Development and psychometric property testing of a skin tear knowledge assessment instrument (OASES) in 37 countries

Hanne Van Tiggelen; Paulo Alves; Elizabeth Ayello; Carina Bååth; Sharon Baranoski; Karen Campbell; Ann Marie Dunk; Mary Gloeckner; Heidi Hevia; Samantha Holloway; Patricia Idensohn; Ayişe Karadağ; Diane Langemo; Kimberly LeBlanc; Karen Ousey; Andrea Pokorná; Marco Romanelli; Vera Lucia Conceição de Gouveia Santos; Steven Smet; Ann Williams; Kevin Woo; Ann Van Hecke; Sofie Verhaeghe; Dimitri Beeckman

doi:10.1111/jan.14713

Development and psychometric property testing of a skin tear knowledge assessment instrument (OASES) in 37 countries

J Adv Nurs. 2021 Mar;77(3):1609-1623. doi: 10.1111/jan.14713. Epub 2020 Dec 10.

Authors

Hanne Van Tiggelen¹, Paulo Alves², Elizabeth Ayello^{3

4

5}, Carina Bååth^{6

7}, Sharon Baranoski⁸, Karen Campbell⁹, Ann Marie Dunk^{10

11}, Mary Gloeckner¹², Heidi Hevia¹³, Samantha Holloway¹⁴, Patricia Idensohn^{14

15

16}, Ayişe Karadağ¹⁷, Diane Langemo^{18

19}, Kimberly LeBlanc^{9

20

21}, Karen Ousey^{22

23

24}, Andrea Pokorná^{25

26}, Marco Romanelli²⁷, Vera Lucia Conceição de Gouveia Santos^{28

29}, Steven Smet^{1

30}, Ann Williams³¹, Kevin Woo^{9

32}, Ann Van Hecke^{33

34}, Sofie Verhaeghe^{33

35}, Dimitri Beeckman^{1

23

36

37

38}

Affiliations

¹ Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.
² Centre for Interdisciplinary Research in Health, Institute of Health Sciences, Catholic University of Portugal, Porto, Portugal.
³ Advances in Skin & Wound Care, Philadelphia, Pennsylvania, USA.
⁴ Faculty Emeritus, School of Nursing, Excelsior College, Albany, New York, USA.
⁵ Ayello, Harris & Associates, Inc., Copake, New York, USA.
⁶ Department of Health Sciences, Faculty of Health, Science and Technology, Karlstad University, Karlstad, Sweden.
⁷ Faculty of Health and Welfare, Østfold University College, Fredrikstad, Norway.
⁸ Nursing Advisory Board, Rasmussen College, Romeoville/Joliet, Illinois, USA.
⁹ School of Physical Therapy, Faculty of Health Sciences, Western University, London, Ontario, Canada.
¹⁰ Tissue Viability Unit, Canberra Health Services, Canberra Hospital, Canberra, ACT, Australia.
¹¹ Synergy Nursing and Midwifery Research Centre, Faculty of Health, University of Canberra and ACT Health, Canberra, ACT, Australia.
¹² UnityPoint Health Trinity, Rock Island, Illinois, USA.
¹³ Nursing School, Nursing Department, Andres Bello University, Santiago, Chile.
¹⁴ Centre for Medical Education, School of Medicine, College of Biomedical and Life Sciences, Cardiff University, Wales, UK.
¹⁵ CliniCare Medical Centre, Ballito, South Africa.
¹⁶ School of Nursing, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa.
¹⁷ School of Nursing, Koç University, Istanbul, Turkey.
¹⁸ College of Nursing, University of North Dakota, Grand Forks, North Dakota, USA.
¹⁹ Langemo and Associates, Grand Forks, North Dakota, USA.
²⁰ Wound Ostomy Continence Institute/Association of Nurses Specialized in Wound Ostomy Continence, Ottawa, ON, Canada.
²¹ Ingram School of Nursing, Faculty of Medicine, McGill University, Montreal, QC, Canada.
²² Institute of Skin Integrity and Infection Prevention, Department of Nursing and Midwifery, University of Huddersfield, Huddersfield, UK.
²³ School of Nursing & Midwifery, Royal College of Surgeons in Ireland (RCSI), Dublin, Ireland.
²⁴ School of Nursing, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia.
²⁵ Department of Nursing, Faculty of Medicine, Masaryk University, Brno, Czech Republic.
²⁶ Czech National Centre for Evidence Based Healthcare and Knowledge Translation (Cochrane Czech Republic, Czech CEBHC JBI Centre of Excellence, Masaryk University GRADE Centre), Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic.
²⁷ Dermatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
²⁸ School of Nursing, Medical-Surgical Nursing Department, University of São Paulo, São Paulo, Brazil.
²⁹ School of Nursing, Portuguese Catholic University, Porto, Portugal.
³⁰ Wound Care Center, Ghent University Hospital, Ghent, Belgium.
³¹ Wound Ostomy Continence Solutions, LLC, Falls Church, Virginia, USA.
³² School of Nursing, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada.
³³ University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.
³⁴ Nursing Department, Ghent University Hospital, Ghent, Belgium.
³⁵ Department Health Care, VIVES University College, Roeselare, Belgium.
³⁶ School of Health Sciences, Örebro University, Örebro, Sweden.
³⁷ Faculty of Health Sciences, Department of Clinical Research, Research Unit of Plastic Surgery, Odense, Denmark.
³⁸ School of Nursing and Midwifery, Monash University, Clayton, VIC., Australia.

