Translation, cultural adaptation and validation of the munro scale to brazilian portuguese
DOI:
https://doi.org/10.5935/1415-2762-20210052Keywords:
Validation Study, Pressure Ulcer, Risk Assessment, Patient Positioning, Perioperative NursingAbstract
Objective: to translate, adapt and validate the Munro Scale for Brazilian patients in the perioperative period. Method: a methodological study conducted in six stages: translation, synthesis, backtranslation, adaptation by experts committee, pre-test, and validation of the instrument. The experts committee consisted of seven nurses. For the psychometric tests, 39 patients were selected in the pre-test stage, and 75 in the validation stage, and Cronbach's alpha, the Intraclass Correlation Coefficient and the Content Validity Index were measured, as well as internal consistency with Friedman's test and concurrent validity with Spearman's correlation between the Munro Scale
and the ELPO instrument. Results: Cronbach's alpha was 0.82, the Intraclass Correlation Index was 0.75, and the Content Validity Index was 0.89 in the adaptation phase by the evaluators. In the pre-test, Cronbach's alpha was 0.91, the Intraclass Correlation Index was 0.91, and there
was internal consistency (p<0.0001) and concurrent validity in the intraoperative period (0.38; p=0.018). In the validation stage, Cronbach's alpha was 0.86, the Intraclass Correlation Index was 0.86, and there was internal consistency (p=0.000) and concurrent validity in the intraoperative
period (0.30; p=0.010). Conclusion: the Munro Scale was translated, adapted and validated with good validity and reliability indices and presents itself as a reliable instrument to assess the risk of pressure ulcer in the perioperative period.
Downloads
References
Burglingame BL. Guideline implementation: positioning the
patient. AORN J. 2017[citado em 2020 fev. 10];106(3):227-37.
Disponível em: https://aornjournal.onlinelibrary.wiley.com/doi/
epdf/10.1016/j.aorn.2017.07.010
Angelo CS, Pachioni CFM, Joaquim EHG, Silva EAL, Santos GC,
Bonfim IM, et al. Effectiveness of the protocol for the prevention of
skin lesions in robotic urological surgeries. Rev SOBECC. 2017[citado
em 2020 fev. 10];22(3):152-60. Disponível em: https://docs.bvsalud.
org/biblioref/2017/09/859107/sobecc-v22n3_in_152-160.pdf
Berwanger DC, Matos FGOA, Alves DA, Oliveira JLC. Links
between diagnostics, results and nursing interventions for patients
in the transoperative period. SOBECC. 2018[citado em 2020 fev.
;23(4):195-204.Disponível em: https://revista.sobecc.org.br/
sobecc/article/view/418/pdf
Lopes CMM, Hass VJ, Dantas RAS, Oliveira CG, Galvão CM. Assessment
scale of risk for surgical positioning injuries. Rev Latino-Am
Enferm. 2016[citado em 2020 fev. 10];24:e2704. Disponível em:
https://www.scielo.br/pdf/rlae/v24/pt_0104-1169-rlae-24-02704.
Munro CA. The Development of a Pressure Ulcer Risk-Assessment
Scale for Perioperative Patients. AORN J. 2010[citado em 2020 fev.
;92(3):272-82. Disponível em: https://aornjournal.onlinelibrary.
wiley.com/doi/abs/10.1016/j.aorn.2009.09.035
Scott S. Progress and challenges in perioperative pressure ulcer
prevention. J Wound Ostomy Cont Nurs. 2015[citado em 2020 fev.
;42(5):480-5. Disponível em: https://journals.lww.com/jwocnonline/
Citation/2015/09000/Progress_and_Challenges_in_Perioperative_
Pressure.8.aspx
Munro C. New pressure ulcer risk tool moves forward with
implementation study. OR Manager. 2014[citado em 2021 jun.
;30(7):1-3. Disponível em: https://pubmed.ncbi.nlm.nih.
gov/25158545/
Li D, Tang J, Gan X. Reliability and validity of the Munro Scale
on the assessment of pressure ulcer risks in adult perioperative
patients: a cross-sectional study. Int J Clin Exp Med. 2018 [citado
em 2020 jan. 20];11(9):9811-8. Disponível em: http://www.ijcem.
com/files/ijcem0065427.pdf
Sengul T, Gul A, Yavuz H. Assessment of the risk of pressure
ulcer during the perioperative period: adaptation of the Munro
Scale to Turkish. J Tissue Viability. 2021[citado em 2021 jun 7].
Disponível em: https://www.sciencedirect.com/science/article/
pii/S0965206X21000759
Beaton DE, Bombardier C, Guillemin F, Ferraz MB. Guidelines for
the Process of Cross-Cultural Adaptation of Self-Report Measures.
