Murat ZENCİRKIRAN, Yasemin KURTOĞLU, Çağla ÖZDEMİR, Adem DURMAZ
Türkiye Aile Hekimliği Dergisi - 2026;30(1):1-10
Objective: This study aimed to adapt the Gosnell Pressure Ulcer Risk Assessment Scale into Turkish and to evaluate its linguistic validity, content validity, inter-observer reliability, and construct validity through exploratory and confirmatory factor analyses. Methods: This methodological study was conducted with 150 patients treated in a palliative care unit over one year. The adaptation process consisted of two stages: linguistic validation and assessment of validity and reliability. Linguistic validity was assessed using the translation-back translation method and expert reviews. Content validity was evaluated using the Lawshe technique with input from five experts from the Department of Family Medicine. Reliability was assessed by measuring inter-observer agreement using the Kappa coefficient, Cramer's V coefficient, and Spearman correlation analysis. To evaluate construct validity, Exploratory Factor Analysis (EFA) using Principal Component Analysis and Confirmatory Factor Analysis (CFA) using the Diagonally Weighted Least Squares (DWLS) estimation method were conducted. Results: A total of 150 participants were included, with a mean age of 74.74 years, and 58% were female. The Content Validity Ratio (CVR) for each item was calculated as 1. Regarding reliability, the Kappa coefficient for the Mental Status item was 0.903, and Cramer's V coefficient was 0.896; for the Continence, Mobility, and Activity items, both the Kappa and Cramer's V coefficients were 1. For the Nutrition item, the Kappa coefficient was 0.840, and Cramer's V coefficient was 0.862. A significant and positive correlation was found between the total scores of the two observers (p<0.001). For construct validity, the EFA revealed a single-factor structure explaining 62.039% of the total variance, with a Kaiser-Meyer-Olkin (KMO) value of 0.783 and Bartlett's test of sphericity being significant (chi²(10)=383.266, p<0.001). The subsequent CFA showed a marginal model fit (chi²/df=5.627), while all factor loadings were statistically significant (p<0.001). The Nutrition item demonstrated a relatively lower loading (0.457), suggesting possible cultural or contextual differences in the Turkish sample. Conclusion: The Turkish version of the Gosnell Pressure Ulcer Risk Assessment Scale was found to be a valid and reliable tool for use by healthcare professionals in Türkiye. The scale showed acceptable content and construct validity.
