Translation, Cultural Adaptation, and Content Validity of a Modified Italian Version of the Jackson/Cubbin Pressure Injury Risk Assessment Scale for ICU Patients
<b>Background/Objectives</b>: The Jackson/Cubbin scale is a recommended tool to assess the risk of pressure injury in intensive care unit (ICU) patients. This scale is deemed to have superior predictive validity compared to the Braden scale. Many Italian nurses struggle with reading and...
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MDPI AG
2025-07-01
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| author | Chiara Rollo Daniela Magnani Sara Alberti Brigitta Fazzini Sergio Rovesti Paola Ferri |
| author_facet | Chiara Rollo Daniela Magnani Sara Alberti Brigitta Fazzini Sergio Rovesti Paola Ferri |
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| description | <b>Background/Objectives</b>: The Jackson/Cubbin scale is a recommended tool to assess the risk of pressure injury in intensive care unit (ICU) patients. This scale is deemed to have superior predictive validity compared to the Braden scale. Many Italian nurses struggle with reading and applying the tool in English. This language barrier results in a lack of use of the Jackson/Cubbin scale clinically, meaning that patients potentially experience worse outcomes. This study aims to translate the original English version of the Jackson/Cubbin scale into the Italian language, conduct a cultural adaptation, and verify its content validity. <b>Methods</b>: An observational study was conducted using Beaton’s five-step methodology: (1) forward translation, (2) synthesis, (3) back-translation, (4) expert committee approval using Fleiss’ Kappa (κ) index, and (5) pre-testing, where participants assessed item clarity on a dichotomous scale (clear/unclear). Items deemed unclear by 20% or more of the sample were revised. Content validity was assessed using the Content Validity Index (CVI). <b>Results</b>: Fleiss’ κ index was 0.74. Item 3 “PMH-affecting condition” was unclear to 36% of the sample and required revision. The item-level CVI (I-CVI) was >0.78 for each item. The scale-level CVI (S-CVI) and the scale-level CVI using the average method (S-CVI-Ave) were 0.92 and 0.94, respectively. <b>Conclusions</b>: The translation process resulted in a linguistically accurate scale requiring content modifications to reflect current evidence and reduce inter-rater variability. This may improve implementation of the Jackson/Cubbin scale in clinical practice for Italian nurses and reduce the incidence of pressure injury for ICU patients. |
| format | Article |
| id | doaj-art-c09e9d45916d4366b52ab4f5df2d4bef |
| institution | Kabale University |
| issn | 2039-439X 2039-4403 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | MDPI AG |
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| series | Nursing Reports |
| spelling | doaj-art-c09e9d45916d4366b52ab4f5df2d4bef2025-08-20T03:56:46ZengMDPI AGNursing Reports2039-439X2039-44032025-07-0115725610.3390/nursrep15070256Translation, Cultural Adaptation, and Content Validity of a Modified Italian Version of the Jackson/Cubbin Pressure Injury Risk Assessment Scale for ICU PatientsChiara Rollo0Daniela Magnani1Sara Alberti2Brigitta Fazzini3Sergio Rovesti4Paola Ferri5Territorial Emergency Nurse, Azienda Sanitaria Locale, 72100 Brindisi, ItalyIntensive Unit, University Hospital of Modena, 41124 Modena, ItalyClinical and Experimental Medicine PhD Program, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41121 Modena, ItalyWilliam Harvey Research Institute, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, London E1 2AT, UKDepartment of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41100 Modena, ItalyDepartment of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41100 Modena, Italy<b>Background/Objectives</b>: The Jackson/Cubbin scale is a recommended tool to assess the risk of pressure injury in intensive care unit (ICU) patients. This scale is deemed to have superior predictive validity compared to the Braden scale. Many Italian nurses struggle with reading and applying the tool in English. This language barrier results in a lack of use of the Jackson/Cubbin scale clinically, meaning that patients potentially experience worse outcomes. This study aims to translate the original English version of the Jackson/Cubbin scale into the Italian language, conduct a cultural adaptation, and verify its content validity. <b>Methods</b>: An observational study was conducted using Beaton’s five-step methodology: (1) forward translation, (2) synthesis, (3) back-translation, (4) expert committee approval using Fleiss’ Kappa (κ) index, and (5) pre-testing, where participants assessed item clarity on a dichotomous scale (clear/unclear). Items deemed unclear by 20% or more of the sample were revised. Content validity was assessed using the Content Validity Index (CVI). <b>Results</b>: Fleiss’ κ index was 0.74. Item 3 “PMH-affecting condition” was unclear to 36% of the sample and required revision. The item-level CVI (I-CVI) was >0.78 for each item. The scale-level CVI (S-CVI) and the scale-level CVI using the average method (S-CVI-Ave) were 0.92 and 0.94, respectively. <b>Conclusions</b>: The translation process resulted in a linguistically accurate scale requiring content modifications to reflect current evidence and reduce inter-rater variability. This may improve implementation of the Jackson/Cubbin scale in clinical practice for Italian nurses and reduce the incidence of pressure injury for ICU patients.https://www.mdpi.com/2039-4403/15/7/256pressure ulcerrisk assessmentintensive care unitstranslationcultural adaptationJackson/Cubbin |
| spellingShingle | Chiara Rollo Daniela Magnani Sara Alberti Brigitta Fazzini Sergio Rovesti Paola Ferri Translation, Cultural Adaptation, and Content Validity of a Modified Italian Version of the Jackson/Cubbin Pressure Injury Risk Assessment Scale for ICU Patients Nursing Reports pressure ulcer risk assessment intensive care units translation cultural adaptation Jackson/Cubbin |
| title | Translation, Cultural Adaptation, and Content Validity of a Modified Italian Version of the Jackson/Cubbin Pressure Injury Risk Assessment Scale for ICU Patients |
| title_full | Translation, Cultural Adaptation, and Content Validity of a Modified Italian Version of the Jackson/Cubbin Pressure Injury Risk Assessment Scale for ICU Patients |
| title_fullStr | Translation, Cultural Adaptation, and Content Validity of a Modified Italian Version of the Jackson/Cubbin Pressure Injury Risk Assessment Scale for ICU Patients |
| title_full_unstemmed | Translation, Cultural Adaptation, and Content Validity of a Modified Italian Version of the Jackson/Cubbin Pressure Injury Risk Assessment Scale for ICU Patients |
| title_short | Translation, Cultural Adaptation, and Content Validity of a Modified Italian Version of the Jackson/Cubbin Pressure Injury Risk Assessment Scale for ICU Patients |
| title_sort | translation cultural adaptation and content validity of a modified italian version of the jackson cubbin pressure injury risk assessment scale for icu patients |
| topic | pressure ulcer risk assessment intensive care units translation cultural adaptation Jackson/Cubbin |
| url | https://www.mdpi.com/2039-4403/15/7/256 |
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