DOI QR코드

DOI QR Code

Reliability of the Visual Discrimination Scale on Oral Mucosa Pressure Ulcer for Healthcare Providers

의료인을 위한 구강점막욕창 시각적 감별도구의 신뢰도

  • Uhm, Ju-Yeon (Department of Nursing, Pukyong National University) ;
  • Kim, Myoung Soo (Department of Nursing, Pukyong National University)
  • Received : 2020.10.08
  • Accepted : 2020.11.20
  • Published : 2020.11.28

Abstract

The purpose of this study was to examine the inter-rater and intra-rater reliability of the oral mucosa pressure ulcer classification system based on the photographs. The study consisted of two stages; development and evaluation. In the developmental stage, 9 photographs of 82 were selected. In the evaluation stage, a total of 49 participants were invited web-based survey by e-mail. Cohen's weighted kappa and Krippendorff's alpha were used to define the inter-rater reliability. Nine photographs consisted of two, three, three, and one in normal, stage 1, stage 2, and stomatitis, respectively. The inter-rater reliabilities of wound care nurse specialist, intensive care nurse specialist, and dentist groups were 0.75, 0.70, and 0.78, respectively. The intra-rater reliability was 0.73. The inter-rater and intra-rater reliabilities of the oral mucosa pressure ulcer classification system showed substantially good agreement.

본 연구는 구강점막욕창의 시각적 감별도구에 대한 신뢰성을 평가하기 위한 연구이다. 연구의 절차는 개발단계와 평가단계로, 개발단계에서는 자료수집, 자문단의 타당도와 신뢰도 평가, 최종도구개발이 수행되었으며, 평가단계에서 대상자들에게 9장의 사진도구를 평가하게 하였다. 세 군에서 측정자 간 신뢰도를 구한 결과, 상처 전문간호사군에서는 Krippendorff's alpha 가 .75이었고, 중환자 전문간호사군에서는 .70이었다. 치과의사군에서의 Cohen's weighted kappa값은 .78 로 나타났다. 측정자 내 신뢰도를 살펴본 결과, 중환자실 일반간호사군들의 intra-rater reliability는 .73으로 나타났다. 신뢰도가 입증된 9장의 사진은 실제 중환자실과 같은 구강점막욕창 위험을 가진 환자를 돌보는 임상환경에서 교육용으로 활용될 수 있을 것으로 보인다.

