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Development and Testing of the Reliability and Validity of the IRMAT: Integrative Review Methodology Appraisal Tool

Kean, Emily
http://orcid.org/0000-0003-3135-9588
http://rave.ohiolink.edu/etdc/view?acc_num=ucin169227362152274

Abstract Details

2023, PhD, University of Cincinnati, Nursing: Nursing - Doctoral Program.
Background: Expert literature reviews and evidence synthesis, such as systematic, scoping, or integrative reviews, represent some of the highest levels of evidence in the health sciences. There is a paucity of research concerning the methodology of integrative reviews, which are prevalent in the nursing literature. Because integrative reviews may incorporate the retrieval, appraisal, and synthesis of a variety of evidence types (empirical [quantitative, qualitative, and/or mixed methods], non-empirical, theoretical, and/or methodological), the integrative review is a somewhat unique type of evidence synthesis. While there is a growing body of literature concerning the methodological rigor of integrative reviews in nursing, advancements in methodological tools are lacking. Purpose: The overarching aim of this dissertation research is to develop and test an appraisal tool to assess the methodological and reporting elements of nursing integrative reviews. The Integrative Review Methodology Appraisal Tool (IRMAT) appraises whether recommended methodological elements are present in published integrative reviews in the nursing literature. Methods: A scoping review was conducted to identify methodological elements of nursing integrative reviews. The 210 methodological elements identified from the scoping review were coded and thematically analyzed to align to the Ellis Model of Information-Seeking Behavior, which resulted in 34 items being generated. Generated items were analyzed by a panel of five nursing integrative review experts for face and content validity. The subsequent version of the tool was used by 204 survey participants and two independent raters so that construct validity, internal consistency reliability, and inter-rater reliability could be analyzed statistically. Results: The expert ratings were used to calculate content validity at the item level using the Content Validity Index (CVI). Twenty-eight items demonstrating sufficient content validity (> 0.80) were retained for further testing. A total of 204 respondents used the 28-item IRMAT to appraise a published nursing integrative review. The analysis of this psychometric testing resulted in ten items being removed. The remaining 18 items loaded onto two factors (Design and Analysis) and were found to have acceptable internal consistency reliability (Cronbach’s α of 0.741 and 0.719, respectively). After exploratory and confirmatory factor analyses, the 18-item tool demonstrated evidence of construct validity. The 18 items loading onto the two factors explained 25.2% of the cumulative variance. Inter-rater reliability (IRR) of the items was slight (0.00-0.20) to moderate (0.41-0.60) for 15 (83%) of the 18 items, with one item demonstrating substantial IRR (0.61-0.80) and two items demonstrating poor IRR (< 0.00). A 16-item version removing the two poor IRR items was analyzed for reliability and model fit; however, the Cronbach’s α of factor two was reduced from adequate to questionable, thus the two items were retained in the final 18-item version of the tool. Conclusion: The Integrative Review Methodology Appraisal Tool (IRMAT) demonstrates evidence of construct validity, internal consistency reliability, and inter-rater reliability. The IRMAT has implications for educating doctoral nursing students and nurses in clinical practice on appraising integrative reviews in the nursing literature. The IRMAT may also be used by editors and peer reviewers to appraise submitted nursing integrative reviews prior to publication.
Elaine Miller, Ph.D. (Committee Chair)
Carolyn Smith, Ph.D. (Committee Member)
Youn Seon Lim, Ph.D. (Committee Member)
282 p.
Nursing
integrative reviews; evidence synthesis methodology; evidence-based nursing; nursing research; appraisal tool

Recommended Citations

Citations

  • Kean, E. (2023). Development and Testing of the Reliability and Validity of the IRMAT: Integrative Review Methodology Appraisal Tool [Doctoral dissertation, University of Cincinnati]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=ucin169227362152274

    APA Style (7th edition)

  • Kean, Emily. Development and Testing of the Reliability and Validity of the IRMAT: Integrative Review Methodology Appraisal Tool. 2023. University of Cincinnati, Doctoral dissertation. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=ucin169227362152274.

    MLA Style (8th edition)

  • Kean, Emily. "Development and Testing of the Reliability and Validity of the IRMAT: Integrative Review Methodology Appraisal Tool." Doctoral dissertation, University of Cincinnati, 2023. http://rave.ohiolink.edu/etdc/view?acc_num=ucin169227362152274

    Chicago Manual of Style (17th edition)

ucin169227362152274
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This open access ETD is published by University of Cincinnati and OhioLINK.