers is important to enable good prevention. Validity and reliability of instruments assessing pressure ulcer knowledge are limited evaluated in previous research.

Aims and objectives

To develop a valid and reliable instrument to assess knowledge of pressure ulcer prevention.

Design

Prospective psychometric instrument validation study.

Methods

An extensive literature review was performed to develop an instrument to assess knowledge of pressure ulcer prevention. Face and content validity were evaluated in a double Delphi procedure by an expert panel of nine trustees of the European Pressure Ulcer Advisory Panel (EPUAP) who each have extensive experience in pressure ulcer care and research (PhD level). A convenience sample of 608 nurses and nursing students from Belgium and The Netherlands participated to evaluate validity of the multiple-choice test items (item difficulty, discriminating index, quality of the response alternatives), construct validity, internal consistency, and stability of the instrument. The data were collected between February and May 2008.

Results

A 26-item instrument was developed, reflecting 6 themes expressing the most relevant aspects of pressure ulcer prevention. The content validity was excellent (CVI=0.78–1.00). Group scores of nurses with a (theoretically expected) high level of expertise were found to be statistically significantly higher than those of participants with (theoretically expected) less expertise (P<0.001). The item difficulty index of the questions ranged from 0.27 to 0.87, while values for item discrimination ranged from 0.29 to 0.65. The quality of the response alternatives was found to be good. The overall internal consistency reliability (Cronbach's α) was 0.77. The 1-week test–retest intraclass correlation coefficient (stability) was 0.88.

Conclusion

The instrument demonstrated acceptable psychometric properties and can be applied in both research and practice for evaluating knowledge about pressure ulcer prevention.

Keywords: Nursing, Pressure ulcers, Prevention, Psychometric, Validity, Reliability, Knowledge, Instrument