Measurement of morphological and physiological skin properties in aged care residents: a test–retest reliability pilot study

Abstract

This test-retest pilot study investigated the intra-rater reliability and reproducibility of non-invasive technologies to objectively quantify morphological (colour, thickness and elasticity) and physiological (transepidermal water loss (TEWL), hydration, sebum and pH) skin properties in an aged care population. Three consecutive measurements were taken from five anatomical skin sites, with the mean of each measurement calculated. The intra-class correlation coefficient (ICC) and the standard error of measurement (SEM) were used to examine the intra-rater reliability and reproducibility of measurements. Non-invasive technologies in this study showed almost perfect reliability for ultrasound measurements of the subepidermal low echogenicity band (SLEB) (ρ = 0·95-0·99) and skin thickness (ρ = 0·95-0·99) across all sites. The ICC was substantial to almost perfect for pH (ρ = 0·76-0·88) and viscoelasticity (ρ = 0·67-0·91) across all sites. Hydration (ρ = 0·53-0·85) and skin retraction (ρ = 0·57-0·99) measurements ranged from moderate to almost perfect across all sites. TEWL and elasticity were substantial to almost perfect across four sites. Casual sebum levels and most colour parameters showed poor ICC. The use of non-invasive technologies in this study provided an objective and reliable means for quantifying ageing skin and may offer future studies a valuable option for assessing skin tear risk.

A risk model for the prediction of skin tears in aged care residents: A prospective cohort study

“…This study is the final of a three‐stage research that comprised a preparatory stage, a pilot study, and the major study. The methodology and results of the preparatory stage and pilot study have previously been reported . This major study followed the same methodology applied in the pilot study, but the research was conducted on a much larger sample of aged care residents over a 6‐month period.…”

“…The Skin‐pH‐meter (Courage + Khazaka, Cologne, Germany) device was used to evaluate skin surface pH. A detailed explanation of these instruments and the various skin properties was provided in the pilot study …”

“…Data derived from the 31 residents who participated in the pilot study were pooled with an additional 169 recruited residents to form the major study's baseline measurements . Pooling of data was considered appropriate as the design and methodology of the major study replicated that of the pilot study, with only minor refinements.…”

“…The extremities had previously been identified as being vulnerable to skin tears . The upper quartile of the lateral lower extremities was selected following technical difficulties identified in the preliminary study …”

“…The initial analysis determined the intra‐class correlation coefficient (ICC) as estimates of the intra‐rater reliability for the pilot study over a 6‐month period. The ICC results for the pilot study have previously been reported . Subsequent analysis was conducted to identify baseline variables that significantly predicted the risk of skin tears at 6 months.…”