PMID: 33305504
DOI: 10.1111/jan.14713

Abstract
in English, Chinese

Aim: To develop and psychometrically evaluate a skin tear knowledge assessment instrument (OASES).

Design: Prospective psychometric instrument validation study.

Method: The skin tear knowledge assessment instrument was developed based on a literature review and expert input (N = 19). Face and content validity were assessed in a two-round Delphi procedure by 10 international experts affiliated with the International Skin Tear Advisory Panel (ISTAP). The instrument was psychometrically tested in a convenience sample of 387 nurses in 37 countries (April-May 2020). Validity of the multiple-choice test items (item difficulty, discriminating index, quality of the response alternatives), construct validity, and test-retest reliability (stability) were analysed and evaluated in light of international reference standards.

Results: A 20-item instrument, covering six knowledge domains most relevant to skin tears, was designed. Content validity was established (CVI = 0.90-1.00). Item difficulty varied between 0.24 and 0.94 and the quality of the response alternatives between 0.01-0.52. The discriminating index was acceptable (0.19-0.77). Participants with a theoretically expected higher knowledge level had a significantly higher total score than participants with theoretically expected lower knowledge (p < .001). The 1-week test-retest intraclass correlation coefficient (ICC) was 0.83 (95% CI = 0.78-0.86) for the full instrument and varied between 0.72 (95% CI = 0.64-0.79) and 0.85 (95% CI = 0.81-0.89) for the domains. Cohen's Kappa coefficients of the individual items ranged between 0.21 and 0.74.

Conclusion: The skin tear knowledge assessment instrument is supported by acceptable psychometric properties and can be applied in nursing education, research, and practice to assess knowledge of healthcare professionals about skin tears.

Impact: Prevention and treatment of skin tears are a challenge for healthcare professionals. The provision of adequate care is based on profound and up-to-date knowledge. None of the existing instruments to assess skin tear knowledge is psychometrically tested, nor up-to-date. OASES can be used worldwide to identify education, practice, and research needs and priorities related to skin tears in clinical practice.

开发并通过心理测量方法评估皮肤撕脱知识评估工具 (OASES) 。前瞻性心理测量工具验证研究。基于文献回顾和专家提供的资料(N=19) , 开发了皮肤撕脱知识评估工具。国际皮肤撕脱顾问委员会(ISTAP) 的10位国际专家采用两轮德尔菲法,评估了表面和内容效度。该工具在37个国家 (2020年4月至5月) 的387名护士的方便样本中进行了心理测量测试。根据国际参考标准, 分析和评估了多项选择测验项目 (项目难度、判别指数、响应方案质量) 、结构效度和重测信度 (稳定性) 的效度。设计了一个20项的工具, 涵盖了与皮肤撕脱最相关的六个知识领域。建立内容效度 (CVI=0.90-1.00) 。项目难度在0.24到0.94之间不等, 响应方案质量在0.01到0.52之间。判别指数可接受 (0.19-0.77) 。理论预期知识水平较高的参与者的总分显著高于理论预期知识水平较低的参与者 (p<0.001) 。全量表的1周重测组内相关系数 (ICC) 为0.83(95%CI=0.78-0.86) , 从0.72(95%CI=0.64-0.79) 到0.85(95%CI=0.81-0.89) 不等。个别项目的Cohen Kappa系数在0.21到0.74之间。皮肤撕脱知识评估工具由可接受的心理测量属性支持, 并可应用于护理教育、研究和实践, 以评估医疗保健专业人员对皮肤撕脱的相关知识。医疗保健专业人员面临皮肤撕脱的预防和治疗挑战。基于大量的最新知识, 应提供充分的护理。现有的评估皮肤撕脱知识的工具并未经过心理测试, 也未研发出最新版本。皮肤撕脱知识评估工具可以在世界范围内用于确定与临床实践中皮肤撕脱相关的教育、实践和研究需求和优先事项。.

Keywords: instrument development; knowledge; nursing; psychometrics; reliability; skin tear; validity.

MeSH terms

Health Knowledge, Attitudes, Practice*
Humans
Prospective Studies
Psychometrics
Reproducibility of Results
Surveys and Questionnaires

Abstract in English, Chinese

MeSH terms

Abstract
in English, Chinese