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Psychometric Properties of the Dutch National Prevalence Measurement of Care Problems Used to Measure Quality of Pressure Ulcer Care in Indonesian Hospitals

Amir, Yufitriana MSc; Kottner, Jan PhD; Schols, Jos M.G.A. MD, PhD; Lohrmann, Christa PhD, RN; Halfens, Ruud J.G. PhD

doi: 10.1097/01.ASW.0000452044.58375.43
Features: Original Investigations

OBJECTIVE: To evaluate the psychometric properties of the Indonesian version of the Dutch National Prevalence Measurement of Care Problems. The questionnaire consists of 6 parts: patient characteristics (including pressure ulcer [PrU] risk; assessed by the Braden Scale) and care dependency (assessed by the Care Dependency Scale [CDS]), PrU categorization, prevention, treatment, and structural quality indicators at ward and hospital level.

DESIGN, PARTICIPANTS, AND SETTING: A 3-phase design was used, including questionnaire translation and psychometric testing. The questionnaire was translated into Indonesian on March 2012. Content validity was assessed by 18 Indonesian experts on July 2012. The interrater agreement and reliability of the PrU categories, Braden Scale, and CDS were assessed on October 2012 in 4 Indonesian large public general hospitals.

RESULTS: Most Indonesian experts (91.8%) rated the Indonesian version of the questionnaire as “good” on clarity of wording. The content validity indices of the questionnaire ranged from 0.50 to 1.00. The PrU categories assessed showed an interrater reliability of κ = 0.92 (95% confidence interval [CI], 0.87–0.97) and an interrater agreement of po = 98.6% (95% CI, 97.5–99.3). The interrater reliability intraclass correlation coefficient (1,1) of the Braden Scale sum score was 0.90 (95% CI, 0.85–0.93). The exact proportion of agreement sum score was 39%. The interrater reliability intraclass correlation coefficient (1,1) of the CDS sum score was 0.88 (95% CI, 0.83–0.92). There was a 45% exact agreement on the CDS sum scores.

CONCLUSIONS: The questionnaire can be used in Indonesian hospitals to measure the PrU prevalence and quality of PrU care.

Yufitriana Amir, MSc, is a Lecturer, Nursing Programme, Riau University, Pekanbaru, Indonesia; and a PhD student, School for Public Health and Primary Care (CAPHRI), Department of Health Services Research, Maastricht University, Maastricht, the Netherlands. Jan Kottner, PhD, is Scientific Director of the Clinical Research Center for Hair and Skin Science, Department of Dermatology and Allergy, Charite-Universitatsmedizin Berlin, Berlin, Germany. Jos M.G.A. Schols, MD, PhD, is Professor of Old Age Medicine, CAPHRI, Department of General Practice and Department of Health Services Research, Maastricht University, the Netherlands. Christa Lohrmann, PhD, RN, is Professor of Nursing Science and Head of Department of Nursing Science, Medical University of Graz, Graz, Austria. Ruud J.G. Halfens, PhD, is Associate Professor, CAPHRI, Department of Health Services Research, Maastricht University, Maastricht, the Netherlands.

Ms Amir has disclosed that her institution has received a grant from the Directorate General of Higher Education, Indonesian Ministry of National Education and Culture and that the sponsor had no role in the study design, collection, analysis, interpretation of data, or writing of the manuscript.

The remaining authors have disclosed that they have no financial relationships related to this article.

Acknowledgments: The authors are grateful to the evaluators of the translation, the Indonesian experts, hospitals, nurses, and patients. Without their willingness to support this study, it would have been impossible to conduct it. All authors designed the study and prepared the manuscript. Y.A., R.J.G.H., and J.M.G.A.S. organized the data collection. Y.A., R.J.G.H., and J.K. performed the data preparation and analysis. Submitted July 10, 2013; accepted in revised form February 24, 2014.

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