to translate and cross-culturally adapt the Leg Ulcer Measurement Tool to Brazilian Portuguese.
Methods:
methodological study involving the steps of initial translation, synthesis of translations, back-translation, expert panel and pretest. For analysis by the expert committee, the content validity index was calculated and in the pretest for practicality, the agreement rate was calculated. Satisfactory agreement was considered when > 0.8 and 80%, respectively.
Results:
the initial steps of translation were satisfactorily developed and there was little disagreement between the translators. In the expert panel, was obtained significant concordance of 0.97. The pretest was performed with ten nurses and 30 patients. The feasibility of the translated version was evaluated with 100% agreement.
Final Considerations:
the instrument presented a high level of concordance among the experts during all steps and showed content validity thereby making the adaptation appropriate for the Brazilian context.
Universidade Federal Fluminense. Niterói, Rio de Janeiro, Brazil.Universidade Federal FluminenseBrazilNiterói, Rio de Janeiro, BrazilUniversidade Federal Fluminense. Niterói, Rio de Janeiro, Brazil.
Universidade Federal Fluminense. Niterói, Rio de Janeiro, Brazil.Universidade Federal FluminenseBrazilNiterói, Rio de Janeiro, BrazilUniversidade Federal Fluminense. Niterói, Rio de Janeiro, Brazil.
Universidade Federal do Estado do Rio de Janeiro. Rio de Janeiro, Rio de Janeiro, Brazil.Universidade Federal do Estado do Rio de JaneiroBrazilRio de Janeiro, Rio de Janeiro, BrazilUniversidade Federal do Estado do Rio de Janeiro. Rio de Janeiro, Rio de Janeiro, Brazil.
Universidade Federal Fluminense. Niterói, Rio de Janeiro, Brazil.Universidade Federal FluminenseBrazilNiterói, Rio de Janeiro, BrazilUniversidade Federal Fluminense. Niterói, Rio de Janeiro, Brazil.
Universidade Federal Fluminense. Niterói, Rio de Janeiro, Brazil.Universidade Federal FluminenseBrazilNiterói, Rio de Janeiro, BrazilUniversidade Federal Fluminense. Niterói, Rio de Janeiro, Brazil.
Universidade Federal Fluminense. Niterói, Rio de Janeiro, Brazil.Universidade Federal FluminenseBrazilNiterói, Rio de Janeiro, BrazilUniversidade Federal Fluminense. Niterói, Rio de Janeiro, Brazil.
Universidade Federal do Estado do Rio de Janeiro. Rio de Janeiro, Rio de Janeiro, Brazil.Universidade Federal do Estado do Rio de JaneiroBrazilRio de Janeiro, Rio de Janeiro, BrazilUniversidade Federal do Estado do Rio de Janeiro. Rio de Janeiro, Rio de Janeiro, Brazil.
0 None 1 Loose white to yellow slough 2 Attached white to yellow slough or fibrin 3 Soft grey to black eschar 4 Hard dry Black eschar
A7. Necrotic tissue amount
0 None visible 1 1 to 25%of wound bed covered 2 26 to 50% of wound bed covered 3 51 to 75% of wound bed covered 4 76 to 100% of wound bed covered
A8. Granulation tissue type
0 Healed 1 Bright beefy red 2 Dusky pink 3 Pale 4 Absent
A9. Granulation tissue amount
0 Healed 1 76 to100%of wound bed covered 2 51 to75% of wound bed covered 3 26 to 50% of wound bed covered 4 1 to 25% of wound bed covered
A10. Edges
0 Healed 1 ≥50%advancing border of epithelium or indistinct borders 2 <50% advancing border of epithelium 3 Attached, no advancing border of epithelium 4 Unattached or undermined
Pa B1. Pain amount (as it relates to the leg ulcer). Rate your pain, experienced in the last 24 hours, on a scale from 0 to 10, where 0 is "no pain" and 10 is the "worst pain".
Chart 3
Portuguese version of instructions the Leg Ulcer Measurement Tool obtained after the expert panel, Niterói, Rio de Janeiro, Brazil, 2018
GENERAL INSTRUCTIONS
SEÇÃO A - Domínios avaliados clinicamente As avaliações devem ser feitas pré-desbridamento, mas após a limpeza da ferida. Os avaliadores devem observar o tipo e a quantidade de exsudato ao remover os curativos. Sempre que possível, o intervalo desde a última troca de curativo deve ser regular de uma avaliação para a próxima.
