Investigating the Psychometric Properties of the Pieper-Zulkowski Pressure Ulcer Knowledge Test among Nurses in Iran

Abstract

OBJECTIVE To evaluate the psychometric properties of the Pieper-Zulkowski Pressure Ulcer Knowledge Test (PZ-PUKT) in Iranian nurses. METHODS A convenience sample of 323 nurses and 161 nursing students from the Ardabil University of Medical Sciences in Iran agreed to participate in the study. To determine the psychometric properties of the PZ-PUKT content and differential validity, item analysis (difficulty and discriminative indices), internal consistency, and test-retest were performed. RESULTS Because the total PZ-PUKT score for critical care nurses (39.84 ± 7.10) was higher compared with general nurses (37.01 ± 8.47) and nursing students (24.59 ± 12.95), the differential validity of the tool was confirmed. The mean difficulty indices of questions with and without considering the “I don’t know” option were 0.53 and 0.65, respectively, and 0.27 and 0.13 for discriminative index. Cronbach α coefficient was .92 for the 72-item test. The correlation coefficient between test and retest for 30 nurses was 0.81. CONCLUSIONS This study showed that the Persian version of the PZ-PUKT is valid and reliable for use in Iran. It can be used in education and research to assess nurses’ knowledge as well as to evaluate the effectiveness of training programs on prevention and care of pressure injuries.

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

“…Similar sociodemographic variables were found in validation studies of the PUKT instrument [35,38,39,41], excluding the Iranian validation that also included nursing students [37]. Educational variables from our study were different because, in Portugal, nurses have had a pre-graduation curriculum of four years since 1999.…”

“…An American investigation of nurses working in critical services noticed even lower results of 52%, although their sample had only 32 participants [36]. However, a study conducted in Iran found that the total PUKT score among critical nurses was higher than among nurses and students [37].…”

“…Continuing professional development, reading articles or books, and attending lectures were more frequently reported than described in the literature [37][38][39]41]. Another study noticed that nurses who participated in PU training in the last two years had better PU prevention knowledge [30].…”

“…In Portugal, nurses who work in long-term care are either inexperienced or work part-time combined with a second job. Furthermore, our study was multicentred, while previously published validations focused on hospital nurses [21,35,[37][38][39]41].…”

“…The Pieper-Zulkowski Pressure Ulcer Knowledge Test (PZ-PUKT) is one of the most used knowledge assessment tools [34][35][36][37][38]. The initial version, the Pressure Ulcer Knowledge Test (PUKT), developed by Pieper and Marvel in 1995, had three themes: prevention, classification, and wound description, with in total 47 items [21].…”