Validity and Reliability Testing of the Turkish Version of the Critical Care Pressure Ulcer Assessment Tool Made Easy (CALCULATE) Scale


POLAT DÜNYA C., ÖZEN N., Ceylan F. N., Ünlü A., McEvoy N. L.

International Journal of Nursing Practice, vol.32, no.1, 2026 (SCI-Expanded, SSCI, Scopus) identifier identifier

  • Publication Type: Article / Article
  • Volume: 32 Issue: 1
  • Publication Date: 2026
  • Doi Number: 10.1111/ijn.70106
  • Journal Name: International Journal of Nursing Practice
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Social Sciences Citation Index (SSCI), Scopus, CINAHL, MEDLINE, Psycinfo
  • Keywords: intensive care unit, pressure injury, reliability, risk assessment, validity
  • Istanbul University Affiliated: Yes

Abstract

Aim: The aim of this study was to translate the CALCULATE Scale into Turkish in adult intensive care unit (ICU) patients and assess its validity and reliability. Method: This study was conducted in a general ICU in Turkey. The CALCULATE and Braden scales were evaluated by two nurses at admission and reassessed daily for 72 h or until discharge, death or PI development. Concurrent validity was assessed using Pearson's correlation. Predictive validity was evaluated via ROC analysis, with sensitivity, specificity, AUC and optimal cut-off points calculated using Youden's Index. Interobserver agreement was examined using intraclass correlation coefficients. Results: In total, 728 assessments (364 CALCULATE and 364 Braden) were performed among 91 patients, resulting in a mean of 4.0 assessments per patient. The Turkish version of the CALCULATE Scale demonstrated excellent content validity (CVI = 0.97) and inter-rater reliability (ICC = 0.952). The CALCULATE Scale demonstrated superior predictive performance (AUC = 0.795) compared with the Braden Scale (AUC = 0.679), showing both higher specificity (78.38%) and greater sensitivity (64.81%). Furthermore, a significant inverse correlation (r = −0.701, p < 0.001) was found between the CALCULATE and Braden scores, confirming concurrent validity. Conclusion: The Turkish CALCULATE Scale is a valid and reliable instrument for assessing PI risk in adult ICU patients. Its integration into ICU practice can support early detection and timely prevention.