Bates-Jensen B M, McNees P
Ostomy Wound Manage. 1995 Aug;41(7A Suppl):80S-86S; discussion 87S.
There is general agreement regarding the need for pressure ulcer assessment methodology which more discretely reflects relevant aspects of wound status than does the commonly used staging system. The Pressure Sore Status Tool (PSST) is one such instrument which was developed with consensual expert input. While the psychometric properties of the PSST have been reported in the literature, the instrument was validated using ET nurses, highly trained wound care specialists, and existed only in manual form. This paper reports results from attempts to establish reliability estimates for healthcare practitioners without extraordinary wound care training or experience. The paper further describes the automation of the PSST and provides examples of pressure ulcer profiles tracked over time. Results indicate that inter-rater reliability with general healthcare practitioners was .78 and intra-rater reliability was .89. The practitioners were able to use the PSST for over six months and the automated system allowed analysis of wound healing profiles that would have been difficult using a manual system. These results imply that movement toward an automated system which makes discriminations regarding the effects of various treatment and intervention strategies is possible and practical.
对于压力性溃疡评估方法的必要性，人们已达成普遍共识，这种方法要比常用的分期系统更能精准反映伤口状况的相关方面。压力性溃疡状态工具（PSST）就是这样一种在专家共识基础上开发的工具。虽然文献中已报道了PSST的心理测量特性，但该工具是通过急诊护士、训练有素的伤口护理专家进行验证的，且仅以手动形式存在。本文报告了针对未经特殊伤口护理培训或经验的医护人员进行可靠性评估的尝试结果。本文还进一步描述了PSST的自动化过程，并提供了随时间跟踪的压力性溃疡概况示例。结果表明，普通医护人员之间的评分者间信度为0.78，评分者内信度为0.89。这些医护人员能够使用PSST超过六个月，并且自动化系统能够分析使用手动系统难以实现的伤口愈合概况。这些结果表明，朝着能够区分各种治疗和干预策略效果的自动化系统发展是可行且实际的。
