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Convergent Validity of Three Pressure Injury Risk Assessment Scales: Comparing the PPRA-Home (Pressure Injury Primary Risk Assessment Scale for Home Care) to Two Traditional Scales

Authors Kohta M, Ohura T, Okada K, Nakamura Y, Kumagai E, Kataoka H, Kitagawa T, Kameda Y, Kitte T

Received 30 November 2020

Accepted for publication 13 January 2021

Published 2 February 2021 Volume 2021:14 Pages 207—217

DOI https://doi.org/10.2147/JMDH.S294734

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 4

Editor who approved publication: Dr Scott Fraser


Masushi Kohta,1 Takehiko Ohura,2 Katsuyuki Okada,3 Yoshinori Nakamura,4 Eiko Kumagai,5 Hitomi Kataoka,6 Tomomi Kitagawa,7 Yuki Kameda,8 Toshihiro Kitte9

1Medical Engineering Laboratory, ALCARE Co. Ltd., Tokyo, Japan; 2Pressure Ulcers and Wound Healing Research Center, Sapporo, Japan; 3Department of Dermatology, Kiryu Kosei General Hospital, Kiryu, Japan; 4Department of Medical Home Healthcare Center, Tenri Hospital Shirakawa Branch, Tenri, Japan; 5Murata Day Surgery & WOC Clinic, Sendai, Japan; 6Department of Nursing, Yamagata University, Yamagata, Japan; 7Department of Nursing, Hikone Municipal Hospital, Hikone, Japan; 8Wound Care Marketing Division, ALCARE Co Ltd., Tokyo, Japan; 9Department of Health Care Policy, Shiga Government Office, Otsu, Japan

Correspondence: Masushi Kohta
Medical Engineering Laboratory, ALCARE Co., Ltd., 1-21-10 Kyojima, Sumida-ku, Tokyo 131-0046, Japan
Tel +81-3-3611-1101
Fax +81-3-3613-6894
Email mkouta@alcare.co.jp

Purpose: The Pressure Injury Primary Risk Assessment Scale for Home Care (PPRA-Home) was developed to predict pressure injury risk in geriatric individuals requiring long-term care in home settings. This study aimed to compare the convergent validity of the PPRA-Home to that of the two other standardized pressure injury prevention scales: the Braden and Ohura-Hotta (OH) scales.
Methods: A multicenter, cross-sectional study was conducted with 34 home-based geriatric support service providers located in five Japanese districts. The study included 69 participants (30 had a pressure injury and 39 did not) who were at classified at care levels of 1 through 5 under Japan’s long-term care insurance system. Care managers served as assessors for the PPRA-Home, while physicians or certified expert nurses served as assessors for the Braden and OH scales. Convergent validity was investigated by examining correlation coefficients between total scores on the PPRA-Home and the other two scales. Receiver operating curve analysis was used to quantify each scale’s accuracy for the two groups: those with and without a pressure injury.
Results: The PPRA-Home was found to be negatively correlated with the Braden scale (r=− 0.79, p< 0.05), and positively correlated with the OH scale (r=0.58, p< 0.05). The area under the curve (AUC) for the PPRA-Home, Braden scale, and OH scale were 0.737, 0.814, and 0.794, respectively. A PPRA-Home cutoff score of 4 had a sensitivity of 63.3% and specificity of 81.6%.
Conclusion: The AUC for the PPRA-Home as scored by care managers was similar to those of the Braden and OH scales as scored by physicians or expert nurses. More research on the PPRA-Home’s content and predictive validity is required.

Keywords: pressure ulcer, risk assessment, geriatrics, wound care

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