Summative index: acute pain management in older adults

Document Type


Peer Reviewed


Publication Date


NLM Title Abbreviation

Appl Nurs Res

Journal/Book/Conference Title

Applied Nursing Research

PubMed ID


DOI of Published Version



One of the challenges in measuring adoption of complex evidence-based practices (EBPs) such as acute pain management is determining what constitutes adherence to an EBP guideline. Traditionally, individual process indicators extrapolated from an EBP guideline are selected as dependent measures of guideline adoption. When using multiple indicators, the challenge is determining the number of indicators that must be met to define adherence to the EBP guideline. The primary goal of the study reported herein was to develop and test a summative index (SI) of guideline adherence for acute pain management of hospitalized older adults. Steps in formulating the initial index are described as well as refinement of this metric. Techniques used included factor analysis, discriminate validity, and split-half reliability. The resulting SI is composed of 18 indicators each scored as 0 (not present) or 1 (present), with a total SI score of 0 to 18. © 2009 Elsevier Inc. All rights reserved.


Aged, Hospitalized, Instrument Construction, Instrument Validation, Pain -- Drug Therapy -- In Old Age, Practice Guidelines -- Utilization, Aged, Aged, 80 and Over, Construct Validity, Content Validity, Delphi Technique, Descriptive Statistics, Discriminant Validity, Factor Analysis, Inpatients, Medical Records, Pain Measurement, Professional Compliance -- Evaluation, Record Review, Retrospective Design, Scales, Spearman's Rank Correlation Coefficient, T-Tests, United States, Validation Studies

Published Article/Book Citation

Applied Nursing Research, 22:4 (2009) pp.264-273. DOI:10.1016/j.apnr.2008.03.002.

This document is currently not available here.