Italian adaptation of the End-of-Life Wound Assessment Tool: translation, content validity and preliminary usability testing

Objective: To translate, culturally adapt and evaluate the content validity and preliminary usability of the End-of-Life Wound Assessment Tool (EoL-WAT) for use in the Italian healthcare context. Method: A methodological study was conducted between March and May 2026 in collaboration between the Italian Association for the Study of Skin Lesions and the Italian Society of Palliative Care. Following forward and back translation, content validity was evaluated by nine experts, and preliminary usability by seven healthcare professionals. Results: All items exceeded the predefined acceptability threshold for content validity (item-level content validity index (I-CVI)≥0.89). A total of 19 of the 20 evaluations achieved complete agreement (I-CVI=1.00). Overall content validity was excellent (scale-level content validity index (S-CVI)/Ave=0.994; S-CVI/universal agreement=0.95). Usability ratings were favourable across all domains (mean score range: 4.00-4.43). Qualitative feedback led to minor wording refinements without substantial modifications to the instrument. Conclusion: The Italian version of the EoL-WAT demonstrated excellent content validity and favourable usability. The instrument is a promising tool for assessing end-of-life wounds, and may facilitate shared clinical understanding and interdisciplinary collaboration in wound care and palliative care settings.