O'Keefe-McCarthy Sheila, McGillion Michael, Nelson Sioban, Clarke Sean, McFetridge-Durdle Judith, Watt-Watson Judy
Can J Cardiovasc Nurs. 2014 Spring;24(2):11-8.
Cardiac pain and/or discomfort arising from acute coronary syndromes (ACS) can often be severe and anxiety-provoking. Cardiac pain, a symptom of impaired myocardial perfusion, if left untreated, may lead to further myocardial hypoxia, which can potentiate myocardial damage. Evidence suggests that once ACS patients are stabilized, their pain may not be adequately assessed. Lack of knowledge and problematic beliefs about pain may contribute to this problem. To date, no standardized tools are available to examine nurses' specific knowledge and beliefs about ACS pain that could inform future educational initiatives.
To examine the content validity of the Toronto Pain Management Inventory-ACS Version (TPMI-ACS), a 24-item tool designed to assess nurses' knowledge and beliefs about ACS pain assessment and management.
Eight clinical and scientific experts rated the relevance of each item using a four-point scale. A content validity index was computed for each item (I-CVI), as well as the total scale, expressed as the mean item CVI (S-CVI/AVE). Items with an I-CVI > or = 0.7 were retained, items with an I-CVI ranging from 0.5-0.7 were revised and clarified, and items with an I-CVI < or = 0.5 were discarded.
I-CVIs ranged from 0.5-1.0 and the S-CVI/AVE was 0.90, reflecting high inter-rater agreement across items. The least relevant item was eliminated.
Preliminary content validity was established on the TPMI-ACS version. All items retained in the TPMI-ACS version met requirements for content validity. Further evaluation of the psychometric properties of the TPMI-ACS is needed to establish criterion and construct validity, as well as reliability indicators.
急性冠状动脉综合征（ACS）引发的心脏疼痛和/或不适通常较为严重且会引发焦虑。心脏疼痛是心肌灌注受损的症状，若不治疗，可能会导致进一步的心肌缺氧，进而加重心肌损伤。有证据表明，ACS患者病情稳定后，其疼痛可能未得到充分评估。对疼痛的认知不足和存在问题的观念可能导致了这一问题。迄今为止，尚无标准化工具可用于检验护士关于ACS疼痛的具体知识和观念，而这些知识和观念可为未来的教育举措提供参考。
检验多伦多疼痛管理量表-ACS版（TPMI-ACS）的内容效度，该量表为一个包含24个条目的工具，旨在评估护士对ACS疼痛评估和管理的知识与观念。
八位临床和科学专家使用四点量表对每个条目的相关性进行评分。计算每个条目的内容效度指数（I-CVI）以及总量表的内容效度指数，以平均条目CVI（S-CVI/AVE）表示。I-CVI≥0.7的条目予以保留，I-CVI在0.5-0.7之间的条目进行修订和澄清，I-CVI≤0.5的条目予以舍弃。
I-CVI范围为0.5-1.0，S-CVI/AVE为0.90，表明各条目间评分者信度较高。最不相关的条目被剔除。
TPMI-ACS版初步建立了内容效度。TPMI-ACS版中保留的所有条目均符合内容效度要求。需要对TPMI-ACS的心理测量特性进行进一步评估，以确立效标效度和结构效度以及信度指标。
