Maylor Miles E
Tissue Viability, Oxford Radcliffe NHS Trust, John Radcliffe Hospital, UK.
Br J Nurs. 2006;15(6):S26-31. doi: 10.12968/bjon.2006.15.Sup1.20689.
This article challenges recommendations to adapt a pressure ulcer risk assessment scale (RAS) according to the clinical context. The transformation of the Cubbin and Jackson (1991) RAS is used to illustrate problems in scale development. When new factors are added to an existing scale, this can lead to unnecessary complexity. When words are changed by a person developing a scale this illustrates their differing beliefs and value judgements. Arbitrary scores for factors are misleading and in some cases mystifying, yet appear to be objective. This article suggests that the relationship between sub-scales and the whole scale have not been adequately accounted for -- they can't simply be added up arithmetically. The paradox of risk is debated, namely, that the more something is thought to be a risk, the less risky it becomes. RASs should be replaced by risk reduction scales linking a risk factor with its outcome following intervention.
本文对根据临床背景调整压疮风险评估量表（RAS）的建议提出了质疑。以Cubbin和Jackson（1991）风险评估量表的转变为例来说明量表开发中存在的问题。当在现有量表中添加新因素时，可能会导致不必要的复杂性。量表开发者对用词的改变体现了他们不同的信念和价值判断。因素的任意评分具有误导性，在某些情况下甚至令人费解，但却看似客观。本文指出，子量表与整个量表之间的关系尚未得到充分考量——它们不能简单地进行算术相加。文中对风险的悖论进行了讨论，即某事物被认为风险越高，其实际风险反而越低。风险评估量表应由将风险因素与干预后的结果联系起来的风险降低量表所取代。
