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Validating the Italian Version of the International Skin Tear Advisory Panel Classification System
Barbara Bassola1, Paolo Ceci, Angela Lolli
1In Milan, Italy, Barbara Bassola, MSc, RN, is a PhD Student and Professor, School of Nursing, University of Milan Niguarda Hospital; Paolo Ceci, RN, is a Nurse, Maddalena Grassi Foundation; and Angela Lolli, MSc, RN, is Nursing Director, Niguarda Hospital. Kimberly LeBlanc, PhD, RN, WOCN, CET(D), is Academy Chair, Canadian Association for Enterostomal Therapists, Ottawa, Ontario, Canada. Maura Lusignani, MSc, RN, is Associate Professor, Department of Biomedical Sciences for Health, University of Milan, Italy. Acknowledgments: The authors thank the International Skin Tear Advisory Panel Classification for permission to use their classification system and thank Niguarda Hospital for participating in the study. The authors have disclosed no financial relationships related to this article. Submitted September 11, 2018; accepted in revised form October 12, 2018; published ahead of print July 10, 2019.
Objective:
To validate the International Skin Tear Advisory Panel (ISTAP) Classification System in Italian.
Methods:
In collaboration with the ISTAP, the classification system was translated into Italian using a forward-back translation process. To validate the translated system, a convenience sample of 212 health professionals classified 30 photographs of skin tears originally used by ISTAP. The wound images were labeled type 1, 2, or 3 as described by the classification system. The resulting scores were compared with the ISTAP classification, and the reliability of agreement was calculated with Fleiss κ.
Results:
Complete data were obtained from 209 healthcare professionals. When the image classifications were compared with the original ISTAP indications, 72.5% of all classifications were correct. Data indicated a moderate level of agreement (Fleiss κ = 0.466, range = 0.41-0.60). Data analysis showed similar agreement levels between nurses (n = 197, Fleiss κ = 0.466) and nonnurses (n = 12, Fleiss κ = 0.46).
Conclusions:
The study validates the Italian version of the ISTAP skin tear classification system. Further studies are necessary to confirm the system's usability in Italian research and clinical settings.
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