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

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.