Article Text

Download PDFPDF

PO-0866 Assessing The Validity And Reliability Of The Comfort-behaviour Scale In Children Three Years Of Age And Over
  1. DM Hughes1,
  2. C Breatnach1,
  3. M van Dijk2,
  4. C Magner3,
  5. G Paul4
  1. 1Intensive Care Unit Floor 1, Our Lady’s Children’s Hospital Crumlin, Dublin, Ireland
  2. 2Pain Expertise Centre, Sophia Children’s Hospital Rotterdam the Netherlands, Dublin, Ireland
  3. 3Intensive Care Unit, Our Lady’s Children’s Hospital Crumlin, Dublin, Ireland
  4. 4The Royal College of Surgeons, Dublin, Ireland


Background Self report is considered to be the “gold standard” of pain assessment but is frequently unobtainable in the ICU. The psychometric properties of the COMFORT-Behaviour (COMFORT-B) scale have been evaluated in children under the age of 3 years.

Aim and objectives To establish the reliability and validity of the COMFORT-B scale in children > 3 years of age in a PICU setting.

Methods A prospective observational study was performed using a repeated measures design in children from 3–17 years in two intensive care and high-dependency units in Ireland. Interrater reliability was tested among nurses using linearly weighted kappa, Cronbach α was applied to test internal consistency of the COMFORT-B scale and concurrent validity involved comparing COMFORT-B with the FLACC and Numeric Rating Scale score of nurses.

69 paired nursing assessments to test the interrater-reliability of the COMFORT-B scale was performed. With a high interrater-reliability of Cronbach 0.87, Single nurse observations were commenced of the COMFORT-B, NRS and FLACC/Self-report scores at specific four-hourly intervals over the first 48 h of each admission.

Results Data in 19 patients (age 3 to 17 years) was collected for the pilot study. Initial compliance of 4% increased to over 80%. Interrater reliability between COMFORT, FLACC and NRS remained high throughout the study.

Conclusion The COMFORT-B is suitable for use in children and adolescents from 3–17years.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.