The Braden Scale

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The Braden Scale is a clinically valued tool that is used to predict pressure ulcers. The scale is broken down into six sub-scales; these subscales determine the risk factors associated with skin break down. Multiple aspects of a patients condition are examined, (sensory perception, moisture, activity, mobility, nutrition, friction and shear), to limit the patients susceptibility for skin break down. Since pressure ulcers are a financial burden and a cause for patient discomfort and possible infection, predicting and assessing risk has enormous benefit and significance.
This study was conducted to determine the validity of the mobility subscale of the Braden scale. The subscale of mobility is defined as the patients ability to change and control body positions. The research was conducted in a veteran hospital, and participants ranged in age from 45-95 years. The tools that were used were the Braden scale and actigraphy which measures movement. It was placed on the patient’s non-dominant ankle in order to observe the larger movements of the patient. The researcher defined each score in relation to movement. They hypothesized that the increase in movement would cause an increase in score of the mobility subscale. As predicted, the mobility subscale scores increased as movement increased.

A similar study to predict risk of ulcers in pediatric patients was conducted to test the validity of using the Braden Q scale. A modified version of the Braden Scale, only containing three subscales, was used to utilize a shorter comparable tool. The Braden Q Scale is a revision of the Braden scale that is applicable in pediatrics. The two tools that were used were: the Braden Q Scale and skin assessments. The sample study consisted of 322 patients who were on bed rest for at least 24 hours. The patients were observed three times per week, for two weeks, and then weekly until discharge, which totaled 887 individual assessments. It was determined that both the Braden Q, as well as the modified Braden Scale was adequate tools to measure skin breakdown.

Both studies modified the original Braden Scale to test the validity of their modifications. The first study was based solely on the mobility scale of the Braden scale, while the second study used three of the original sub-scales to prove comparable results to the overall scale. Both studies were designed to simplify the Braden scale in order to determine the effectiveness of the subscales alone.

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Both studies determined that the modified Braden scale was comparably effective.

The results of the studies were similar but they varied in sample size and the numbers of variables in each study were different. Study one used one variable and a small sample size, whereas study number two had multivariable, and had a large sample size. The first study used inductive reasoning to prove their hypotheses, because they started with the subscale and worked towards the Braden scale. The second study uses deductive reasoning, because it stared with the Braden scale and then they started to remove subscales. The two studies proved their hypotheses, but used different approaches to reach them.














Bibliography
Curley, A. M. (2003). Predicting pressure ulcer risk on pediatric patients. Nursing
Research, 52, 22-30.

Powers C. G. (2004). Validation of the mobility subscale of the Braden scale for
predicting pressure sore risks. Nursing Research, 53, 340-346.
     


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