Development and psychometric evaluation of the Psychiatric In-patients Comfort Scale (PICS)

To develop and evaluate the psychometric characteristics of the Psychiatric In-patients Comfort Scale (PICS) in hospitalized psychiatric patients.

The items of the PICS were drawn from a literature review, existing comfort instruments, suggestions made by experts, and interviews on perceived comfort with 18 hospitalized patients. A pilot study was performed with the first version of the scale, containing 98 items, in a sample of 49 patients. This process resulted in a 51-item version. Internal consistency, construct validity, and concurrent validity were measured in a second sample of 273 patients.

Data analysis, factor analysis, and reliability analysis resulted in a 38-item version. The factor analysis indicated a 3-factor structure: relief, ease, and transcendence, which explained 38.64% of the total variance. The comfort dimensions correlated positively with well-being and with positive experiences of suffering and negatively with the remaining dimensions of suffering, supporting concurrent validity. Cronbach's alpha coefficient of the total PICS-38 was 0.89, and the subscales ranged from 0.75 to 0.90.

Based on psychometric properties, the PICS is a valid and reliable tool that can be used by nurses to assess comfort in hospitalized psychiatric patients. The items are conceptually grouped in 3 factors corresponding to the states of relief, ease, and transcendence of the comfort structure proposed by Kolcaba.