Validation of the Bluebelle Wound Healing Questionnaire for assessment of surgical-site infection in closed primary wounds after hospital discharge

Abstract

Background Accurate assessment of surgical‐site infection (SSI) is crucial for surveillance and research. Self‐reporting patient measures are needed because current SSI tools are limited for assessing patients after leaving hospital. The Bluebelle Wound Healing Questionnaire (WHQ) was developed for patient or observer completion; this study tested its acceptability, scale structure, reliability and validity in patients with closed primary wounds after abdominal surgery. Methods Patients completed the WHQ (self‐assessment) within 30 days after leaving hospital and returned it by post. Healthcare professionals completed the WHQ (observer assessment) by telephone or face‐to‐face. Questionnaire response rates and patient acceptability were assessed. Factor analysis and Cronbach's α examined scale structure and internal consistency. Test–retest and self‐ versus observer reliability assessments were performed. Sensitivity and specificity for SSI discrimination against a face‐to‐face reference diagnosis (using Centers for Disease Control and Prevention criteria) were examined. Results Some 561 of 792 self‐assessments (70·8 per cent) and 597 of 791 observer assessments (75·5 per cent) were completed, with few missing data or problems reported. Data supported a single‐scale structure with strong internal consistency (α greater than 0·8). Reliability between test–retest and self‐ versus observer assessments was good (κ 0·6 or above for the majority of items). Sensitivity and specificity for SSI discrimination was high (area under the receiver operating characteristic (ROC) curve 0·91). Conclusion The Bluebelle WHQ is acceptable, reliable and valid with a single‐scale structure for postdischarge patient or observer assessment of SSI in closed primary wounds.

Prospective multicenter study on the incidence of surgical site infection after emergency abdominal surgery in China

“…The WHO states in the surgical site infection prevention guideline 1 : Surgical site infection (SSI) is among the most common health-care-associated infections in developing countries. The occurrence of SSI causes great pain to patients, prolongs the length of hospital stay, and causes expensive hospitalization cost 2 , 3 .…”

Development of a ‘universal-reporter’ outcome measure (UROM) for patient and healthcare professional completion: a mixed methods study demonstrating a novel concept for optimal questionnaire design

“…The possibility that the medical term may have introduced uncertainty, ‘noise’ or measurement error was not formally explored. The detailed validation of the SSI outcome measure and the accuracy of the tool for assessing wound infection has been reported in full elsewhere14, however, did not explore this possibility.…”

Feasibility and diagnostic accuracy of Telephone Administration of an adapted wound heaLing QuestiONnaire for assessment for surgical site infection following abdominal surgery in low and middle-income countries (TALON): protocol for a study within a trial (SWAT)

“…The WHQ was designed to be either completed by a healthcare professional or selfreported by patients [19] and as such has been described as a 'universal-reporter' outcome measure (UROM) [20]. In a UK validation study, the WHQ demonstrated good reliability and excellent discrimination [21][22][23]. The WHQ was completed both in-person and over the telephone by a healthcare professional trained in wound assessment (e.g.…”