Convergent Validity of Three Pressure Injury Risk Assessment Scales: Comparing the PPRA-Home (Pressure Injury Primary Risk Assessment Scale for Home Care) to Two Traditional Scales

• Main Authors: Kohta M, Ohura T, Okada K, Nakamura Y, Kumagai E, Kataoka H, Kitagawa T, Kameda Y, Kitte T
• Format: Article
• Language: English
• Published: Dove Medical Press 2021-02-01
• Series: Journal of Multidisciplinary Healthcare
• Subjects: pressure ulcer; risk assessment; geriatrics; wound care
• Online Access: https://www.dovepress.com/convergent-validity-of-three-pressure-injury-risk-assessment-scales-co-peer-reviewed-article-JMDH
• ISSN: 1178-2390

Masushi Kohta,1 Takehiko Ohura,2 Katsuyuki Okada,3 Yoshinori Nakamura,4 Eiko Kumagai,5 Hitomi Kataoka,6 Tomomi Kitagawa,7 Yuki Kameda,8 Toshihiro Kitte9 1Medical Engineering Laboratory, ALCARE Co. Ltd., Tokyo, Japan; 2Pressure Ulcers and Wound Healing Research Center, Sapporo, Japan; 3Department of Dermatology, Kiryu Kosei General Hospital, Kiryu, Japan; 4Department of Medical Home Healthcare Center, Tenri Hospital Shirakawa Branch, Tenri, Japan; 5Murata Day Surgery & WOC Clinic, Sendai, Japan; 6Department of Nursing, Yamagata University, Yamagata, Japan; 7Department of Nursing, Hikone Municipal Hospital, Hikone, Japan; 8Wound Care Marketing Division, ALCARE Co Ltd., Tokyo, Japan; 9Department of Health Care Policy, Shiga Government Office, Otsu, JapanCorrespondence: Masushi KohtaMedical Engineering Laboratory, ALCARE Co., Ltd., 1-21-10 Kyojima, Sumida-ku, Tokyo 131-0046, JapanTel [phone]Fax [phone]Email [e-mail]: The Pressure Injury Primary Risk Assessment Scale for Home Care (PPRA-Home) was developed to predict pressure injury risk in geriatric individuals requiring long-term care in home settings. This study aimed to compare the convergent validity of the PPRA-Home to that of the two other standardized pressure injury prevention scales: the Braden and Ohura-Hotta (OH) scales.Methods: A multicenter, cross-sectional study was conducted with 34 home-based geriatric support service providers located in five Japanese districts. The study included 69 participants (30 had a pressure injury and 39 did not) who were at classified at care levels of 1 through 5 under Japan’s long-term care insurance system. Care managers served as assessors for the PPRA-Home, while physicians or certified expert nurses served as assessors for the Braden and OH scales. Convergent validity was investigated by examining correlation coefficients between total scores on the PPRA-Home and the other two scales. Receiver operating curve analysis was used to quantify each scale’s accuracy for the two groups: those with and without a pressure injury.Results: The PPRA-Home was found to be negatively correlated with the Braden scale (r=− 0.79, p< 0.05), and positively correlated with the OH scale (r=0.58, p< 0.05). The area under the curve (AUC) for the PPRA-Home, Braden scale, and OH scale were 0.737, 0.814, and 0.794, respectively. A PPRA-Home cutoff score of 4 had a sensitivity of 63.3% and specificity of 81.6%.Conclusion: The AUC for the PPRA-Home as scored by care managers was similar to those of the Braden and OH scales as scored by physicians or expert nurses. More research on the PPRA-Home’s content and predictive validity is required.Keywords: pressure ulcer, risk assessment, geriatrics, wound care