A1. Exudate type-Reminder: Some wound care products may change the appearance of the exudate, eg, silver sulfadiazine or hydrocolloids. Definitions: 1 Serosanguineous-thin, watery, pale red to pink 2 Serous-thin, watery, clear, pale yellowish 3 Seropurulent-thin, opaque 4 Purulent-thick, opaque, yellow to green with foul odour (as distinct from body or foot odour)
A2. Exudate amount-Reminder: Consider time since last dressing change. 0 None-ulcer healed or wound tissue dry (if wound dressings changes are not regular) 1 Scant-wound bed moist with dressing dry 2 Small-wound bed moist with some drainage on dressing 3 Moderate-obvious fluid in wound bed and > 50% of dressing soaked 4 Copious-overwhelming the dressing system
A3. Size-Measure length as the longest diameter; width is perpendicular to length. Avoid diagonals. Calculate wound area as length by width. Write this in space provided and select appropriate response category.
A4. Depth-layers. Pick the most appropriate descriptor.
A5. Undermining-Place moistened rayon-tipped sterile applicator or wound probe under the edge of the wound. Advance it gently as far as it will go. Place gloved thumb on the applicator against the wound edge to mark the extent of undermining on the applicator. Holding the thumb in place, remove the applicator and measure the distance along the applicator in centimetres. Indicate the area of greatest undermining according to the face of a clock, with 12 o'clock at the top of the patient.
A6. Necrotic tissue type-Reminder: The wound should be thoroughly cleansed before evaluating. Pick the predominant type of necrotic tissue, eg, if most of thewound bed is attached fibrin with small amount of blackeschar, choose attached fibrin as tissue type.
A7. Necrotic tissue amount of predominant type selected in A6. The sum of the percentages in A7 and A9 may be less than but should not exceed 100%.
A8. Granulation tissue type-Choose predominant type of granulation tissue.
A9. Granulation tissue amount-(The sum of the percentages in A7 and A9 may be less than but should not exceed 100%.) The percentage of granulation tissue refers only to the non epithelialized (open) portion of the wound. The advancing border of epithelium is not considered part of the wound surface.
A10. Edges-Definition: Indistinct borders-where you would not beable to trace the wound edge. 1- More than half of advancing borders may be indistinct because most of wound is epithelializing.
2- Less than half of the wound edge is advancing (the process of epidermal resurfacing appears smooth and shiny).
3- Attached, no advancing border-unable to probe.
4- Unattached wound edge is undermined
A11. Periulcer skin viability-Select the following items that are present; count the number selected; then use this total to determine appropriate response category. Definitions: Callus-thick, dry epidermis Scaling dermatitis-scaling, red skin which may be weeping Maceration-wet, white, opaque skin Induration-feels firmer than surrounding skin when pressed Erythema-skin redness (bright red)
A12. Leg edema type-Indicate the worst edema type located anywhere on leg. Definition: lipodermatosclerosis-waxy, white, firm tissue.
A13. Leg edema location-Indicate the most proximal location of any type of edema. Clinical example: pitting edema ankles with nonpitting edema to mid-calf: For A10, leg edema type = 2 > pitting; A11, leg edema location = 3 > to mid-calf.
A14. Assessment of bioburden 1 Lightly colonized: small amount of serous-type exudate. 2 Heavily colonized: large amount of seropurulent drainage with foul odour and no other cardinal signs of inflammation. 3 Localized infection: large amount of seropurulent drainage with foul odour and either induration, erythema, warmth, or pain. 4 Systemic infection: advancing cellulitis or osteomyelitis
Section B - PATIENT- (PROXY) RATED DOMAINS Read the questions "as they are" to the patient. It is important to qualify that the questions refer to the last 24 hours. If the patient is unable to understand the questions due to cognition or language deficits, section B should not be completed or it may be completed by a proxy only if the proxy knows the patient well and has been with the patient for most of the last 24 hours. The same person should provide proxy information for each assessment; do not complete section B by proxy if the person providing proxy information is not the same.
B1. Pain amount as it relates to the leg ulcer in the last 24 hours. Determine the rating based on a numerical rating scale ranging from 0-10, then place response in appropriate category.
B2. Pain frequency as it relates to the leg ulcer in the last 24 hours. How often patient experienced pain in the last 24 hours.
B3. Quality of life as it relates to the leg ulcer in the last 24 hours.
