Cultural adaptation of the Pieper-Zulkowski Pressure Ulcer Knowledge Test for use in Brazil

Rabeh, Soraia Assad Nasbine; Palfreyman, Simon; Souza, Camilla Borges Lopes; Bernardes, Rodrigo Magri; Caliri, Maria Helena Larcher

doi:10.1590/0034-7167-2017-0029

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Revista Brasileira de Enfermagem

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RESEARCH • Rev. Bras. Enferm. 71 (4) • Jul-Aug 2018 • https://doi.org/10.1590/0034-7167-2017-0029 copy

Cultural adaptation of the Pieper-Zulkowski Pressure Ulcer Knowledge Test for use in Brazil

Adaptación cultural del instrumento Pieper-Zulkowski Pressure Ulcer Knowledge Test para Brasil

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

To carry out the cultural adaptation of the Pieper-Zulkowski Pressure Ulcer Knowledge Test (PZ-PUKT) for use in Brazil and analyze the internal consistency of the adapted version.

Method:

This was a methodological study. The PZ-PUKT is a knowledge test consisting of 72 items, divided into: prevention, staging, and wound description. The present study was developed in two phases: (1) translation of the questionnaire from English to Brazilian Portuguese, back-translation, and assessment of equivalence between the original and back-translated version by an expert panel; (2) pre-testing with nurses.

Results:

The questionnaire showed face and content validity according to the opinions of the experts. Cronbach's alpha for the total test score was higher than 0.70. The adapted version presented satisfactory internal consistency for the studied sample.

Conclusion:

The adapted version of the instrument for Portuguese can be used in intervention studies as a tool to measure “nursing knowledge about pressure injury/ulcers” as a dependent variable.

Descriptors:
Validation Studies; Evidence-Based Nursing; Ulcer Wounds; Knowledge, Health Attitudes and Practices; Wounds and Injuries

	Prevention (29 items)	Staging (20 items)	Wound (23 items)	Total (72 items)
Time of practice (years)
Less than 1	67.2%	47.5%	65.2%	61.1%
1 to 5	72.7%	70.7%	65.0%	69.7%
5 to 10	72.8%	67.5%	70.7%	70.7%
10 to 15	70.4%	69.3%	67.7%	69.2%
15 to 20	68.5%	65.0%	65.2%	66.5%
20 or more	73.7%	69.4%	66.3%	70.1%
Highest degree obtained
Baccalaureate	71.0%	68.8%	65.5%	68.6%
Master	77.0%	63.3%	69.6%	70.8%
PhD	82.8%	100.0%	65.2%	81.9%
Other	70.6%	66.2%	67.6%	68.4%
Searched for information on pressure injury on the Internet?
Yes	72.4%	69.0%	67.0%	69.7%
No	63.8%	57.5%	59.8%	60.8%^* * p<0,05.
Read the international guidelines set forth by the National Pressure Ulcer Advisory Panel/European Pressure Ulcer Advisory Panel?
Yes	77.3%	71.3%	67.8%	72.6%
No	70.2%	67.3%	66.0%	68.1%
Total	71.8%	68.1%	66.4%	69.1%

Item	PZ-PUKT Corrected English Version	Final Portuguese Version with modified items
46	Patients who are spinal cord injured need knowledge about pressure injury/ulcer prevention and self-care.	Pacientes com lesão de medula espinhal precisam ter conhecimento sobre a prevenção da lesão/úlcera por pressão e o autocuidado.
48	A mucosal membrane pressure injury/ulcer is found on mucous membrane as the result of medical equipment used at that time on that location; this pressure injury is not staged.	Uma lesão/úlcera por pressão pode ser encontrada em uma membrana mucosa, como resultado do uso de equipamento médico no local, e essa lesão não pode ser estadiada.
56	To help prevent pressure injury/ulcers, the head of the bed should be elevated at a 45-degree angle or higher.	Para auxiliar na prevenção da lesão/úlcera por pressão, a cabeceira da cama deve ser elevada em ângulo de 45 graus ou mais.
58	Pressure injury/ulcers may be avoided in patients who are obese with use of properly sized equipment.	As lesões/úlceras por pressão podem ser evitadas em pacientes que são obesos com o uso de equipamento de tamanho apropriado.
67	Alginate dressings can be used for heavily draining pressure injury/ulcers or those with clinical evidence of infection.	Cobertura de alginato pode ser utilizada para lesão/úlcera por pressão com muito exsudato ou com evidência clínica de infecção.
68	Deep tissue injury will not progress to another injury/ulcer stage.	Lesão tissular profunda não progride para lesão/úlcera de outra categoria/estágio.
72	Bacteria can develop permanent immunity to silver dressings.	As bactérias podem desenvolver imunidade permanente para coberturas com prata.

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[1] CORRESPONDING AUTHOR: Karin Viégas. E-mail: kviegas@gmail.com