Reliability of the McSweeney Acute and Prodromal Myocardial Infarction Symptom Survey among black and white women

Jean C. McSweeney, Mario A. Cleves, Ellen P. Fischer, Martha O. Rojo, Narain Armbya, Debra K. Moser

Research output: Contribution to journalArticlepeer-review

14 Scopus citations


Background: Coronary heart disease (CHD) mortality rates are higher among women, particularly black, than men. Women's mortality rates may reflect difficulty in recognizing CHD prodromal symptoms (PS) but reliable screening instruments for women are scarce. The McSweeney Acute and Prodromal Myocardial Infarction Symptom Survey (MAPMISS) captures women's PS presentation, but has limited testing among black women. Aim: To assess the test-retest reliability of the MAPMISS PS section for black and white women. Methods: The sample was recruited from women enrolled in a longitudinal study examining the predictive validity of the MAPMISS. The MAPMISS was re-administered to 42 women (22 white, 20 black) 3-5 days after baseline assessment. Results: Women endorsed an average of 7.5 PS (SD 4.8; range 0-20) initially and 7.6 (SD 4.7; range 0-20) at retest. Over half of the women (54.8%) of both races endorsed the same number of PS at test and retest; for 69%, the number endorsed at both testings differed by no more than one. Percentage agreement and kappa statistics on the number of PS endorsed were excellent overall and by race. PS test and retest scores, reflecting PS intensity and frequency, were highly correlated overall (r = 0.92, p < 0.001) and separately for white (r = 0.93, p < 0.001) and black women (r = 0.91, p < 0.001). Racial differences were insignificant. Conclusions: Findings indicate (i) the MAPMISS PS score has excellent test-retest reliability (r = 0.92) when administered to women without a history of CHD, and (ii) test-retest reliability is as strong for black (r = 0.91) as for white women (r = 0.93).

Original languageEnglish
Pages (from-to)360-367
Number of pages8
JournalEuropean Journal of Cardiovascular Nursing
Issue number4
StatePublished - Aug 2013

Bibliographical note

Funding Information:
The McSweeney Acute and Prodromal Myocardial Infarction Symptom Survey (MAPMISS) is one of the few instruments that capture women’s distinct presentation of acute and prodromal symptoms of CHD and MI. The MAPMISS was developed based on symptom reports from women of various ages, ethnicities and races, and employs the language women most commonly used to describe their symptom experience. It has been used with over 3000 racially diverse women in three studies funded by the National Institute of Nursing Research. Initial psychometric testing indicated that the MAPMISS has high content validity and acceptable test–retest reliability for women with known CHD. However, although the MAPMISS was developed for use with an ethnically diverse population, the initial psychometric study sample consisted primarily of white women and, to date, no further psychometric studies have been completed. ,

Funding Information:
The National Institute of Nursing Research supported this work with a grant, R01 NR04908.


  • coronary heart disease
  • prodromal symptoms
  • women

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Medical–Surgical
  • Advanced and Specialized Nursing


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