Evidence validity of the Triage Rule-Out Using High-Sensitivity Troponin Algorithm for emergency nurses in Brazil.

Abstract

Objective: To demonstrate evidence of the validity of the Triage Rule-Out Using High-Sensitivity Troponin algorithm (TRUST) for cardiac risk assessment by nurses in Brazil.

Method: A six-stage methodological study: translation; synthesis of translations; back-translation; validation by a committee of judges; pre-testing; and submission to the original author. The committee was comprised by of four bilingual translators and two specialist nurses, who assessed the translated version for semantic, idiomatic, conceptual, and cultural equivalence, as well as content validity, internal consistency and clarity. In the pre-test, 31 nurses evaluated the clarity of the algorithm. Content validity was analyzed by the Content Validity Index and reliability by internal consistency using Cronbach's Alpha.

Results: The TRUST algorithm consists of three clinical criteria: history of chest pain, electrocardiogram, and a rapid troponin test. The adapted version demonstrated content validity and good comprehensibility, with a Content Validity Index of over 0.90 and a Cronbach's alpha of 0.80. The adaptations involved technical and cultural adjustments. In the pre-test, nurses considered the algorithm to be clear and relevant.

Conclusion: The cross-cultural adaptation of the algorithm proved to be valid, being equivalent to the original, adapted to the Brazilian context and suitable for use by emergency nurses.