# A Multicentric Study to Validate the Patient-Reported Experience Measures (PREM) Tool for Wound Management and Safety in India

## TL;DR

This study developed and validated a tool to assess patient experiences during wound care in India, highlighting the importance of patient feedback in improving care quality.

## Contribution

The novel contribution is the development and validation of a PREM tool tailored for wound management in the Indian healthcare context.

## Key findings

- The PREM tool showed good reliability with a KR-20 coefficient of 0.748.
- Most patients reported positive experiences with communication and infection control practices.
- Only about 56-60% of patients received adequate home wound care training, indicating a need for improvement in patient education.

## Abstract

Background: Effective wound management is a vital aspect of healthcare that significantly influences patient morbidity and mortality. While traditional wound care quality assessments focus on clinical outcomes such as healing rates, infection control, and recurrence, patient experience during wound therapy remains an important yet underexplored dimension of care quality.

Objective: This multi-centric prospective study aimed to develop and validate a Patient Reported Experience Measures (PREM) tool specifically designed to capture patient perspectives on safety, communication, infection prevention, and overall care during wound dressing procedures within the Indian healthcare setting.

Methods: Seventeen hospitals across diverse geographic regions and varying sizes in India participated. The PREM tool was developed through a systematic process involving iterative surveys, focus group discussions with healthcare professionals, and pilot testing. The initial tool included 19 items covering communication, infection control, patient education, privacy, and patient identification. After pilot testing with 170 patients, the instrument was refined and administered to 904 patients. Psychometric validation was performed using confirmatory factor analysis (CFA).

Results: The PREM tool demonstrated excellent reliability with a Kuder-Richardson Formula 20 (KR-20) internal consistency coefficient of 0.748. Majority of patients reported positive experiences: 91.3% confirmed name and ID verification prior to dressing, 95.7% received procedure explanations, 100% observed infection control practices, and 97.6% reported maintained privacy. However, only 56.7% received adequate training for home wound care, and 59.1% could demonstrate dressing techniques to healthcare providers, highlighting a need for improved patient education. Enhanced patient adherence to infection control measures reflected increased awareness following the COVID-19 pandemic.

Conclusion: The study underscores the importance of incorporating patient feedback into wound care quality evaluation, complementing traditional clinical outcomes with experiential factors that influence patient satisfaction and adherence. The validated PREM tool offers a structured framework for healthcare providers to assess and enhance the wound care experience, promoting patient-centered care. Future research should focus on cross-cultural validation, demographic diversification, and integration of PREM data with clinical parameters to improve wound care quality comprehensively.