Development of the McSweeney Acute and Prodromal Myocardial Infarction Symptom Survey.
OBJECTIVE
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).


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
College of Nursing, University of Arkansas for Medical Sciences, Little Rock, Ark 72205, USA. jcmcsweeney@uams.edu
Jean C
JC
McSweeney
Patricia
P
O'Sullivan
Marisue
M
Cody
Patricia B
PB
Crane
D000328:Adult; D000368:Aged; D001294:Attitude to Health; D015984:Causality; D004244:Dizziness / Q000209:etiology; D004415:Dyspepsia / Q000209:etiology; D004417:Dyspnea / Q000209:etiology; D005221:Fatigue / Q000209:etiology; D005260:Female; D006261:Headache / Q000209:etiology; D006801:Humans; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology; D015404:Nursing Methodology Research; D011237:Predictive Value of Tests; D011379:Prognosis; D011594:Psychometrics; D036301:Qualitative Research; D011795:Surveys and Questionnaires / Q000592:standards*; D014930:Women / Q000523:psychology*; D016387:Women's Health