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Development and psychometric evaluation of an instrument measuring ambulance nurses’ adherence and attitudes to acute chest pain guidelines

Hansen, Michael Ulrich ; Zdravkovic, Slobodan LU ; Jakobsson, Ulf LU orcid ; Vejzovic, Vedrana and Axelsson, Malin (2024) In BMC Nursing 23(1).
Abstract

Background: Effective prehospital care for acute chest pain critically relies on ambulance nurses’ adherence to clinical guidelines. However, current adherence is inadequate, with no instruments available to improve the situation. Therefore, this study aimed to develop and psychometrically evaluate an instrument measuring ambulance nurses’ adherence to and attitudes towards acute chest pain guidelines, and to adapt and test the Attitudes Regarding Practice Guidelines instrument for measuring general attitudes towards guidelines. Methods: An instrument development design was used. A 49-item Adherence Instrument was initially developed for measuring adherence to and attitudes towards acute chest pain guidelines and the 18-item Attitudes... (More)

Background: Effective prehospital care for acute chest pain critically relies on ambulance nurses’ adherence to clinical guidelines. However, current adherence is inadequate, with no instruments available to improve the situation. Therefore, this study aimed to develop and psychometrically evaluate an instrument measuring ambulance nurses’ adherence to and attitudes towards acute chest pain guidelines, and to adapt and test the Attitudes Regarding Practice Guidelines instrument for measuring general attitudes towards guidelines. Methods: An instrument development design was used. A 49-item Adherence Instrument was initially developed for measuring adherence to and attitudes towards acute chest pain guidelines and the 18-item Attitudes Regarding Practice Guidelines instrument was translated into Swedish. Both instruments were validated through cognitive interviews and expert reviews. To ascertain its reliability, a test‒retest was conducted. The construct validity of the Adherence Instrument was assessed via principal component analysis on the basis of a polychoric correlation matrix. Results: The developed Adherence Instrument was refined to 18 items and showed strong validity and reliability. Similarly, the Attitudes Regarding Practice Guidelines instrument, refined to 12 items, demonstrated strong validity and reliability. Principal component analysis of the Adherence Instrument identified five components: professional evidence-based practice, assessment of symptoms, confidence in skills, clinical autonomy, and guideline clarity and education. These components accounted for 64.5% of the total variance and demonstrated strong reliability, with an ordinal alpha of 0.84 for the entire scale. Conclusion: The psychometric properties of the Adherence Instrument were satisfactory and will be useful in prehospital emergency care to measure attitudes and adherence towards acute chest pain guidelines.

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author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Ambulance nursing, Chest pain, Clinical guidelines, Instrument development
in
BMC Nursing
volume
23
issue
1
article number
934
publisher
BioMed Central (BMC)
external identifiers
  • pmid:39707335
  • scopus:85212703857
ISSN
1472-6955
DOI
10.1186/s12912-024-02615-3
language
English
LU publication?
yes
id
153b0feb-26a6-42eb-bcda-3c7637f5c7e6
date added to LUP
2025-01-16 15:04:07
date last changed
2025-07-04 05:21:27
@article{153b0feb-26a6-42eb-bcda-3c7637f5c7e6,
  abstract     = {{<p>Background: Effective prehospital care for acute chest pain critically relies on ambulance nurses’ adherence to clinical guidelines. However, current adherence is inadequate, with no instruments available to improve the situation. Therefore, this study aimed to develop and psychometrically evaluate an instrument measuring ambulance nurses’ adherence to and attitudes towards acute chest pain guidelines, and to adapt and test the Attitudes Regarding Practice Guidelines instrument for measuring general attitudes towards guidelines. Methods: An instrument development design was used. A 49-item Adherence Instrument was initially developed for measuring adherence to and attitudes towards acute chest pain guidelines and the 18-item Attitudes Regarding Practice Guidelines instrument was translated into Swedish. Both instruments were validated through cognitive interviews and expert reviews. To ascertain its reliability, a test‒retest was conducted. The construct validity of the Adherence Instrument was assessed via principal component analysis on the basis of a polychoric correlation matrix. Results: The developed Adherence Instrument was refined to 18 items and showed strong validity and reliability. Similarly, the Attitudes Regarding Practice Guidelines instrument, refined to 12 items, demonstrated strong validity and reliability. Principal component analysis of the Adherence Instrument identified five components: professional evidence-based practice, assessment of symptoms, confidence in skills, clinical autonomy, and guideline clarity and education. These components accounted for 64.5% of the total variance and demonstrated strong reliability, with an ordinal alpha of 0.84 for the entire scale. Conclusion: The psychometric properties of the Adherence Instrument were satisfactory and will be useful in prehospital emergency care to measure attitudes and adherence towards acute chest pain guidelines.</p>}},
  author       = {{Hansen, Michael Ulrich and Zdravkovic, Slobodan and Jakobsson, Ulf and Vejzovic, Vedrana and Axelsson, Malin}},
  issn         = {{1472-6955}},
  keywords     = {{Ambulance nursing; Chest pain; Clinical guidelines; Instrument development}},
  language     = {{eng}},
  number       = {{1}},
  publisher    = {{BioMed Central (BMC)}},
  series       = {{BMC Nursing}},
  title        = {{Development and psychometric evaluation of an instrument measuring ambulance nurses’ adherence and attitudes to acute chest pain guidelines}},
  url          = {{http://dx.doi.org/10.1186/s12912-024-02615-3}},
  doi          = {{10.1186/s12912-024-02615-3}},
  volume       = {{23}},
  year         = {{2024}},
}