Cultural adaptation and content validity of the ISTAP Skin Tear Classification System into Chilean Spanish version

Introduction: to have a universal language to describe, and classify skin tears and to increase awareness of their occurrence, the International Skin tears Advisory Panel - ISTAP Classification System was developed. ^1,2 There is no Spanish version³.

Aims: perform the cultural adaptation and content validation of the ISTAP Classification to the Chilean culture.

Methods:  methodological study with a quantitative approach. Procedures included: translation, synthesis, expert committee review, back translation and pretest ^4,5. Agreement among experts were analyzed using Fleiss Kappa coefficient to analyze the content validity. The research  was approved by Ethical Committees.

Results:  It was agreed that the best translation for ST is “desgarro de piel”. The terms “colgajo de piel” replaced cutaneous flap.    For the semantic and idiomatic equivalences, the level of agreement among  the expert committee members was 83.3%. The word skin was added after the term "flap" to differentiate it from muscle flap. In ST type 2 definition: "that cannot be repositioned to cover the whole wound bed" was added. Kappa Fleiss Coefficients showed a moderate agreement among generalist nurses (0.4804; n=30) and expert nurses group (0.5308; n=5).

Discussion: Kappa results are similar to those obtained by Skiveren et al. ³ who found a moderate level of agreement in RN group (0.464) and for unregistered (0.443) respectively.  LeBlanc et al.  ² found Kappa levels of Fleiss 0.616 for expert nurses, a moderate agreement (0.555) for health professionals  (n=303) and acceptable level for those who were not from the health area (0.338).

The interobserver reliability was checked:                                                                         

 1: application of the 30 original photos to 150 health professionals, Kappa de Fleiss calculation                                                                                                                                                                

2. Clinical application of the Spanish version in 20 clinical cases (weighted clarity Kappa (kw) bouth in process

Conclusion: This study shows that it was possible to obtain the adapted Chilean Spanish version of the ISTAP