Content Validity and Reliability of the Pressure Ulcer Knowledge Test and the Knowledge Level of Portuguese Nurses at Long-Term Care Units: A Cross-Sectional Survey

Abstract

(1) Background: Improvement in pressure ulcer care depends both on the dissemination of knowledge and its implementation. This study aims to translate the Pressure Ulcer Knowledge Test into Portuguese from Portugal and evaluate the internal consistency of the questionnaire. The second aim is to assess nurses’ pressure ulcer knowledge level. (2) Methods: The Pressure Ulcer Knowledge Test was translated into Portuguese, and the translated test’s internal consistency and content validity were assessed. Further, the authors conducted a cross-sectional survey using the test among 221 nurses working in long-term care units. (3) Results: The Cronbach’s alpha internal coefficient of reliability recorded for the 47 items was 0.738, which is higher than the minimum acceptable level of 0.7. The Cronbach’s alpha for the subscales was 0.709 for prevention/risk and less than 0.5 for staging and wound description. Only two of the 221 nurses achieved a score of 90% correct answers or more. The nurses scored lower in questions related to prevention/risk (Me = 67.4%, IQR = 60.6–75.8% vs. staging: ME = 85.7%, IQR = 71.4–85.7%, description: ME = 85.7%, IQR = 71.4–85.7%, p < 0.001). (4) Conclusion: The internal consistency of the instrument was acceptable. The instrument can accurately measure Portuguese nurses’ knowledge of pressure ulcers, and its information can help improve education and implementation of best practices.

Students’ knowledge, attitude and practices towards pressure ulcer prevention and management

“…However, the findings of 30% of the respondents from this study, who demonstrated only satisfactory knowledge is of concern, because they would put patients at risk. A concern for risk to patients owing to a lack of knowledge of pressure ulcers concurs with the reports by Dalvand et al (2018) and Furtado et al (2022) who indicated that ulcer development is associated with a lack of knowledge and incompetence in managing pressure ulcers among nurses.…”

“…Most developed (high-income) countries hire competent nurses to facilitate quality patient care and secure their market (Bahrambeygi et al 2019;Ortega et al 2020). In lower-income countries, the prevalence of a lack of knowledge on ulcer is noted as evidenced by incompetence among nurses especially in managing pressure ulcers (Dalvand et al 2018;Furtado et al 2022).…”

“…Similarly, practice is reflected in the psychomotor domain as the student nurse applies the theory to practice by implying high-quality care to prevent pressure ulcers development (Moura et al 2020;Sucu & Kilic 2022). Early detection, prevention and treatment are particularly important for the successful management of pressure ulcers (Boyko, Longaker & Yang 2018;Furtado et al 2022). According to Bahrambeygi et al (2019), the effects of pressure ulcers delay rehabilitation, and contribute to prolonged morbidity and time of discharge, which raises healthcare costs because of the need for more resources and nursing hours while untreated ulcers may contribute to disability and death.…”

“…Classification of pressure ulcers is necessary to determine the right intervention and to enhance recovery. It is necessary to develop the curriculum content with essential information and application of knowledge on nutrition, assessment, uses of barrier creams, patient positioning and education to patient and relative as major interventions in prevention and management of pressure ulcers (Kielo et al 2020;Furtado et al 2022). However, high workload is one of the factors leading to a lack of patients re-positioned as needed, thereby resulting in the development of pressure ulcers (Berihu et al 2020;Ebi et al 2019;Reynolds 2008).…”

A Multicenter Assessment of Nurses’ Knowledge Regarding Pressure Ulcer Prevention in Intensive Care Units Utilizing the PUKAT 2.0

“…The findings showed inadequate knowledge among nurses regarding PU prevention. Furtado et al (2022) also reported that nurses scored lower on questions related to prevention and risk, with only two of the 221 nurses achieving 90% correct answers or more. Meanwhile, Tulek et al (2016) noted a lack of knowledge among nurses regarding PU prevention.…”