McSweeney Jean C, O'Sullivan Patricia, Cody Marisue, Crane Patricia B
College of Nursing, University of Arkansas for Medical Sciences, Little Rock, Ark 72205, USA.
J Cardiovasc Nurs. 2004 Jan-Feb;19(1):58-67. doi: 10.1097/00005082-200401000-00010.
BACKGROUND/OBJECTIVES: 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.
背景/目的：冠心病（CHD）是女性死亡的首要原因，然而，关于女性症状的了解却很少。女性冠心病症状的早期识别至关重要，但大多数工具并未同时评估前驱症状和急性冠心病症状。我们的目的是开发一种能够有效描述女性心肌梗死前驱症状和急性症状的工具，并确定该工具——麦克休尼急性和前驱心肌梗死症状调查（MAPMISS）的可靠性。
四项研究有助于该工具的内容效度和可靠性。两项定性研究提供了在研究3中得到确认的症状清单。最终形成的工具评估37种急性症状和33种前驱症状。在研究4中，90名女性在初次调查后7至14天接受了重新测试。我们使用kappa统计量来评估不同调查之间的一致性。
女性并未给MAPMISS添加新的症状。急性症状的平均kappa值为0.52，前驱症状的平均kappa值为0.49。接下来我们计算了加权分数。第一次测量时急性症状的平均分数为19.4（标准差=14.43）；第二次测量时为12.4（标准差=8.79），皮尔逊相关性表明具有稳定性（r=.84；P<.01）。第一次测量时前驱症状的平均分数为23.80（标准差=24.24）；第二次测量时为26.79（标准差=30.52），皮尔逊相关性为r=.72；P<.01。
该工具全面，具有较高的内容效度和可接受的重测信度。较低的kappa值与出现这些症状的女性较少有关。不同次调查之间症状分数保持稳定。
