Pressure injury prevention in older people: construction and validation of an instrument for caregivers

Matos, Suellen Duarte de Oliveira; Souza, Ana Paula Marques de Andrade; Abreu, Margarida da Silva Neves de; Gomes, Anne Carolinne Marie dos Santos; Oliveira, Jacira dos Santos; Silva, Mirian Alves da; Soares, Maria Júlia Guimarães Oliveira; Oliveira, Simone Helena dos Santos

doi:10.1590/0034-7167-2021-0930

Suellen Duarte de Oliveira Matos Corresponding author: Suellen Duarte de Oliveira Matos, E-mail: suellenduarteom@gmail.com

contributed to the conception or design of the study/research

contributed to the analysis and/or interpretation of data

contributed to the final review with critical and intellectual participation in the manuscript

Faculdade de Enfermagem Nova Esperança. João Pessoa, Paraíba, Brazil

https://orcid.org/0000-0002-5881-3827

Ana Paula Marques de Andrade Souza

contributed to the analysis and/or interpretation of data

contributed to the final review with critical and intellectual participation in the manuscript

Universidade Federal da Paraíba. João Pessoa, Paraíba, Brazil

https://orcid.org/0000-0002-1957-9935

Margarida da Silva Neves de Abreu

contributed to the final review with critical and intellectual participation in the manuscript

Escola Superior de Enfermagem do Porto. Porto, Portugal

https://orcid.org/0000-0003-0136-6816

Anne Carolinne Marie dos Santos Gomes

contributed to the analysis and/or interpretation of data

Universidade Federal da Paraíba. João Pessoa, Paraíba, Brazil

https://orcid.org/0000-0001-8464-2585

Jacira dos Santos Oliveira

contributed to the final review with critical and intellectual participation in the manuscript

Universidade Federal da Paraíba. João Pessoa, Paraíba, Brazil

https://orcid.org/0000-0002-3863-3917

Mirian Alves da Silva

contributed to the final review with critical and intellectual participation in the manuscript

Universidade Federal da Paraíba. João Pessoa, Paraíba, Brazil

https://orcid.org/0000-0003-2959-4642

Maria Júlia Guimarães Oliveira Soares

contributed to the final review with critical and intellectual participation in the manuscript

Universidade Federal da Paraíba. João Pessoa, Paraíba, Brazil

https://orcid.org/0000-0001-8025-9802

Simone Helena dos Santos Oliveira

contributed to the conception or design of the study/research

contributed to the analysis and/or interpretation of data

contributed to the final review with critical and intellectual participation in the manuscript

Universidade Federal da Paraíba. João Pessoa, Paraíba, Brazil

https://orcid.org/0000-0002-9556-1403

Corresponding author: Suellen Duarte de Oliveira Matos, E-mail: suellenduarteom@gmail.com

EDITOR IN CHIEF: Álvaro Sousa

ASSOCIATE EDITOR: Jules Teixeira

Variables	Delphi I
	Clarity	Relevance
	I-CVI^* * I-CVI: Item content validity index;	I-CVI^* * I-CVI: Item content validity index;
Questions addressing Knowledge
1. Do you know or have you heard of pressure injuries (bedsore)?	0.70^ Reformulated items;	0.90
2. Do you agree or disagree with the following statement? Pressure injury is a wound on the skin of a bony prominence.	0.60^ Reformulated items;	1.00
3. Do you agree or disagree with the following statement? Massaging the red area can prevent skin wound.	0.30^ Reformulated items;	0.70^ Reformulated items;
4. When you see a red area, do you massage it to reduce redness?	0.60^ Reformulated items;	0.70^ Reformulated items;
5. Do you know what areas are at higher risk for developing pressure injuries?	0.60^ Reformulated items;	0.90
6. I will read some sentences about preventive measures for pressure injuries and I want you to tell me if they are right or wrong.	0.70^ Reformulated items;	0.80
Questions addressing Attitudes
7. Do caregivers have a critical role in maintaining the skin integrity of institutionalized older people?	0.80^ Reformulated items;	1.00
8. Is it important to encourage repositioning of bedridden older people?	0.80^ Reformulated items;	0.80
9. Should caregivers observe eating problems in older people?	0.60^ Reformulated items;	0.90
10. Are caregivers essential in the care process of institutionalized older people?	0.70^* ***** Excluded items.	0.60^* ***** Excluded items.
11. Is it important to massage the red bony prominences?	0.60^* ***** Excluded items.	0.70^* ***** Excluded items.
Questions addressing Practices
12. Do you reposition bedridden older people?	0.70^ Reformulated items;	1.00
13. Regarding skin care of older people:	0.40^ Reformulated items;	0.90
14. Do you check the skin watching for changes?	0.90	1.00
15. Do you try to keep bed sheets tight?	0.60^ Reformulated items;	0.60^ Reformulated items;
16. Do you use any material to support any area of the body?	0.60^ Reformulated items;	0.90
17. Regarding the materials, which one(s) do you use to support the body area?	0.60^ Reformulated items;	0.90
18. Do you check if the older people accept the diet well?	0.80	0.90
19. Do you offer liquids (water/juice) to older people?	0.80	0.90
Scale content validity index	0.66	0.85
Kappa coefficient of agreement	0.76

