The Development Of Disease Severity Assessment Scale For Acute Coronary Syndrome Patients

Objective To select the brief and understanding clinical indicators through scientific and systematic research methods, and develop a disease severity assessment scale for acute coronary syndrome(ACS) patients which is suitable, available and can be used on time by nurses, then to confirm the reliability and validity of the assessment scale. According to this study and assessment scale, to contribute to observe the condition and formulate nursing care plans for patients with ACS by cardiology nurses, improve the accuracy of medical communication, and further nursing grades research.Methods 1.On the basic content framework of the disease severity of the grading nursing indicators,the study combined with three disease severity scoring scales, the Early Warning Score, the Global Registry of Acute Coronary Events and The Thrombolysis In Myocardial Infarction risk score, to form ACS disease severity assessment scale primary items pool. 2.The items of the scale was under a two-round Delphi consultation by 15 experts from three general hospitals in Tianjin city, the experts engaged from cardiology care management, clinical care to clinical.The positive coefficient of experts and authoritative coefficient are used to analyze the reliability. Then the items were deleted, modified and supplied according to the advises given by the experts, finally ACS disease severity assessment scale was formed. 3.Adopted the method of convenience sampling, the study selected ACS patients from May 2015 to October 2015 in cardiology center of a general hospital in Tianjin. To establish the scale's reliability and validity, internal consistency reliability, intra-class correlation reliability, content validity and criterion-related validity were undertaken.Results 1.Expert advice Results: Primary items pool includes 11 entries. After two-round of consultation, the primary items pool deleted one item, modified two items, added three items. Eventually the ACS disease severity assessment scale contains the heartrate, systolic blood pressure, respiratory rate, body temperature, mental status, age, basic disease, ST segment changes, NYHA classification, Killip classification, characteristics of chest pain, risk factors and arrhythmia, a total of 13 items. 2 Reliability results: ACS disease severity assessment scale had higher internal consistency and intra-class correlation reliability, with Cronbach?s a 0.761 and ICC 0.989(95%CI, 0.983 to 0.994). 3.Validity results: the Principal Component Analysis of the scale resulted in four principal factors and explained 64.405% variances. The factor loading of each item in its corresponding dimensions were 0.403-0.846. The correlation analysis, between the ACS disease severity assessment scale and the Global Registry of Acute Coronary Events risk score, r value was 0.805.Conclusions 1.The study developed a ACS disease severity assessment scale, which contained 13 items. 2.The ACS disease severity assessment scale has good reliability and validity, can be used to evaluate the disease severity of ACS patients. 3.The ACS disease severity assessment scale can be used quickly and simple, with a high degree of patient, easily understood and got, provide scientific and effective assessment tools to nurses when they observe the condition of ACS.