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Psychometrics of 0-5 Nausea and Vomiting Scales

Principal Investigator: Angela P. Halpin, RN, MN, CNS
Co-Principal Investigators/Collaborators: Loucine M. Huckabay, Aran Levine
Organization: Hoag Memorial Hospital Presbyterian

Abstract

Problem

An implemented 0–5 Nausea (N) and 0–5 Vomiting (V) Scale using descriptors in 2008 required psychometric testing. The N/V scales have been applied for over a year, electronic reports demonstrate active use of the scales in patient assessment of N/V symptoms.

Evidence

Satisfaction with tools and content validity as reported by application are not enough to measure the soundness. Measurement tool attributes require study to demonstrate their construct validity and reliability.

Strategy

This methodological study aims to establish psychometric properties of the new nausea and vomiting scales with descriptors (NVWD), measuring their inter-rater reliability, validity, practicality, & sensitivity.

Practice Change

Content validity has been established in two previous studies. In a Post Operative N/V study 172 patients rated their N/V using the 0-5 N/V scales with descriptors. Sixty of sixty five (60/65) or 92% of nurses applying the N/V scales rated them satisfactory. In evaluation of nausea scale study results: nurses preferred significantly more the 0–5 point scale over the 0-10 point scale; results in four areas: (a) nurses understanding (t=3.61, p=.001), (b) nurse’s communication with the patient (t=4.23, p=0003), (c) ability for patients to communicate (t=5.4, p=0001) and (d) communication with the physician ( t=5.7, p=0001).

Evaluation

Psychometric properties is examined on three groups of patients. Group I are admitted with diagnosis of nausea and vomiting. Group II are cancer patients admitted with no reported feelings of nausea and vomiting but meet the predictive criteria or are scheduled for chemotherapy. Group III: the control group.

Results

Pending from two acute care hospitals.

Recommendations

The tools are found effective by nurses & patients in two studies. Use of the scale is practical & useful in communication of intensity of N/V symptoms. Psychometrics are necessary for wider application.

Lessons Learned

Scales are adapted when found to be useful by physicians, nurses and patients. Psychometrics allows for further use in national and international hospitals.

Bibliography

  • Apfel, C.C., Laara, E., Koivuranta, M., Greim, C–A. & Rower, N. (1999). A simplified risk score for predicting postoperative nausea and vomiting. Anesthesiology, 91, 693–700.
  • Boogaerts, J.G., Vanacker, S.L., Albert, A., Bardiau, F.M. (2000). Assessment of postoperative nausea using a visual analogue scale. ACTA. Printed in Denmark. 44:470–474.
  • Borjeson, S., Hursti, T., Peterson, C., Fredikson,M., Furst, C.J., Avall–Lundqvist, E, et al. (1997). Similarities and differences in assessing nausea on a verbal category scale and a visual analogue scale. Cancer Nursing. Lipppincott–Raven.
  • Dibble, S.L., Casey, K., Nussey, B., Israel, J., Luce, J. (2004). Chemotherapy–Induced Vomiting in Women Treated for Breast Cancer. Oncology Nursing Forum. 31: (1) pp.E1–E8.
  • DeVon, H.A., Block, M.E., Moyle–right, P. Ernst, S.J., Hayden, S. J. Lazzara, D.J., Savoy, S.M., Kostas–Polston, E. (2007). A Psychometric Toolbox for Testing Validity and Reliability. Journal of Nursing Scholoarship. 39:(2) pp.15–164.
  • Guttuso, T. Jr., Roscoe, J. Griggs, J. (2003). Effect of gabapentin on nausea induced by chemotherapy in patients with breast cancer. Lancet 361: pp.1703–1705.
  • Herrstedt, J. (1998). Antiemetic research: a look to the future. Support Care Cancer 6:8–12.
  • Howland, R.D., & Mycek, M.J. (Eds). (2006). Lippincott’s illustrated reviews: Pharmacology (3rd edition). Philadelphia, PA: Lippincott Williams and Wilkins.
  • Kirkova, J., Mellar, P.D., Walsh, D, Tiernan, E., O’Leary, N., LeGrand, S.B, Lagman, R. L. Russell, K.M. (2006), Cancer symptom assessment instruments: A systematic review. American Society of Clinical Oncology. 24 :(9), 1459–2973.
  • McCorkle R, Young K. (1978). Development of a symptom distress scale. Cancer Nursing. Oct; 1 (5):373–8. Update retrieved May 2007 from Description Copyright (c) 1995, CINAHL Information Systems: McCorkle, R., (1995), Symptom Distress Scale (SDS). http://search.ebscohost.com/login.aspx?direct=true&db=rzh&AN=1995025145&site=ehost-live.
  • Mertens, W.C., Higby, D.B., Parisi, R., Fitzgerald, J., Benjamin, E.M., Lindenauer, P. K. (2003). Improving the Care of Patients with regard to Chemotherapy–Induced nausea and Emesis: The Effect of Feedback to Clinicians on Adherence to Antiemetic Prescribing Guideline. Journal of Clinical Oncology. 21: (7): pp. 1373–1378.
  • Morrow, G. (1984). The Assessment of Nausea & Vomiting, Past Problems, Current Issues and Suggestions for Future Research. Cancer. 51:10. 2267–2280.
  • Morrow, G. (1992). A Patient report measure for quantification of chemotherapy induced nausea and emesis: psychometric properties of the Morrow assessment of nausea and emesis (MANE). British Journal Cancer. 66. Suppl. XIX. S72–S74.
  • Muth, E.R., Stern R.M., Thayer, J.F., Koch, K.L. (1996). Assessment of the Multiple Dimensions of Nausea: The Nausea Profile (NP). Journal of Psychosomatic Research. 40: (5) pp. 511–520.
  • Measuring Oncology Nursing–Sensitive Patient Outcomes: Evidence based Summary. American Cancer Society and National Comprehensive Cancer Network. (2004).
  • National NCI National Cancer Institute publication No. 03–5410 6/2003 (guidelines for toxicity grading of both nausea and vomiting).
  • Norred, C.L., (2003). Antiemetic prophylaxis pharmacology and therapeutics. AANA Journal. 71 :(2) 133–140.
  • Oncology Nursing Society Guidelines (2007). Putting Evidence into Practice (PEP) Cards.
  • Prommer, E & Casciato, D. (2004). Supportive Care. In Casciato, D. Manual of Clinical Oncology (5th ed) 113–114. Philadelphia, PA: Lippincott Williams and Wilkins.
  • Rhodes, V.A., McDaniel, R.W. (2001). Nausea, Vomiting, and Retching: Complex Problems in Palliative Care. CA. A Cancer Journal for Clinicians. 51(4) 232–320.
  • Roscoe.J., Morrow, G.R., Hickok, J.T. & Stern, R.M. Nausea and Vomiting Remain Significant Clinical Problem: Trends Over Time in Congrolling Chemotherapy–Induces Nausea and Vomiting in 1413 patients Treated in Community Clinical Practices. Journal of Pain and Symptom Management. (2): (2) 113–121.
  • Stromborg. F., Olsen, M. & Olsen, S.J. (2009). “Instruments for Clinical Health Care Research” p.587. (5th ed). Massachusetts: Jones & Bartlett Publishers.
  • Tipton, J. McDaniel, R.W. Barbour, L, Johnston., MP., Kayne, M. LeRoy, P. & Ripple, M. Putting Evidence Into Practice: Evidence Based Interventions to Prevent, Manage, and Treat Chemotherapy–Induces Nausea and Vomiting. Clinical Journal of Oncology Nursing. 11: (1) 69–76.