Predictive validity and reliability of the Turkish version of the risk assessment pressure sore scale in intensive care patients: results of a prospective study.

Multiple pressure ulcer (PU) risk assessment instruments have been developed and tested, but there is no general consensus on which instrument to use for specific patient populations and care settings. The purpose of this study was to determine the reliability and predictive validity of the Turkish version of the Risk Assessment Pressure Sore (RAPS) instrument, which includes 12 variables--5 from the modified Norton Scale, 3 from the Braden Scale, and 3 from other research results--for use in intensive care unit (ICU) patients. The English version of the RAPS instrument was translated into Turkish and tested for internal consistency and predictive validity (sensitivity, specificity, positive predictive value, and negative predictive value) using a convenience sample of 122 patients consecutively admitted to an ICU unit in Turkey. The patients were assessed within 24 hours of admission, and after that, once a week until the development of a PU or discharge from the unit. The incidence of PUs in this population was 23%. The majority of ulcers that developed were Stage I. Internal consistency of the RAPS tool was adequate (Cronbach's α = 0.81). The best balance between sensitivity and specificity for ICU patients was reached at a cut-off point of ≤ 27 (ie, sensitivity = 74.2%, specificity = 31.8%, positive predictive value = 38.7%, and negative predictive value 91.3%). This is lower than the cut-off point reported in other studies of the RAPS scale. In this population of ICU patients, the RAPS scale was found to have acceptable reliability and poor validity. Additional studies to evaluate the predictive validity and reliability of the RAPS scale in other patient populations and care settings are needed.