The reliability and validity of the COMFORT scale as a postoperative pain instrument in 0 to 3-year-old infants
The reliability and validity of the COMFORT scale as a postoperative pain instrument in 0 to 3-year-old infants
复制标题
DOI：
10.1016/s0304-3959(99)00239-0
复制
发表时间：
2000-02-01
期刊：
影响因子：
7.4
通讯作者：
Duivenvoorden, HJ
中科院分区：
文献类型：
--
作者：
van Dijk, M;de Boer, JB;Duivenvoorden, HJ
本研究的目的是测试舒适量表作为0-3岁儿童术后疼痛工具的信度和效度。受试者为158名腹部或胸部大手术后的新生儿和幼儿。经过培训的护士在术后3、6和9小时在儿科外科重症监护室使用舒适度和疼痛VAS对儿童的疼痛进行评分。除“呼吸反应”项为中等（Kappa 0.54）外，所有项目的COMFORT项目的评定者间可靠性均良好（Kappa 0.63-0.93）。LISREL分析表明，COMFORT数据的结构最好由三个潜在变量表示：COMFORT“行为”，其负载来自行为项目（警觉性、冷静、呼吸反应/哭泣、身体运动、肌张力和面部张力），以及“心率基线”（HR）和“平均动脉血压基线”（MAP）的单独潜在变量。项目的因子负荷随时间变化不变，表明结构稳定。潜变量舒适的“行为”和VAS疼痛高度相关，表明一致的有效性。COMFORT“行为”和VAS疼痛的稳定性为中度，这可能是由于该样本中不同的疼痛发作所致。HR和MAP虽然随时间推移保持稳定，但与VAS疼痛和COMFORT“行为”弱相关。这些发现支持使用COMFORT“行为”量表来评估新生儿和婴儿的术后疼痛。(C)2000年国际疼痛研究协会。出版社：Elsevier Science B. V.
The aim of this study was to test the reliability and validity of the COMFORT scale as a postoperative pain instrument for children aged 0-3 years. Subjects were 158 neonates and toddlers after major abdominal or thoracic surgery. Trained nurses rated the children's pain at 3, 6 and 9 h postoperative on the Pediatric Surgical Intensive Care Unit using the COMFORT and a VAS for pain. Interrater reliability of the COMFORT items proved to be good (Kappa 0.63-0.93) for all items with the exception of the item 'Respiratory response', which was moderate (Kappa 0.54). LISREL, analyses showed that the structure of the COMFORT data was best represented by three latent variables: COMFORT 'behaviour' with loadings from the behavioural items (Alertness, Calmness, Respiratory response/Crying, Physical movement, Muscle tone and Facial tension) and separate latent variables for 'Heart rate baseline' (HR) and 'Mean arterial blood pressure baseline' (MAP). Factor loadings of the items were invariant across time, indicating stability of the structure. The latent variables COMFORT 'behaviour' and VAS pain were highly interrelated indicating congruent validity. Stability of COMFORT 'behaviour' and VAS pain was moderate which might be due to varying painful episodes in this sample. HR and MAP, although stable across time, were weakly related to VAS pain and COMFORT 'behaviour'. These findings support the use of the COMFORT 'behaviour' scale to assess postoperative pain in neonates and infants. (C) 2000 International Association for the Study of Pain. Published by Elsevier Science B.V.