Cardiac instrument development in a low-literacy population: The revised Chest Discomfort Diary

• Type of Material: Article
• Authors: Laura Kimble, Emory University; Sandra B Dunbar, Emory University; Deborah B. McGuire, University of Pennsylvania; Anindya De, Emory University; Sharon Fazio, Emory University; Ora Strickland, Emory University
• Language: English
• Date: 2001-07-01
• Publisher: Elsevier: 12 months
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2001 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1067/mhl.2001.116136
• Title of Journal or Parent Work: Heart & Lung: The Journal of Acute and Critical Care
• ISSN: 0147-9563
• Volume: 30
• Issue: 4
• Start Page: 312
• End Page: 320
• Grant/Funding Information: Supported by National Institutes of Health, National Institute for Nursing Research Grant # R29NR/HL04425-01 (L. Kimble, PI).
• Keywords: Respiratory System; Cardiovascular System & Cardiology; QUESTIONNAIRE; Cardiac & Cardiovascular Systems; PAIN; Life Sciences & Biomedicine; Science & Technology; Nursing; FUNCTIONAL HEALTH LITERACY; SYMPTOMS; CHRONIC STABLE ANGINA
• Research Categories: Health Sciences, Nursing; Health Sciences, Medicine and Surgery

Abstract

OBJECTIVE: The purpose of this study was to pilot test a self-administered chest pain questionnaire, a revised version of the Chest Discomfort Diary (CDD-R), in a sample of patients with chronic angina selected from a population known to have low literacy. DESIGN: The study design was descriptive and correlational. SAMPLE: The study used a convenience sample of 27 subjects with documented history of coronary artery disease and angina. Characteristics of the sample included a mean age of 56.3 years (SD, 12.4 years), 88.9% African-American, and 56.3% male, and 59.3% had a history of acute myocardial infarction. Approximately 28% had achieved a 9th-grade education or less, and reading levels ranged from 4th grade to 12th grade. Subjects completed the CDD-R, a 36-item instrument reflecting multiple dimensions of anginal chest pain. RESULTS: Descriptions of the location (left chest, 66.6%), character (pressure, 59.2%), and precipitants of chest pain (walking, 51.8%) were consistent with clinical descriptions of "typical angina." Other physical symptoms such as shortness of breath (88.8%) and fatigue (85.1%) were reported. Walking (55.5%) was the activity most frequently described as difficult to perform because of chest pain, with sublingual nitroglycerin (77.7%) the most frequently used and most effective chest pain relief strategy. CONCLUSION: The CDD-R adequately measured multiple characteristics of anginal chest pain. Further research is needed to establish construct validity of the CDD-R and to determine the feasibility of using the instrument to monitor changes over time in patients' chronic angina.