Establishing nurses' preferences in wound assessment: a concept evaluation

The aim of the study was to contribute to increasing reliability of wound assessment. The objectives were to capture terminology used and to assess whether these words reflected personality preferences for information.

Wound assessment forms are expected to be used reliably by non-experts. This assumes that they mean the same thing to all practitioners. But many wound assessment forms are too complicated and do not necessarily show whether a wound is healing or not. Literature indicates that people have different information preferences that they use to aid judgement.

A correlational study investigating the relationship between word-preferences and assessor's personality type.

Postregistration students (n = 45) and Tissue Viability Nurses (n = 16) suggested words or phrases to be used in an hypothetical wound assessment. Analysis was performed of how they preferred to describe healing, stasis and deterioration. They ranked the three most important signs they would look for in the three phases of wounds. Words were classified into categories (e.g. subjective, objective, value judgement), then matched with preferences seen in a personality type indicator.

Healing and deteriorating wounds were assessed relative to different signs or symptoms and static wounds were the most difficult to describe (mostly by absence of signs of healing). Personal types of approach to assessment could be identified: including subjectifiers and quantifiers.

In this preliminary study, statistically significant results support the view that wound assessment involves assessor preferences. Assessors judge by the absence rather than the presence of some signs and symptoms.

Wound assessment forms need to take account of assessor preferences for subjectivity or quantification if reliability is to be increased, also different wound assessment forms could suit different wound phases. Potentially, assessor types could seek agreement more on outcomes of assessment rather than input.