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GLOBIAD-tool: a tool for the categorisation of incontinence-associated dermatitis

Hödl M.

Background

Incontinence is a common care problem and increases with age1. Urinary, fecal- and double incontinence lead to rising health care costs and a higher workload for nursing staff. Additionally, incontinence can lead to serious consequences for the affected individual, such as a decreased health status or quality of life2-4 as well as incontinence-associated dermatitis (IAD)1, 5.

IAD is commonly caused by the prolonged exposure of the skin to urine or fecal material6. International prevalence and incidence rates are reported to be up to 30%7 8.

IAD can lead to pain and itching9 and is a well-known risk factor for pressure injuries10. Besides IAD management is also time-consuming for nurses9. Authors showed that the total costs (nursing time, product cost) for the management of an IAD range between 108.77 USD and 135.68USD per patient11.

The Ghent Global Incontinence-associated dermatitis Categorisation Tool (GLOBIAD) was invented/developed at Ghent University (Belgium) by 34 experts from 13 countries worldwide9. The project was leaded by the Skin Integrity Group (SKINT) from 2015 to 2018. The English version of the GLOBIAD-tool was tested by more than 800 health care professionals from 30 countries9.

In a first step, the English version of the GLOBIAD-tool was translated in the years 2016-2018 from German, Swiss and Austrian experts in accordance with the guidelines of the “International Society for Pharmacoeconomics and Outcomes Research” 12, into German13. Moreover a pilot version of the GLOBIAD-tool was tested on its clinical relevance14. This study showed, that more than 75% of the participants, assess the GLOBIAD-tool as clinically relevant.

 

Aim

 

However before using an instrument in nursing practice, psychometric testing is recommended. More specifically, the reliability, validity and practicability should be investigated 15. Therefore, the aim of this study is to test the GLOBIAD tool with regard to interrater reliability, practicability, and clinical relevance.

 

Methods

This multicenter cross-sectional study is conducted in participating health care institutions (Hospitals, Long-term care etc.) in Germany and Austria. Hence, two nurses independently assess the IAD of the affected individual based on skin inspection. Data on practicability and clinical relevance are collected with a questionnaire.

 

Current publications

Köberich S, Hoedl M, Kohler M, et al. Übersetzung eines Instrumentes zur Kategorisierung der Inkontinenz assoziierten Dermatitis: Deutsche Version des Ghent Global IAD Categorisation Tools (GLOBIAD). Paper presented at: Pflegekongress19, 2019; Wien.

Hoedl M, Eglseer D, Lohrmann C. Clinical utility of the German Ghent Global IAD Categorization tool including incontinence‐associated dermatitis prevalence and categories. International Journal of Urological Nursing. 2019.

 

REFERENCES

1. Gray M, Bliss DZ, Doughty DB, Ermer-Seltun J, Kennedy-Evans KL, Palmer MH. Incontinence-associated dermatitis: a consensus. Journal of wound, ostomy, and continence nursing : official publication of The Wound, Ostomy and Continence Nurses Society / WOCN. 2007;34(1):45-54; quiz 55-46.

2. Gray M, Beeckman D, Bliss DZ, et al. Incontinence-associated dermatitis: a comprehensive review and update. Journal of wound, ostomy, and continence nursing : official publication of The Wound, Ostomy and Continence Nurses Society / WOCN. 2012;39(1):61-74.

3. Van Damme N, Van den Bussche K, De Meyer D, Van Hecke A, Verhaeghe S, Beeckman D. Independent risk factors for the development of skin erosion due to incontinence (incontinence-associated dermatitis category 2) in nursing home residents: results from a multivariate binary regression analysis. International wound journal. 2017;14(5):801-810.

4. Avsar P, Karadag A. Efficacy and Cost-Effectiveness Analysis of Evidence-Based Nursing Interventions to Maintain Tissue Integrity to Prevent Pressure Ulcers and Incontinence-Associated Dermatitis. Worldviews on evidence-based nursing. 2018;15(1):54-61.

5. Beeckman D, Van den Bussche K, Alves P, et al. Towards an international language for Incontinence-Associated Dermatitis (IAD): design and evaluation of psychometric properties of the Ghent Global IAD Categorisation Tool (GLOBIAD) in 30 countries. The British journal of dermatology. 2018.

6. Wild D, Grove A, Martin M, et al. Principles of Good Practice for the Translation and Cultural Adaptation Process for Patient-Reported Outcomes (PRO) Measures: report of the ISPOR Task Force for Translation and Cultural Adaptation. Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research. 2005;8(2):94-104.

7. Köberich S, Hoedl M, Kohler M, et al. Übersetzung eines Instrumentes zur Kategorisierung der Inkontinenz assoziierten Dermatitis: Deutsche Version des Ghent Global IAD Categorisation Tools (GLOBIAD). Paper presented at: Pflegekongress192019; Wien.

8. Hoedl M, Eglseer D, Lohrmann C. Clinical utility of the German Ghent Global IAD Categorization tool including incontinence‐associated dermatitis prevalence and categories. International Journal of Urological Nursing. 2019.

9. Polit DF, Beck CT. Nursing research : generating and assessing evidence for nursing practice. 2017.

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