Strategies to support prevention, identification and management of pressure ulcers in the community

Cultural adaptation of the Glamorgan Scale to Brazilian Portuguese: Pressure Injury in Pediatrics

OBJECTIVE

to describe the methodological process of cultural adaptation of the Glamorgan Scale to Brazilian Portuguese.

METHOD

a methodological study of translation and cultural adaptation of the Glamorgan Scale, following the six stages: initial translation, synthesis of translations, back-translation, committee of experts, pre-test, and submission of the adapted version to the author for approval. The committee of experts was composed of five physicians and, during evaluation, a semantic, idiomatic, cultural and conceptual analysis was carried out. The agreement and representativeness of the items were assessed using the Content Validity Index. A minimum value of 80% agreement was considered.

RESULTS

all stages of the translation and cross-cultural adaptation process were satisfactory. In the evaluation made by the committee of experts, all items obtained an agreement greater than 80% in the first evaluation round. The pre-test stage allowed for a critical overview of the instrument, where few modifications were suggested by the participants.

CONCLUSION

the Glamorgan Scale was translated and culturally adapted to Brazilian Portuguese. Future psychometric studies are necessary to validate the scale.

Predictive accuracy of the Braden Q Scale in risk assessment for paediatric pressure ulcer: A meta-analysis

Aims

Paediatric pressure ulcers are a serious problem to healthcare service. Thus, effective and early identification of the risk of developing pressure ulcer is essential. The Braden Q scale is a widely used tool in the risk assessment of paediatric pressure ulcer, but its predictive power is controversial. Hence, we performed a meta-analysis to evaluate the predictive power of the Braden Q scale for pressure ulcer in hospitalised children and offer recommendations for clinical decision.

Methods

Studies that evaluated the predictive power of the Braden Q scale were searched through databases in English and Chinese, including Medline, Cochrane Library, Embase, CINAHL, SinoMed, CNKI, Wangfang and VIP. The studies were screened by two independent reviewers. QUADAS-2 was used to assess the risk of bias of eligible studies. Demographic data and predictive value indices were extracted. The pooled sensitivity, specificity and receiver operating characteristics (ROC) were calculated by MetaDiSc 1.4 using random-effects models.

Results

Cochran Q = 26.13 (P = 0.0036) indicated the existence of heterogeneity; the I² for pooled DOR was 61.7%, suggesting significant heterogeneity among the included studies. The pooled sensitivity and specificity were 0.73 (95% CI: 0.67–0.78) and 0.61 (95% CI: 0. 59–0.63), respectively, yielding a combined DOR of 3.47 (95% CI: 2–6.01). The area under the ROC curve was 0.7078 ± 0.0421, and the overall diagnostic accuracy (Q*) was 0.6591 ± 0.0337. Sensitivity analysis showed the results were robust.

Conclusion

The Braden Q scale has moderate predictive validity with medium sensitivity and low specificity for pressure ulcers in hospitalised children. Further development and modification of this tool for use in paediatric population are warranted.