SCIENCE, PRACTICE AND EDUCATION recommendations. 34 First, the lead author familiar- ised herself with the data, generated initial codes and identified themes from the skin tear definition 1 and risk factors for skin tear development identified in the literature. 1,35,36 Second, LC highlighted words from the respondents’ answers, and the codes and themes were compared and grouped for the final analysis. Third, the thematic analysis was reviewed by SP and GG. Quality criteria for studies on developing and evalu- ating health status questionnaires exist. 37 White’s original survey 28 and the updated survey used in this study provided a clear description of the aspects of the development of the questionnaire to grade the content validity. The measurement aims of the survey used were evaluative, and the items were valid for assessing nurses’ knowledge and clinical practices related to skin tears. The survey was adapted to the target population, as the updated version was clearly addressed to nurses and wound care specialists. Item selection and reduction choices were made through the pilot test as part of the translation process. 33 Cri- terion validity refers to the degree to which scores on a particular instrument relate to a gold standard. 37 The survey development and update were based on evidence-based guidelines; therefore, it had a posi- tive rating because it was related to a gold standard. The study was approved by the Ethics Committee in the Canton of Geneva, Reference number: Req- 2020-01021. RESULTS A response rate of 45% (117/258) was achieved. Par- ticipants were almost exclusively from the French- speaking part of Switzerland (97%, n=113), with the remainder from the Italian part. Half (50%, n=59) worked in a hospital environment – either a univer- sity hospital, a general hospital or a clinic. Only 34% (n=40) worked in a home care setting or private prac- tice. Complete information on respondents’ working specialities is summarised in Figure 1. Nurses’ educational backgrounds Of the respondents, 56% (n=66) had a Diploma of Nursing, 20% (n=23) a Bachelor of Nursing and 3% (n=4) a Master of Science degree. Fifteen per cent (n=17) had been nurses for 3 to 10 years, 60% (n=70) for 11 to 30 years and 23% (n=27) for 31 to 40 years (median = 21–30 years). The majority (83%, n=97) had completed a Certificate of Advanced Studies in wound care. Sixty-eight per cent (n=79) had up to 10 years of experience as wound care specialists (median = 3–10 years). Nurses’ perceptions of skin tears Of the respondents, 89% (n=102) indicated skin tears were ‘common’ to ‘extremely common’. Sixty- five per cent (n=75) indicated being aware of 1–2 skin tears per week, and 7% (n=8) reported knowledge of 3–5 new skin tears per week. Nurses’ knowledge of skin tears Of the respondents, 78% (n=90) described a skin tear in their own words. Words from these defini- tions and similarities were highlighted and grouped for analysis (Table 1). All participants used the words ‘wound’ or ‘injury’ to describe a skin tear, but only a few described a skin tear as a ‘traumatic wound’. More than half (56%, n=50) specified that ‘mechani- cal forces, shear, friction or trauma’ cause skin tears. The ‘removal of dressings or adhesive dressings’ Figure 1: Nurses’working specialities 35 30 25 20 15 13 15 10 10 5 3 2 0 Medicine Surgery Palliative care Intensive care Outpatients/consultations Home care 33 24 12 5 Geriatrics / Long-term care Rehabilitation Other JOURNAL OF WOUND MANAGEMENT Figure 1: Nurses’ w O o FF r I k C i IA n L g JO s U p R e N c A i L a O li F ti T e H s E EUROPEAN WOUND MANAGEMENT ASSOCIATION 80
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