Adaptação cultural e validação para a população portuguesa de um instrumento de monitorização de feridas crónicas

: escala resvech 2.0

Abstract

The existing literature on monitoring chronic wound healing shows that the only scale validated to Portugal is PUSH-PT. The evidence demonstrates the need for an instrument that is both easy to apply but more complete, so the adaptation and validation to the Portuguese population of the RESVECH 2.0 - chronic wound healing monitoring tool become our goal, aiming to estimate its psychometric properties, namely internal consistency, concurrent validity and sensitivity. Using the quantitative methodology, an observational research of prospective character and repeated evidences was designed. All the steps and principles of translation and cultural adaptation of measuring tools were accomplished. In order to clear up some previously raised doubts and aiming to improve the understanding and the linguistic/scientific accuracy of the tool, a Focus Group of 15 experts was formed. After the final version of the tool and the corresponding back translation was built, one of the authors of the original scale assessed its conceptual, semantic and cultural equivalence (content validity). Based on 44 individuals (residents in the MDR ,LDM of the UCC-A and Nursing Home as well as in UCC-B), who met the defined requirements, a sample of 57 chronic wounds was made, an average of 1,3 wounds per individual. The field work was during the months of Mars to July 2015 and the monitoring of the chronic wounds happened in 5 different moments: initial assessment - 2 - 4 – 6 and after 8 weeks of evolution. The individuals had a median of 80 years, mostly female gender (63.64%), and regarding wound etiology: mainly pressure ulcer (74%), 16% leg ulcers and 10% diabetic foot. About 75% of the lesions had necrotic or fibrinous tissue, more than half showed damaged or thickened edges; and 5 or more signs of local inflammation were seen in 31.58% of them. Results of the reliability study allowed us to conclude that the Portuguese version of the RESVECH 2.0-PT scale shows good internal consistency, Cronbach's α =0.786 at the beginning, which increased throughout the study. Associations of the items that compose it with the total score were also observed, becoming stronger throughout the study. The criterion validity was evaluated by means of a coincident validation, simultaneously applying the PUSH-PT scale in the same participants. The study of sensitivity to change was performed based on changes in the wounds of the sample. Thus, it was decided to study the changes that occurred in function as a result of the final healing of the lesions (n = 12). It was verified that the instrument discriminated between wounds that healed and those that did not heal, as well as wounds of the first and fourth quartiles, with statistical significance (p <0.001).

Date of Award	16 Nov 2016
Original language	Portuguese
Awarding Institution	Universidade Católica Portuguesa
Supervisor	Luís Sá (Supervisor)