Development of a Wound Assessment Tool for Use in Adults at End of Life: A Modified Delphi Study.
Journal
Advances in skin & wound care
ISSN: 1538-8654
Titre abrégé: Adv Skin Wound Care
Pays: United States
ID NLM: 100911021
Informations de publication
Date de publication:
01 Mar 2023
01 Mar 2023
Historique:
entrez:
22
2
2023
pubmed:
23
2
2023
medline:
25
2
2023
Statut:
ppublish
Résumé
Some patients at end of life (EOL) develop wounds known as Kennedy terminal ulcers, terminal ulcers, and Skin Changes At Life's End. However, there is ambiguity around the defining wound characteristics of these conditions and a lack of validated clinical assessment tools available to identify them. To gain consensus on the definition and characteristics of EOL wounds and establish the face and content validity of a wound assessment tool for use in adults at EOL. Using a reactive online Delphi technique, international wound experts reviewed the 20 items in the tool. Over two iterative rounds, experts assessed item clarity, relevance, and importance using a four-point content validity index. The content validity index scores were calculated for each item, with a level of 0.78 or higher signifying panel consensus. Round 1 included 16 panelists (100.0%). The agreement for item relevance and importance ranged from 0.54% to 0.94%, and item clarity scored between 0.25% and 0.94%. Following round 1, four items were removed, and seven others reworded. Other suggestions included changing the tool name and including Kennedy terminal ulcer, terminal ulcer, and Skin Changes At Life's End in the EOL wound definition. In round 2, the now 13 panel members agreed with the final 16 items included and suggested minor wording changes. This tool could provide clinicians with an initially validated tool to accurately assess EOL wounds and gather much needed empirical prevalence data. Further research is needed to underpin accurate assessment and the development of evidence-based management strategies.
Sections du résumé
BACKGROUND
BACKGROUND
Some patients at end of life (EOL) develop wounds known as Kennedy terminal ulcers, terminal ulcers, and Skin Changes At Life's End. However, there is ambiguity around the defining wound characteristics of these conditions and a lack of validated clinical assessment tools available to identify them.
OBJECTIVE
OBJECTIVE
To gain consensus on the definition and characteristics of EOL wounds and establish the face and content validity of a wound assessment tool for use in adults at EOL.
METHODS
METHODS
Using a reactive online Delphi technique, international wound experts reviewed the 20 items in the tool. Over two iterative rounds, experts assessed item clarity, relevance, and importance using a four-point content validity index. The content validity index scores were calculated for each item, with a level of 0.78 or higher signifying panel consensus.
RESULTS
RESULTS
Round 1 included 16 panelists (100.0%). The agreement for item relevance and importance ranged from 0.54% to 0.94%, and item clarity scored between 0.25% and 0.94%. Following round 1, four items were removed, and seven others reworded. Other suggestions included changing the tool name and including Kennedy terminal ulcer, terminal ulcer, and Skin Changes At Life's End in the EOL wound definition. In round 2, the now 13 panel members agreed with the final 16 items included and suggested minor wording changes.
CONCLUSIONS
CONCLUSIONS
This tool could provide clinicians with an initially validated tool to accurately assess EOL wounds and gather much needed empirical prevalence data. Further research is needed to underpin accurate assessment and the development of evidence-based management strategies.
Identifiants
pubmed: 36812079
doi: 10.1097/01.ASW.0000911992.83362.eb
pii: 00129334-202303000-00008
doi:
Types de publication
Journal Article
Langues
eng
Pagination
142-150Informations de copyright
Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
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