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Validation of the Bluebelle Wound Healing questionnaire (WHQ) for assessment of surgical site infection in primary surgical wounds after hospital discharge

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Andronis, L. (Lazaros) , Blazeby, Jane, Reeves, Barnaby , Brookes, Sara , Avery, Kerry, Rogers, Chris , Woodward, Mark, Welton, Nicky, Rooshenas, Leila, Mathers, Jonathan et al.
(2019) Validation of the Bluebelle Wound Healing questionnaire (WHQ) for assessment of surgical site infection in primary surgical wounds after hospital discharge. British Journal of Surgery, 106 (3). pp. 226-235. doi:10.1002/bjs.11008

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Official URL: https://doi.org/10.1002/bjs.11008

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Abstract

Background

Accurate assessment of surgical‐site infection (SSI) is crucial for surveillance and research. Self‐reporting patient measures are needed because current SSI tools are limited for assessing patients after leaving hospital. The Bluebelle Wound Healing Questionnaire (WHQ) was developed for patient or observer completion; this study tested its acceptability, scale structure, reliability and validity in patients with closed primary wounds after abdominal surgery.

Methods

Patients completed the WHQ (self‐assessment) within 30 days after leaving hospital and returned it by post. Healthcare professionals completed the WHQ (observer assessment) by telephone or face‐to‐face. Questionnaire response rates and patient acceptability were assessed. Factor analysis and Cronbach's α examined scale structure and internal consistency. Test–retest and self‐ versus observer reliability assessments were performed. Sensitivity and specificity for SSI discrimination against a face‐to‐face reference diagnosis (using Centers for Disease Control and Prevention criteria) were examined.

Results

Some 561 of 792 self‐assessments (70·8 per cent) and 597 of 791 observer assessments (75·5 per cent) were completed, with few missing data or problems reported. Data supported a single‐scale structure with strong internal consistency (α greater than 0·8). Reliability between test–retest and self‐ versus observer assessments was good (κ 0·6 or above for the majority of items). Sensitivity and specificity for SSI discrimination was high (area under the receiver operating characteristic (ROC) curve 0·91).

Conclusion

The Bluebelle WHQ is acceptable, reliable and valid with a single‐scale structure for postdischarge patient or observer assessment of SSI in closed primary wounds.

Item Type: Journal Article
Subjects: R Medicine > RD Surgery
Divisions: Faculty of Medicine > Warwick Medical School > Health Sciences > Clinical Trials Unit
Faculty of Medicine > Warwick Medical School > Health Sciences
Faculty of Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH): Surgical wound infections
Journal or Publication Title: British Journal of Surgery
Publisher: John Wiley & Sons Ltd.
ISSN: 0007-1323
Official Date: February 2019
Dates:
DateEvent
February 2019Published
17 December 2018Available
5 September 2018Accepted
Volume: 106
Number: 3
Page Range: pp. 226-235
DOI: 10.1002/bjs.11008
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Open Access
RIOXX Funder/Project Grant:
Project/Grant IDRIOXX Funder NameFunder ID
12/200/04Health Technology Assessment programmehttp://dx.doi.org/10.13039/501100000664
MR/K025643/1[MRC] Medical Research Councilhttp://dx.doi.org/10.13039/501100000265
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Contributors:
ContributionNameContributor ID
Research GroupBluebelle Study Group, UNSPECIFIED

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