Initial Validation and Psychometric Properties of the Croatian Version of the Pieper-Zulkowski Pressure Ulcer Knowledge Test

Background: Understanding and preventing pressure ulcers are key aspects of healthcare, with nurses playing a crucial role in their management and prevention through education and clinical practice to improve patient outcomes. Objectives: This quantitative, psychometric, cross-sectional study aims to translate and culturally adapt the Pieper-Zulkowski Pressure Ulcer Knowledge Test and to evaluate the psy-chometric properties of the Croatian version of this measurement instrument. Meth-ods: A study was conducted in a state hospital in Šibenik, Croatia on a sample of 268 participants. Results: The content validity of the instrument, with an S-CVI of 0.981, indicates excellent validity, while its internal consistency is acceptable, as reflected in an overall KR-20 of 0.79. The maximum split-half reliability is 0.87, and Guttman Lambda 6 reaches 0.89, indicating excellent internal consistency. The overall test-retest reliability is excellent (ICC = 0.91), with the Prevention subscale showing the highest reliability (ICC = 0.88), followed by Staging (ICC = 0.86) and Wound Description (ICC = 0.84). Item-level difficulty and discrimination index were calculated. Conclusions: The adapted, translated, and validated questionnaire represents a valuable tool for measuring knowledge about pressure ulcers, suitable for use in Croatian society. The instrument can be used to assess knowledge in clinical settings and evaluate the effec-tiveness of educational programs, providing valuable insights into the education and professional competence development of healthcare professionals.