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April 30, 2026Health Science Reports0 citationsOpen Access

Methodological Appraisal of the Munro Scale: Psychometric Properties and Diagnostic Accuracy in Adult Surgical Patients: A Methodological Study

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LSLeila SadatiJahrom University of Medical SciencesSKSahar KaramiTehran University of Medical SciencesNMNasim Jamshid MalekaraUrmia University of Technology

Key Points

  • This study aims to evaluate the psychometric properties and diagnostic accuracy of the Munro Pressure Ulcer Risk Assessment Scale in surgical patients.
  • Conducted on 200 adult surgical patients from October 2024 to May 2025.
  • Used the Munro Pressure Injury Risk Assessment Scale and a demographic questionnaire for data collection.
  • Employed psychometric testing including content validity, construct validity, and reliability analysis.
  • 18.5% of surgical patients developed pressure injuries, mainly Stage I and II.
  • Reliability analysis showed Cronbach's alpha values of 0.84, 0.62, and 0.83 for different risk factors.
  • Confirmatory factor analysis indicated a moderate or limited fit, confirming the scale's construct validity.

Abstract

ABSTRACT Background Pressure injuries during the perioperative period can adversely affect postoperative outcomes and patient recovery. An essential component of prevention and patient care is systematic risk assessment. The Munro Pressure Ulcer Risk Assessment Scale is a perioperative‐specific tool designed to evaluate patients' risk for pressure injuries, enabling early identification of high‐risk individuals and facilitating timely preventive interventions by perioperative nurses. Aim This methodological study aimed to evaluate the validity, reliability, and diagnostic Accuracy of the Munro Pressure Ulcer Risk Assessment Scale (Munro Scale) in adult patients undergoing surgery. Method This methodological study was conducted on a sample of 200 adult surgical patients from October 2024 to May 2025. Data were collected using the Munro Pressure Injury Risk Assessment Scale alongside a demographic questionnaire. The scale underwent a rigorous process of translation and cultural adaptation following established methodological standards. Psychometric testing encompasses evaluations of content validity, construct validity, and Cronbach's alpha coefficient. Result Out of 200 surgical patients, 37 (18.5%) developed pressure injuries, mostly classified as Stage I and Stage II. Confirmatory factor analysis (CFA) was conducted using AMOS to evaluate the construct validity of the scale, which included three latent factors: preoperative, intraoperative, and postoperative risk factors. Factor loadings for most items exceeded 0.4, indicating acceptable item relevance. Reliability analysis showed Cronbach's alpha values of 0.84, 0.62, and 0.83 for the preoperative, intraoperative, and postoperative factors, respectively. Composite reliability (CR) values were 0.83, 0.71, and 0.82, confirming acceptable internal consistency. Conclusion The Munro Scale demonstrated acceptable reliability and validity, confirmatory factor analysis indicating a moderate or limited fit. This scale can be used to assess the risk of pressure injuries in perioperative patients.

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Cite This Study

Sadati et al. (2026) studied this question.

synapsesocial.com/papers/69f2a4b78c0f03fd67763b76https://doi.org/10.1002/hsr2.72464
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