Development and psychometric validation of PUKAT 2·0, a knowledge assessment tool for pressure ulcer prevention

Int Wound J. 2017 Dec;14(6):1041-1051. doi: 10.1111/iwj.12758. Epub 2017 May 26.


The aim of this study was to develop a tool to measure the knowledge of nurses on pressure ulcer prevention. PUKAT 2·0 is a revised and updated version of the Pressure Ulcer Knowledge Assessment Tool (PUKAT) developed in 2010 at Ghent University, Belgium. The updated version was developed using state-of-the-art techniques to establish evidence concerning validity and reliability. Face and content validity were determined through a Delphi procedure including both experts from the European Pressure Ulcer Advisory Panel (EPUAP) and the National Pressure Ulcer Advisory Panel (NPUAP) (n = 15). A subsequent psychometric evaluation of 342 nurses and nursing students evaluated the item difficulty, discriminating power and quality of the response alternatives. Furthermore, construct validity was established through a test-retest procedure and the known-groups technique. The content validity was good and the difficulty level moderate. The discernment was found to be excellent: all groups with a (theoretically expected) higher level of expertise had a significantly higher score than the groups with a (theoretically expected) lower level of expertise. The stability of the tool is sufficient (Intraclass Correlation Coefficient = 0·69). The PUKAT 2·0 demonstrated good psychometric properties and can be used and disseminated internationally to assess knowledge about pressure ulcer prevention.

Keywords: Knowledge assessment tool; Nursing; Pressure ulcers; Prevention; Psychometric validity.

MeSH terms

  • Adult
  • Belgium
  • Clinical Competence*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Nursing Staff, Hospital
  • Pressure Ulcer / diagnosis
  • Pressure Ulcer / nursing*
  • Pressure Ulcer / prevention & control*
  • Prospective Studies
  • Psychometrics
  • Reproducibility of Results
  • Students, Nursing
  • Young Adult