EXAMINING THE CONVERGENT CONSTRUCT VALIDITY OF THE BRADEN SCALE’S MOBILITY AND ACTIVITY SUBSCALES IN NURSING HOMES USING TRIAXIAL ACCELEROMETRY

Abstract

EXAMINING THE CONVERGENT CONSTRUCT VALIDITY OF THE BRADEN SCALE’S MOBILITY AND ACTIVITY SUBSCALES IN NURSING HOMES USING TRIAXIAL ACCELEROMETRY

By Christine Barnes July 2022

Director of Dissertation: Susan M. Kennerly, PhD, RN, CNE, WCC, FAAN Major Department: Nursing

ABSTRACT Pressure injuries (PrIs) are areas of skin, muscle, and tissue believed to be damaged by external pressure usually due to lack of movement/mobility and remaining in one position. Most PrIs are preventable, yet remain a healthcare problem in nursing homes (NHs) where many residents experience aging related cognitive and physical declines that increase PrI risk. A valid tool is foundational to nursing staff ability to assess and identify individuals at risk in order to prevent PrIs. The Braden Scale for Predicting Pressure Sore Risk© (hereafter, Braden Scale), the most commonly used PrI risk assessment tool in the U.S., has demonstrated reliability and predictive validity in NH settings; however, its construct validity has been challenged and has not been as well studied. This retrospective non-experimental study examined the convergent construct validity of the Braden Scale’s Mobility and Activity subscales using secondary analysis of subscale and repositioning movement data collected in nine U.S. NHs during implementation of the 1R01NR016001 (Turn Everyone And Move for Ulcer Prevention [TEAM-UP] cluster randomized controlled trial). Results of bivariate analyses for NH residents’ (N = 562) Braden Scale Mobility, Activity, and Sensory Perception subscale scores and movement parameters (upright, lying, ambulating) revealed consistent correspondence between Braden Scale subscale scores and movement parameters [r(561) > .16-.59, p < .0001] and together accurately predicted movement outcomes (.0444 < R2 < .3667, p < .005). Mobility and Activity subscale scores had individual predictive effects (p < .05), while Sensory Perception subscale scores were not significant predictors (p > .05) of movement parameters. Findings indicate that subscale ratings assigned by nursing staff accurately represented resident movements and reinforce the confidence one can have in nursing staff’s ability to use the Braden Scale for PrI risk assessment and to guide care planning of mobility and activity interventions, such as repositioning and walking aimed at preventing PrI.