Development and psychometric property testing of a skin tear knowledge assessment instrument (OASES) in 37 countries

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Aim: To develop and psychometrically evaluate a skin tear knowledge assessment instrument (OASES). Design: Prospective psychometric instrument validation study. Method: OASES was developed based on a literature review and expert input (n=19). Face and content validity were assessed in a two-round Delphi procedure by 10 international experts affiliated with the International Skin Tear Advisory Panel (ISTAP). The instrument was Psychometrically tested in a convenience sample of 387 nurses in 37 countries (April–May 2020). Validity of the multiple-choice test items (item difficulty, discriminating index, quality of the response alternatives), construct validity, and test-retest reliability (stability) were analysed and evaluated in light of international reference standards. Results: A 20-item instrument, covering six knowledge domains most relevant to skin tears, was designed. Content validity was established (CVI=0.90-1.00). Item difficulty varied between 0.24 and 0.94 and the quality of the response alternatives between 0.01 and 0.52. The discriminating index was acceptable (0.19-0.77). Participants with a theoretically expected higher knowledge level had a significantly higher total score than participants with theoretically expected lower knowledge (p<0.001). The 1-week test-retest intraclass correlation coefficient (ICC) was 0.83 (95% CI=0.78-0.86) for the full instrument, and varied between 0.72 (95% CI=0.64-0.79) and 0.85 (95% CI=0.81-0.89) for the domains. Cohen’s Kappa coefficients of the individual items ranged between 0.21 and 0.74.Conclusion: OASES is supported by acceptable psychometric properties and can be applied in nursing education, research and practice to assess knowledge of healthcare professionals about skin tears. Impact: Prevention and treatment of skin tears are a challenge for healthcare professionals. The provision of adequate care is based on profound and up-to-date knowledge. None of the existing instruments to assess skin tear knowledge is psychometrically tested, nor up-to-date. OASES can be used worldwide to identify education, practice and research needs and priorities related to skin tears in clinical practice.
Original languageEnglish
JournalJournal of Advanced Nursing
Publication statusAccepted/In press - 15 Nov 2020

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