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Interrater agreement, reliability and validity of the Glamorgan Paediatric Pressure Ulcer Risk Assessment Scale
Author(s) -
Kottner Jan,
Kenzler Martina,
Wilborn Doris
Publication year - 2014
Publication title -
journal of clinical nursing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.94
H-Index - 102
eISSN - 1365-2702
pISSN - 0962-1067
DOI - 10.1111/jocn.12025
Subject(s) - inter rater reliability , intraclass correlation , kappa , reliability (semiconductor) , scale (ratio) , observational study , medicine , visual analogue scale , physical therapy , intra rater reliability , clinical practice , criterion validity , psychometrics , psychology , clinical psychology , rating scale , construct validity , developmental psychology , linguistics , philosophy , power (physics) , physics , quantum mechanics
Aims and objectives To determine (1) What is the degree of interrater agreement and reliability of G lamorgan scale item and sum scores? and (2) Are G lamorgan scale sum scores valid? Background Pressure ulcer risk assessment scales are recommended for use in clinical practice. For paediatric patients, 12 instruments are currently described. Empirical evidence about the performance of G lamorgan scale scores in clinical practice is limited. Design An observational validation study was conducted on a paediatric cardiac unit of a large university hospital in G ermany in A pril and M ay 2010. Methods Children were assessed simultaneously and independently by varying convenience samples of three nurses per assessment situation. Pressure ulcer risk was measured by the G lamorgan scale and a 100 mm Visual Analogue Scale (VAS). Proportions of agreement ( p o ), multirater kappa and intraclass correlation coefficients were calculated. Results Thirty children were rated by 27 nurses. Median children's age was 5·5 years. Agreement among item scores was high, whereas reliability coefficients of item scores were low. Interrater reliability for the G lamorgan scale sum scores was higher than for VAS scores. Correlation between both scales was moderate. Conclusions High agreement among item scores indicates that nurses are able to make precise judgements. The low interrater reliability of item and sum scores indicates that nurses were unable to differentiate the rated children based on their item and sum scores, thus providing little additional clinical relevant information about pressure ulcer risk in this setting. Relevance to clinical practice The G lamorgan scale and the VAS are unable to make clear distinctions in a low‐risk setting. Therefore, it is unlikely that the tools in this setting provide additional information for clinical decision making. Both tools are not recommended for daily use.