Construct validity of the Braden scale in acute- and long-term care settings in Austria: A structural equation modeling analysis

Abstract

Objective: The Braden scale is frequently used to assess pressure ulcer risk in health care settings. Selected psychometric properties have been tested using various methods of classical test theory in international studies. However, limited information on construct validity is available. Aim was to determine if the Braden subscale items correlate with the construct pressure ulcer risk and whether the construct validity concerning the factor structure of the Braden scale is adequate in acute and long-term settings.Methods: A quantitative design with secondary analysis of data from one acute (n = 328) and eight long-term care facilities (n = 311) in Austria was used to test construct validity. Data analysis included principal axis factor analysis with Promax rotation and assessment of internal consistency, followed by structural equation modeling.Results: For the acute care setting, a structure equation model with two latent factors and for the long-term care setting with one latent factor was tested according to principal axis factoring results. The Braden subscale items correlated with the construct pressure ulcer risk. Almost all examined model fit indices were within recommended reference values. Thus, the construct validity of the Braden scale was adequate in both settings.Conclusions: The factor structure in the acute care setting did not match that in the investigated long-term care setting. Further research regarding the construct validity of the Braden scale is therefore necessary.