Kohta Masushi, Ohura Takehiko, Okada Katsuyuki, Nakamura Yoshinori, Kumagai Eiko, Kataoka Hitomi, Kitagawa Tomomi, Kameda Yuki, Kitte Toshihiro
Medical Engineering Laboratory, ALCARE Co. Ltd., Tokyo, Japan.
Pressure Ulcers and Wound Healing Research Center, Sapporo, Japan.
J Multidiscip Healthc. 2021 Feb 2;14:207-217. doi: 10.2147/JMDH.S294734. eCollection 2021.
The Pressure Injury Primary Risk Assessment Scale for Home Care (PPRA-Home) was developed to predict pressure injury risk in geriatric individuals requiring long-term care in home settings. This study aimed to compare the convergent validity of the PPRA-Home to that of the two other standardized pressure injury prevention scales: the Braden and Ohura-Hotta (OH) scales.
A multicenter, cross-sectional study was conducted with 34 home-based geriatric support service providers located in five Japanese districts. The study included 69 participants (30 had a pressure injury and 39 did not) who were at classified at care levels of 1 through 5 under Japan's long-term care insurance system. Care managers served as assessors for the PPRA-Home, while physicians or certified expert nurses served as assessors for the Braden and OH scales. Convergent validity was investigated by examining correlation coefficients between total scores on the PPRA-Home and the other two scales. Receiver operating curve analysis was used to quantify each scale's accuracy for the two groups: those with and without a pressure injury.
The PPRA-Home was found to be negatively correlated with the Braden scale (r=-0.79, p<0.05), and positively correlated with the OH scale (r=0.58, p<0.05). The area under the curve (AUC) for the PPRA-Home, Braden scale, and OH scale were 0.737, 0.814, and 0.794, respectively. A PPRA-Home cutoff score of 4 had a sensitivity of 63.3% and specificity of 81.6%.
The AUC for the PPRA-Home as scored by care managers was similar to those of the Braden and OH scales as scored by physicians or expert nurses. More research on the PPRA-Home's content and predictive validity is required.
开发居家护理压力性损伤初级风险评估量表(PPRA-Home)以预测居家环境中需要长期护理的老年人发生压力性损伤的风险。本研究旨在比较PPRA-Home与另外两种标准化压力性损伤预防量表(Braden量表和大村-堀田(OH)量表)的收敛效度。
在日本五个地区的34个居家老年支持服务提供商中进行了一项多中心横断面研究。该研究纳入了69名参与者(30名有压力性损伤,39名没有),他们在日本长期护理保险系统下被分类为1至5级护理水平。护理管理人员作为PPRA-Home的评估者,而医生或认证专家护士作为Braden量表和OH量表的评估者。通过检查PPRA-Home总分与其他两个量表总分之间的相关系数来研究收敛效度。采用受试者工作特征曲线分析来量化每个量表对两组(有压力性损伤和无压力性损伤)的准确性。
发现PPRA-Home与Braden量表呈负相关(r = -0.79,p < 0.05),与OH量表呈正相关(r = 0.58,p < 0.05)。PPRA-Home、Braden量表和OH量表的曲线下面积(AUC)分别为0.737、0.814和0.794。PPRA-Home的临界值为4时,灵敏度为63.3%,特异度为81.6%。
护理管理人员评分的PPRA-Home的AUC与医生或专家护士评分的Braden量表和OH量表的AUC相似。需要对PPRA-Home的内容和预测效度进行更多研究。