Spine. 2000[citado em 2020 fev. 10];25(24):3186-91. Disponível
em: https://journals.lww.com/spinejournal/Citation/2000/12150/
Guidelines_for_the_Process_of_Cross_Cultural.14.aspx
Souza AC, Costa Alexandre NM, Guirardello EB. Psychometric
properties in instruments evaluation of reability and validity.
Epidemiol Serv Saúde. 2017[citado em 2020 fev. 25];26(3):649-59.
Disponível em: https://www.scielo.br/pdf/ress/v26n3/2237-9622-
ress-26-03-00649.pdf
Coluci MZO, Alexandre NMC, Milani D. Construction of measurement
instruments in the area of health. Ciênc Saúde Colet.2015[citado em
fev. 25];20(3):925-36. Disponível em: https://www.scielo.
br/pdf/csc/v20n3/1413-8123-csc-20-03-00925.pdf
Mokkink LB, Terwee CB, Patrick DL, Alonso J, Stratford PW, Knol
DL, et al. The COSMIN checklist for assessing the methodological
quality of studies on measurement properties of health status
measurement instruments: an international Delphi study. Qual
Life Res. 2010[citado em 2020 fev. 10];19(4):539-49. Disponível
em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2852520/
pdf/11136_2010_Article_9606.pdf
Tavakol M, Dennick R. Making sense of Cronbach’s alpha. Int J
Med Educ. 2011[citado em 2020 fev. 25];2:53-5. Disponível em:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4205511/pdf/
ijme-2-53.pdf
Weir JP. Quantifying test-retest reliability using the intraclass
correlation coefficient and the SEM. J Strength Cond Res. 2005[citado
em 2020 fev.25];19(1):231-40. Disponível em: https://pubmed.ncbi.
nlm.nih.gov/15705040/
Conselho Nacional de Saúde (BR). Resolução n° 466, de 12 de
dezembro de 2012. Aprova normas regulamentadoras de pesquisas
envolvendo seres humanos. Brasília: Diário Oficial da União;
[citado em 2020 jan. 18]. Disponível em: https://conselho.
saude.gov.br/resolucoes/2012/Reso466.pdf
Putnam K. Minimizing pressure ulcer risk for surgical patients.
AORN J. 2016[citado em 2020 fev. 25];103(4):7-9. Disponível em:
https://aornjournal.onlinelibrary.wiley.com/doi/abs/10.1016/
S0001-2092%2816%2930009-6
Souza AC, Alexandre NMC, Guirardello EB. Psychometric properties in
instruments evaluation of reability and validity. Epidemiol Serv Saúde.
[citado em 2021 jun. 7];26(3):649-59. Disponível em: https://www.
scielo.br/j/ress/a/v5hs6c54VrhmjvN7yGcYb7b/?lang=pt&format=pdf
Trevethan R. Intraclass correlation coefficients: clearing the air,
extending some cautions, and making some requests. Health Serv
Outcomes Res Methodol. 2017[citado em 2021 jun. 6];17(2):127-43. Disponivel em: https://link.springer.com/article/10.1007/s10742-
-0156-6 doi:10.1007/s10742-016-0156-6
Tong L, Zhao M, Yang Y, Gao C, Wang Y, Yuan M, et al. Study on
application of Munro adult operating room pressure ulcer risk assessment
table in general anesthesia. Chongqing Yi Xue. 2018[citado em 2020 fev.
;47(10):1336-9. Disponível em: http://cnki.cgl.org.cn/kcms/detail/
detail.aspx?&DbCode=CJFQ&filename=CQYX201810011
Peixoto CA, Ferreira MBG, Felix MMS, Pires OS, Barichello E, Barbosa MH.
Risk assessment for perioperative pressure injuries. Rev Latino-Am Enferm.
[citado em 2021 jun. 06]; 27:e3117. Disponível em: https://www.
scielo.br/j/rlae/a/ZLJQLYV5hDBTsXCrpqySsnL/?lang=pt&format=pdf
Buso FDS, Ferreira MBG, Felix MMS, Galvão CM, Barichello E,
Barbosa MH. Pressure injury related to surgical positioning and
associated factors. Acta Paul Enferm. 2021[citado em 2021 jun.
;34:eAPE00642. Disponível em: https://www.scielo.br/j/ape/a/
VPg7mpWnvhgkDVXWGWjR6hn/?format=pdf&lang=pt



































