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Purpose: The Braden Scale for Predicting Pressure Sore Risk© (Braden Scale) is used widely in nursing homes to identify those residents likely to develop pressure ulcers. By examining its subscales, nurses can target interventions to address specific risk areas. Although the validity of the entire tool has been demonstrated, the individual subscale of moisture has not been explored. The purpose of this study was to examine the construct validity of the moisture subscale.
Methods: Data were derived from a large randomized controlled trial (RCT), where nurses measured Braden Scales weekly and nursing assistants (CNAs) performed “wet checks” during repositionings. The moisture subscale scored subjects from 1 (always wet) to 4 (almost never wet). Braden Scale assessments were paired with CNA documentation from the prior 24 hours. Relationships between documented wet episodes and brief changes and the moisture subscale score were analyzed using Spearman correlation coefficients and Duncan groupings.
Results: There were 741 participants, of which 720 had total Braden scores of 10-14, and 1944 Braden assessments with correlating CNA documentation. A decreasing trend in wet observations for subscale scores of 1 (4.9 ± 1.9), 2 (4.4 ± 1.8), 3 (3.9 ± 2.0), and 4 (2.4 ± 2.3) was identified. Significant negative correlations exist between mean moisture subscale scores and both mean wet observations (r=-0.16, p<0.0001) and mean brief changes (r=-0.099, p<0.0001). For both wet observations and brief changes Duncan’s Multiple Range Test reveals subscale 1 is significantly different than subscale scores 2-4 and subscales scores 2 and 3 are significantly different than 4 (F=28, p<0.0001; F=22.55, p<0.0001).
Conclusions: This study provides preliminary support for the construct validity of the Braden Scale moisture subscale. Because the larger RCT only included subjects with Braden scores 10-14, a complete range of Braden scores (6-23) may better differentiate mean frequencies and Duncan groupings.
Methods: Data were derived from a large randomized controlled trial (RCT), where nurses measured Braden Scales weekly and nursing assistants (CNAs) performed “wet checks” during repositionings. The moisture subscale scored subjects from 1 (always wet) to 4 (almost never wet). Braden Scale assessments were paired with CNA documentation from the prior 24 hours. Relationships between documented wet episodes and brief changes and the moisture subscale score were analyzed using Spearman correlation coefficients and Duncan groupings.
Results: There were 741 participants, of which 720 had total Braden scores of 10-14, and 1944 Braden assessments with correlating CNA documentation. A decreasing trend in wet observations for subscale scores of 1 (4.9 ± 1.9), 2 (4.4 ± 1.8), 3 (3.9 ± 2.0), and 4 (2.4 ± 2.3) was identified. Significant negative correlations exist between mean moisture subscale scores and both mean wet observations (r=-0.16, p<0.0001) and mean brief changes (r=-0.099, p<0.0001). For both wet observations and brief changes Duncan’s Multiple Range Test reveals subscale 1 is significantly different than subscale scores 2-4 and subscales scores 2 and 3 are significantly different than 4 (F=28, p<0.0001; F=22.55, p<0.0001).
Conclusions: This study provides preliminary support for the construct validity of the Braden Scale moisture subscale. Because the larger RCT only included subjects with Braden scores 10-14, a complete range of Braden scores (6-23) may better differentiate mean frequencies and Duncan groupings.