Keywords

References

  1. J. Black et al. (2015). Use of wound dressing to enhance prevention of pressure ulcers caused by medical devices. International Wound Journal, 12(3), 322-327. DOI : 10.1111/iwj.12111
  2. C. Kim, M. S. Kim, M. J. Kang, H. H. Kim, N. J. Park & H. J. Jung. (2019). Oral mucosa pressure ulcers in intensive care unit patients: a preliminary observational study of incidence and risk factors. Journal of Tissue Viability, 28(1), 27-34. DOI : 10.1016/j.jtv.2018.11.002
  3. D. Jackson, A. M. Sarki, R. Betteridge & J. Brooke. (2019). Medical device-related pressure ulcers: a systemic review and meta-analysis. International Journal of Nursing Studies, 92, 109-120. DOI : 10.1016/j.ijnurstu.2019.02.006
  4. S. Hanonu & A. Karadag. (2016). A prospective, descriptive study to determine the rate and characteristics of and risk factors for the development of medical device-related pressure ulcers in intensive care units. Ostomy Wound Management, 62(2), 12-22.
  5. M. Barakat-Johnson, M. Lai, T. Wand, M. Li, K. White & F. Coyer. (2019). The incidence and prevalence of medical device-related pressure ulcers in intensive care: A systematic review. Journal of Wound Care, 28(8), 512-521. DOI : 10.12968/jowc.2019.28.8.512
  6. S. Reaper, C. Green, S. Gupta & R. Tiruvoipati. (2017). Inter-rater reliability of the reaper oral mucosa pressure injury scale (ROMPIS): A novel scale for the assessment of the severity of pressure injuries to the mouth and oral mucosa. Australian Critical Care, 30(3), 167-171. https://doi.org/10.1016/j.aucc.2016.06.003
  7. E. N. Marieb & K. Hoehn. (2011). Anatomy and physiology (4thed.). San Francisco: Pearson.
  8. D. J. Whitby & M. W. Ferguson. (1991). The extracellular matrix of lip wounds in fetal, neonatal and adult mice. Development, 112(2), :651-668. https://doi.org/10.1242/dev.112.2.651
  9. National Pressure Ulcer Advisory Panel. (2020. 06. 12). Consensus conference on pressure ulcer staging. http://www.npuap.org/wp-content/uploads/2015/03/As-of-2-12-Reg-Brochure.pdf
  10. Y. J. Lee, J. Y. Kim & T. W. Lee. (2011). Inter-rater reliability of the pressure ulcer classification system. Korean Wound Management Society, 7(2), 75-80.
  11. National Pressure Ulcer Advisory Panel. (2020. 06. 12) National Pressure Ulcer Advisory Panel announces a change in terminology from pressure ulcer to pressure injury and updates the stages of pressure injury . http://www.npuap.org/national-pressure-ulcer-advisory-panel-npuap-announces-a-change-in-terminology-from-pressure-ulcer-to-pressure-injury-and-updates-the-stages-of-pressure-injury.
  12. J. Kottner et al. (2020). Pressure ulcer/injury classification today; An international perspective. Journal of Tissue Viability, 29(3), 197-203. DOI : 10.1016/j.jtv.2020.04.003.
  13. J. Kottner, B. J. Gajewski & D. L. Streiner. (2011). Guidelines for reporting reliability and agreement studies. International Journal of Nursing Studies, 48(6), 659-660. DOI : 10.1016/j.ijnurstu.2011.01.017
  14. International Council for Harmonization. (2019. 09. 12). The international council for harmonization of technical requirements for pharmaceuticals for human use (ver. 3). http://www.ich.org/fileadmin/Public_Web_Site/ABOUT_ICH/Articles_Procedures/ICH_EWG_IWG_SOP_v3.0_final_22Jun2017-.pdf
  15. Y. J. Lee & S. Park. (2016). Effects of pressure ulcer classification system education programme on knowledge and visual discrimination ability of pressure ulcer classification and incontinence-associated dermatitis for clinical nurses in Korea. International Wound Journal, Supple 1, 26-32. DOI : 10.1111/iwj.12546
  16. J. R. Landis & G. G. Koch. (1977). The measurement of observer agreement for categorical data. Biometrics, 33(1), 159-174. https://doi.org/10.2307/2529310
  17. T. Defloor & L. Schoonhoven. (2014). Inter-rater reliability of the EPUAP pressure ulcer classification system using photographs. Journal of Clinical Nursing, 13(8), 952-959. DOI : 10.1111/j.1365-2702.2004.00974.x
  18. E. J. Lee & S. O. Yang. (2011). Clinical knowledge and actual performance of pressure ulcer care by hospital nurses. Journal of Korean Clinical Nursing Research, 17(2), 251-261.
  19. J. L. Fleiss. (1981). Statistical methods for rates and proportions. London: John Wiley & Sons.
  20. D. V. Cincchetti & S. A. Sparrow. (1981). Developing criteria for establishing interrater reliability of specific items: Applications to assessment of adaptive behavior. American Journal of Mental Deficiency. 86(2), 127-137.
  21. T. Abe et al. (2018). Epidemiology and patterns of tracheostomy practice in patients with acute respiratory distress syndrome in ICUs across 50 countries. Critical Care, 22(1), 195. DOI : .10.1186/s13054-018-2126-6.
  22. M. Koo, Y. Sim & I. Kang. (2019). Risk Factorsof Medical Device-Related Pressure Ulcer in Intensive Care Units. Journal of Korean Academy of Nursing, 49(1), 36-45. https://doi.org/10.4040/jkan.2019.49.1.36
  23. T. Defloor et al. (2006). Reliability of the European Pressure Ulcer Advisory Panel classification system. Journal of Advanced Nursing, 54, 189-198. https://doi.org/10.1111/j.1365-2648.2006.03801.x
  24. National Cancer Information Center. (2020. 02. 12) Understanding of Cancer. http;//www.cancer.go.kr/ncic/cics_a/03/031/0312/index.html
  25. S. H. Kim. (2020). Correlation among mechanical physiological characteristics and oral mucosa pressure ulcer of intubated patients in intensive care unit. Master's thesis. Pukyong National University, Busan.
  26. G. Amrani & A. Gefen. (2019). Which endotracheal tube location minimises the device-related pressure ulcer risk: The centre or a corner of the mouth? International Wound Journal, 17(2), 268-276. https://doi.org/10.1111/iwj.13267
  27. North of England Critical Care Network. (2020. 03. 6). BPG 02: Endo-tracheal tube care. https://www.noeccn.org.uk/resources/Documents/Benchmarks%20Guidelines/Guideline%20-%20New/BPG%2002%20-%20ETT%20Care%20Final.pdf