[German translation and adaptation of the uncertainty stress scale high risk pregnancy version III (USS-HRPV) for hospitalised women with high-risk pregnancy]. / Deutsche Übersetzung und Adaptation der «Uncertainty Stress Scale High Risk Pregnancy Version III¼ (USS-HRPV) für hospitalisierte Frauen mit Risikoschwangerschaft.

BACKGROUND: A number of medical and societal factors currently contribute to an increasing number of women who are hospitalised because they are experiencing high-risk pregnancies. The unpredictability of the further course of pregnancy may lead to a feeling of uncertainty, as well as to stress, depending on coping strategies. AIMS: The aims of this study were thus to translate and adapt the USS-HRPV so that uncertainty and stress could be systematically measured on affected women in German speaking areas. METHOD: Translation of the scale was undertaken by first translating into German and then back into English. The two-phase adaptation, carried out with affected women (n = 24) and midwives (n = 10), comprised cognitive interviews and testing of content validity using the Content Validity Index (CVI). Following each data collection phase the instrument was modified with the help of midwifery experts (n = 3). RESULTS: For each item the calculated CVI (I-CVI) in the first phase ranged between 0,10 and 1,0 for the sample of relevant women and midwives while the CVI of the total instrument (S-CVI/Ave) was 0,62 and 0,70 respectively. In the second phase the I-CVI values of the hospitalised women ranged between 0,17 and 1,0 while the S-CVI/Ave value was 0,73. With regard to all of the data, 44 of the original 86 items were removed and 28 altered on language grounds. CONCLUSIONS: As a result of the methodical approach utilised, a firm basis for further validation of the instrument for German speaking areas has been provided.

Period prevalence and risk factors for postoperative short-term wound complications in vulvar cancer: a cross-sectional study.

INTRODUCTION: Although clinicians recognize that postoperative wound management in patients with vulvar cancer (VC) is challenging, the prevalence and risk factors for different types of short-term wound complications (WCs) remain unclear. The aims of this study were: (1) to determine the period prevalence of postoperative short-term WCs and (2) to identify risk factors associated with short-term WCs in patients with VC. METHOD: In a cross-sectional study in a Swiss University Hospital, a sample of 108 patients with VC treated surgically (and free of WCs at the time of admission) was included. Data were collected retrospectively from 2007 to 1997 from medical records using an investigator-developed data collection instrument to assess risk factors preoperatively and perioperatively and WCs that occurred within the first 30 postoperative hospital days. The period prevalence of WCs was calculated, and logistic regression was used to identify risk factors for WCs. RESULTS: The median age was 69 years (interquartile range [IQR], 21 years). The period prevalence of WCs was 45.4% (49/108), showing at least 1 of 8 assessed WCs per patient within the median hospital duration of 11 days (IQR, 12 days). The period prevalence for each type of WC was 31.5% for dehiscence, 12% for hematoma, 6.5% for necrosis, 5.6% for infections, 4.6% for seroma, 1.9% for lymph cysts, 1.9% for malignant wounds, and 0% for disturbed tissue formation. Two significant predictors of WCs were identified out of 14 risk factors examined (P < 0.05). The odds ratio (OR) for WC increased with the extent of surgical therapy, ie, from excision to hemivulvectomy and to radical vulvectomy, by a factor of 2.6 (OR, 2.6; 95% confidence interval [CI], 1.34-5.14), and, in the case of inguinofemoral lymphadenectomy, by a factor of 3 (OR, 3.0; 95% CI, 1.03-8.76). CONCLUSION: The high prevalence of short-term WCs (45.4%) indicates a need for systematic wound assessment and early risk management--especially after hemivulvectomy, radical vulvectomy, and inguinal lymphadenectomy.