Inter-Rater Reliability of a Pressure Injury Risk Assessment Scale for Home Care: A Multicenter Cross-Sectional Study

• Published in: Journal of multidisciplinary healthcare Vol. 13; pp. 2031 - 2041
• Main Authors: Kohta, Masushi, Ohura, Takehiko, Tsukada, Kunio, Nakamura, Yoshinori, Sukegawa, Mishiho, Kumagai, Eiko, Kameda, Yuki, Kitte, Toshihiro
• Format: Journal Article
• Language: English
• Published: New Zealand Dove Medical Press Limited 01.01.2020; Taylor & Francis Ltd; Dove; Dove Medical Press
• Subjects: agreement; Bedsores; Cross-sectional studies; Data collection; Edema; Geriatrics; Health risks; Home care; Hospitals; Injuries; Long term health care; Long-term care; Nursing care; Original Research; pressure ulcer; Pressure ulcers; Real property; Reproducibility; Risk assessment; Risk factors; Secondary analysis; Validity; Valuation; Japan; geriatrics; risk assessment; agreement; reproducibility; pressure ulcer
• ISSN: 1178-2390; 1178-2390
• DOI: 10.2147/jmdh.s291162

The aim of the current study was to assess the inter-rater reliability and agreement of the Pressure Injury Primary Risk Assessment Scale for Home Care (PPRA-Home), a risk assessment scale recently developed for Japan-specific social welfare professionals called care managers, to predict pressure injury risk in geriatric individuals who require long-term home care needs. A multicenter cross-sectional study was conducted at 30 home-based geriatric support services facilities located at four local districts in Japan. Eligible participants were individuals who needed partial or full assistance for daily living under Japan's long-term care insurance system (care levels 1-5). The degree of agreement and kappa coefficient were calculated for each item and the total score, after which inter-rater reliability was determined. The effect of the participant's care level on reliability was also evaluated as secondary analysis. A total of 96 participants were assessed by 83 care managers (two assessors scored each participant). The degree of agreement and calculated kappa coefficient of the PPRA-Home total score were 59% and 0.72, respectively, with the inter-rater reliability for the total score determined to be "Substantial". Our subgroup analysis showed that the inter-rater reliability differed according to the participant's care level. Accordingly, the kappa coefficient for the total score was lower in subgroup "care level 1-3" than in subgroup "care level 4-5" (0.51 and 0.76, respectively). Our result showed that the PPRA-Home has substantial inter-rater reliability for evaluation of risks of pressure injury development at home care. However, some research focusing on intra-later reliability and validity of the PPRA-Home with adequate sample sizes are required to provide categorical conclusions on whether it can be used for the risk assessment scale in actual clinical settings.