Revision Of Evaruci Pressure Injury Risk Assessment Scale And Empirical Study In ICU Population

Research Purpose:Reliability and validity of the Spanish EVARUCI pressure injury risk assessment scale was evaluated after translation.The revised version of the EVARUCI scale,the Braden scale,and the modified Jackson & Cubbin scale were used for clinical applications.Predictive capabilities of the three scales were compared to provide a simple,efficient,and objective assessment tool for nursing staff in China with a view of improving the efficiency and quality of ICU nursing work..Research Methods:After obtaining the informed consent of the original author of the scale by E-mail,the modified Brislin model and expert consultation method were used to translate and culturally adjust the EVARUCI pressure injury risk assessment scale.A pre-survey version of the EVARUCI pressure injury risk assessment scale was formed after preliminary investigation.From January to August 2019,this pre-survey version of the EVARUCI pressure injury risk assessment scale was used to assess the risk of occurrence of pressure injury for 404 patients in the intensive care unit and its reliability and validity were evaluated as well.The item analysis method was used to check the scale item's discrimination and homogeneity.The reliability of the scale was evaluated by internal consistency and inter-observer reliability.The validity of the scale was evaluated from the aspects of content validity,structure validity,criterion-related validity,and prediction validity.The theoretical structure of the scale was analyzed using factor analysis.Evaluate the content validity index of each item and the overall scale by expert consultation method.By comparing the correlation coefficient,sensitivity,specificity and other indicators of the EVARUCI scale with the Braden scale,the correlation degree and predictive ability of the two scales were evaluated.The revised EVARUCI scale whose reliability and validity were tested,Braden scale,and modified Jackson & Cubbin scale were used to survey 142 patients in the intensive care unit from September to December 2019.The occurrence of pressure injury risk was assessed by these three different scales.The predictive abilities of these three scales were evaluated by comparing the scores of the three scales in the pressure injury group and the non-pressure injury group,as well as the comprehensive effects of the sensitivity,specificity,and ROC curve of the application effect.Research Results:After the standard revision process,the final revised EVARUCI pressure injury risk assessment scale is divided into two parts consisting of 10 items and its specific usage principles.In the item analysis,the criteria value of all items on the scale and the correlation coefficients between each item and the total score of the scale are statistically significant.In the reliability evaluation,the interobserver reliability is 0.989,and the Cronbach's ? coefficients of the first and last evaluation of the internal consistency scale are 0.745 and 0.794.The Cronbach's ? coefficient is smaller than the original Cronbach's ? coefficient after deleting any entry.In the validity analysis,the scale entry level of Item-level Content Validity Index(I-CVI)is 0.8~1.0,and the average of all I-CVIs on the scale is 0.91.The scale has four factors whose eigenvalues are greater than 1 and the eigenvalues of these four principal components are 2.37,1.57,1.11,1.02,and the cumulative contribution rate of the four principal components to the total variance after the rotation is 60.756%.The model fitting indexes all meet the evaluation criteria.The correlation coefficients of EVERUCI scale and Braden scale are-0.444 and-0.459.When the diagnostic threshold of the first and final assessment in the predictive validity is 9 points and 10 points respectively,the sensitivity of the first and final assessment of the revised EVERUCI scale is 83.3% and 97.60%,the specificity is 53.9% and 81.80%,the Jordan index is 0.372 and 0.794,the positive predictive value is 17.33% and 38.32%,the negative predictive value is 96.53%,and the area under the ROC curve is 0.725 and 0.928,which are all higher than that of the Braden scale.The diagnostic thresholds for the first and final score of the revised EVERUCI scale,Braden scale,and the modified Jackson & Cubbin scale are 8,12,and 32 points,respectively.The areas under the ROC curve in the first assessment of the three scales are 0.789,0.586,and 0.847.Research Conclusion:The introduced EVARUCI scale has been shown to have good reliability and validity,and the conceptual framework and risk factor considerations are complete.Compared with other commonly used scales,the predictive ability of the revised EVARUCI scale and the modified Jackson & Cubbin scale is similar.However under comprehensive consideration,the use of the revised EVARUCI scale can save time and have better predictive ability,which is suitable for intensive care unit.