Lindgren Margareta, Unosson Mitra, Krantz Ann-Margret, Ek Anna-Christina
Department of Medicine and Care, Division of Nursing Science, Faculty of Health Sciences, Linköping, Sweden.
J Adv Nurs. 2002 Apr;38(2):190-9. doi: 10.1046/j.1365-2648.2002.02163.x.
The ability to assess the risk of a patient developing pressure sores is a major issue in pressure sore prevention. Risk assessment scales should be valid, reliable and easy to use in clinical practice.
To develop further a risk assessment scale, for predicting pressure sore development and, in addition, to present the validity and reliability of this scale.
The risk assessment pressure sore (RAPS) scale, includes 12 variables, five from the re-modified Norton scale, three from the Braden scale and three from other research results. Five hundred and thirty patients without pressure sores on admission were included in the study and assessed over a maximum period of 12 weeks. Internal consistency was examined by item analysis and equivalence by interrater reliability. To estimate equivalence, 10 pairs of nurses assessed a total of 116 patients. The underlying dimensions of the scale were examined by factor analysis. The predictive validity was examined by determination of sensitivity, specificity and predictive value.
Two variables were excluded as a result of low item-item and item-total correlations. The average percentage of agreement and the intraclass correlation between raters were 70% and 0.83, respectively. The factor analysis gave three factors, with a total variance explained of 65.1%. Sensitivity, specificity and predictive value were high among patients at medical and infection wards.
The RAPS scale is a reliable scale for predicting pressure sore development. The validity is especially good for patients undergoing treatment in medical wards and wards for infectious diseases. This indicates that the RAPS scale may be useful in clinical practice for these groups of patients. For patients undergoing surgical treatment, further analysis will be performed.
评估患者发生压疮风险的能力是压疮预防中的一个主要问题。风险评估量表应在临床实践中有效、可靠且易于使用。
进一步开发一种用于预测压疮发生的风险评估量表，并展示该量表的有效性和可靠性。
压疮风险评估（RAPS）量表包括12个变量，其中5个来自重新修订的诺顿量表，3个来自布拉德恩量表，3个来自其他研究结果。纳入530例入院时无压疮的患者，最长评估12周。通过项目分析检验内部一致性，通过评分者间信度检验等效性。为评估等效性，10对护士共评估了116例患者。通过因子分析检验量表的潜在维度。通过确定敏感性、特异性和预测值来检验预测效度。
由于项目间和项目与总分的相关性较低，排除了两个变量。评分者之间的平均一致百分比和组内相关系数分别为70%和0.83。因子分析得出三个因子，共解释总方差的65.1%。在内科和感染病房的患者中，敏感性、特异性和预测值较高。
RAPS量表是一种可靠的预测压疮发生的量表。其有效性在接受内科治疗的患者和传染病病房的患者中尤其良好。这表明RAPS量表在临床实践中可能对这些患者群体有用。对于接受手术治疗的患者，将进行进一步分析。