Variables	Delphi I
	Clarity	Relevance
	I-CVI^* * I-CVI: Item content validity index.	I-CVI^* * I-CVI: Item content validity index.
Questions addressing Knowledge
1. Do you know or have you heard of pressure injuries (pressure ulcers)?	1.00	1.00
2. Is pressure injury usually caused on the skin of a bony prominence?	0.80	1.00
3. Can massaging the red area prevent pressure injuries?	1.00	1.00
4. Is adequate nutrition important to preserve skin integrity?	0.90	1.00
5. When you see a red area, do you massage it to reduce redness?	0.80	1.00
6. What areas are at higher risk for developing pressure injuries?	1.00	1.00
7. There are several precautions to avoid the development of pressure injuries. Check the ones you consider right or wrong.	1.00	1.00
Questions addressing Attitudes
8. In your opinion, the caregiver’s role in maintaining the skin integrity of dependent and bedridden older people is:	1.00	1.00
9. In your opinion, repositioning dependent and bedridden older people every two hours to prevent pressure injuries is:	1.00	1.00
10. In your opinion, ensuring dependent and bedridden older people have adequate food at all meals is:	1.00	1.00
11. In your opinion, keeping skin hydration of dependent and bedridden older people to prevent pressure injuries is:	0.90	1.00
12. In your opinion, keeping the skin of dependent and bedridden older people clean and free of moisture to prevent pressure injuries is:	1.00	1.00
13. In your opinion, keeping the anogenital region of dependent and bedridden older people clean and dry immediately after urinary and fecal elimination is:	1.00	1.00
14. In your opinion, watching for changes on the skin of dependent and bedridden older people is:	1.00	1.00
15. In your opinion, keeping the bed sheets clean and tight is:	1.00	1.00
Questions addressing Practices
16. Do you reposition dependent and bedridden older people every two hours?	0.90	1.00
17. Do you keep the skin of dependent and bedridden older people hydrated?	1.00	1.00
18. Do you keep the skin of dependent and bedridden older people clean and dry?	1.00	1.00
19. Do you clean and dry the anogenital region of dependent and bedridden older people immediately after urinary and fecal elimination?	1.00	1.00
20. Do you watch for changes on the skin of dependent and bedridden older people?	1.00	1.00
21. Do you keep the bed sheets clean and tight?	1.00	1.00
22. To prevent pressure injuries, do you use any material to support any area of the body of dependent and bedridden older people? If not, go to question 24.	0.90	1.00
23. Which materials listed below do you use to support the area of the body of dependent and bedridden older people?	1.00	1.00
24. Do you adequately feed dependent and bedridden older people at all meals?	1.00	1.00
25. How often do you offer liquids (juice, water, tea, or other) to dependent and bedridden older people?	1.00	1.00
Scale content validity index	0.95	1.00
Kappa coefficient of agreement	0.97

[1] Corresponding author: Suellen Duarte de Oliveira Matos, E-mail: suellenduarteom@gmail.com

Brasil

Brasil

Pressure injury prevention in older people: construction and validation of an instrument for caregivers

Prevención de lesiones por presión en ancianos: construcción y validación de instrumento orientado al cuidador

ABSTRACT

Objectives:

Methods:

Results:

Conclusions: