Development and validation of the pressure ulcer management self-efficacy scale for nurses

Federica Dellafiore, Cristina Arrigoni, Greta Ghizzardi, Irene Baroni, Gianluca Conte, Francesca Turrini, Gianluca Castiello, Arianna Magon, Francesco Pittella, Rosario Caruso

Research output: Contribution to journalArticlepeer-review


Background: Pressure ulcers (PUs) represent a current issue for healthcare delivery. Nurse self-efficacy in managing PUs could predict patients’ outcome, being a proxy assessment of their overall competency to managing PUs. However, a valid and reliable scale of this task-specific self-efficacy has not yet been developed. Objectives: To develop a valid and reliable scale to assess nurses’ self-efficacy in managing PUs, that is, the pressure ulcer management self-efficacy scale for nurses (PUM-SES). Methods: This study had a multi-method and multi-phase design, where study reporting was supported by the STROBE checklist (File S1). Phase 1 referred to the scale development, consisting in the items’ generation, mainly based on themes emerged from the literature and discussed within a panel of experts. Phase 2 focused on a three-step validation process: the first step aimed to assess face and content validity of the pool of items previously generated (initial version of the PUM-SES); the second aimed to assess psychometrics properties through exploratory factorial analysis; the third step assessed construct validity through confirmative factorial analysis, while concurrent validity was evaluated describing the relationships between PUM-SES and an established general self-efficacy measurement. Reliability was assessed through the evaluation of stability and internal consistency. Results: PUM-SES showed evidence of face and content validity, adequate construct and concurrent validity, internal consistency and stability. Specifically, PUM-SES had four domains, labelled as follows: assessment, planning, supervision and decision-making. These domains were predicted by the same second-order factor, labelled as PU management self-efficacy. Conclusion: PUM-SES is a 10-item scale to measure nurses’ self-efficacy in PU management. A standardised 0–100 scoring is suggested for computing each domain and the overall scale. PUM-SES might be used in clinical and educational research. Relevance to clinical practice: Optimising nurses’ self-efficacy in PU management might enhance clinical assessment, determining better outcomes in patients with PUs.

Original languageEnglish
Pages (from-to)3177-3188
Number of pages12
JournalJournal of Clinical Nursing
Issue number17-18
Publication statusPublished - Jan 1 2019


  • pressure ulcers
  • reliability
  • scale development
  • self-efficacy
  • validation

ASJC Scopus subject areas

  • Nursing(all)


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