Coronary heart disease (CHD) is the number one cause of death in women, yet, little is known about women's symptoms. Early symptom recognition of CHD in women is essential but most instruments do not assess both prodromal and acute CHD symptoms. Our aims were to develop an instrument validly describing women's prodromal and acute symptoms of myocardial infarction and to establish reliability of the instrument, the McSweeney Acute and Prodromal Myocardial Infarction Symptom Survey (MAPMISS).
Four studies contributed to the content validity and reliability of this instrument. Two qualitative studies provided the list of symptoms that were confirmed in study 3. The resulting instrument assesses 37 acute and 33 prodromal symptoms. In study 4, 90 women were retested 7 to 14 days after their initial survey. We used the kappa statistic to assess agreement across administrations.
The women added no new symptoms to the MAPMISS. The average kappa of acute symptoms was 0.52 and 0.49 for prodromal. Next we calculated a weighted score. The mean acute score for time 1 was 19.4 (SD = 14.43); time 2 was 12.4 (SD = 8.79) with Pearson correlation indicating stability (r = .84; P < .01). The mean prodromal score at time 1 was 23.80 (SD = 24.24); time 2 was 26.79 (SD = 30.52) with a Pearson correlation of r = .72; P < .01.
The tool is comprehensive, has high content validity, and acceptable test-retest reliability. Low kappas were related to few women having those symptoms. The symptom scores remained stable across administrations.
Jean C. McSweeney, PhD, RN, FAHA, FAAN Professor, College of Nursing, University of Arkansas for Medical Sciences, Little Rock, Ark.
Patricia O'Sullivan, EdD Professor, Office of Educational Development, University of Arkansas for Medical Sciences, Little Rock, Ark.
Marisue Cody, PhD, RN Assistant Professor, Department of Psychiatry and Behavioral Sciences, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Ark.
Patricia B. Crane, PhD, RN Assistant Professor, School of Nursing, University of North Carolina at Greensboro, Greensboro, NC.
A series of studies associated with the development and evaluation of psychometric properties of this instrument were funded by the following agencies: American Nurses Foundation, Southern Nursing Research Society, Arkansas Affiliate of the American Heart Association, College of Nursing at the University of Arkansas for Medical Sciences, and the National Institute of Nursing Research (NINR-RO1 NR04908).
Corresponding author Jean McSweeney, PhD, RN, FAHA, FAAN, College of Nursing, 4301 W Markham St, Slot 529, Little Rock, AR 72205 (e-mail: firstname.lastname@example.org).