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[Validity and reliability study of sedation diagnosis method comfort scale]
Dilek Beytut1, Zümrüt Başbakkal2, Bülent Karapınar3
1İzmir University Faculty of Health, İzmir, Turkey. dilekbeytut@gmail.com.
Insights
The COMFORT scale reliably measures sedation in ventilated pediatric patients. This study confirmed its validity and reliability for use in pediatric critical care units.
Area of Science:
- Pediatric Critical Care Medicine
- Clinical Measurement Validation
- Pain and Sedation Assessment
Background:
- Assessing sedation levels in pediatric patients on mechanical ventilation is crucial for appropriate care.
- The COMFORT scale is a tool used for this purpose, but its psychometric properties require rigorous evaluation.
- Ensuring the validity and reliability of assessment tools is fundamental in critical care settings.
Purpose of the Study:
- To evaluate the validity and reliability of the COMFORT scale in pediatric patients undergoing mechanical ventilation.
- To determine if the COMFORT scale provides consistent and accurate measurements of sedation.
- To establish the COMFORT scale as a dependable tool for clinical use in pediatric critical care.
Main Methods:
- A methodological descriptive study was conducted in a pediatric critical care unit.
- Data were collected from 84 pediatric patients receiving mechanical ventilation using the COMFORT scale and the Visual Analog Scale (VAS).
- Reliability was assessed using Cronbach's alpha, item analysis, and inter-observer agreement (weighted kappa); validity was tested through correlation analyses.
Main Results:
- The COMFORT scale demonstrated good internal consistency with a Cronbach's alpha of 0.77.
- Item-total correlations were satisfactory, and inter-observer agreement was high (weighted kappa: 0.703–0.888).
- Strong positive correlations were found between primary and assistant researcher scores (r=0.961) and between the COMFORT scale and VAS scores (r=0.775, r=0.786), confirming convergent validity.
Conclusions:
- The COMFORT scale is a valid and reliable instrument for assessing sedation levels in mechanically ventilated children.
- The findings support the use of the COMFORT scale in pediatric critical care units for objective sedation monitoring.
- This study validates the COMFORT scale, enhancing its utility in clinical practice and research.
Objectives:
The aim of the present methodological descriptive study was to test the validity and reliability of the COMFORT scale.
Methods:
The study was conducted at a pediatric critical care unit at a university hospital between February 2009 and June 2010. Study sample included 84 pediatric patients (n=37) receiving mechanical ventilation. Data were collected via child information form, COMFORT scale, and visual analog scale (VAS). Having been assured of the language and context validity of the scale, researchers conducted reliability tests (Cronbach's alpha coefficient, item analysis), inter- and intra-observer reliability tests, and correlation analyses based on the data obtained during their own observations.
Results:
Cronbach's alpha coefficient was 0.77. Results of the item analysis indicated that item-total correlations were satisfactorily high. Significance of inter-observer agreement was analyzed for each item, and it was found that weighted kappa values varied between 0.703 and 0.888. Convergent validity tests demonstrated a positive strong correlation between COMFORT scale scores of the primary researcher and the assistant researchers (r= 0.961, p<0.000), and between the scores of the COMFORT scale and the VAS (r= 0.775, p<0.000; r=0.786, p<0.000).
Conclusion:
It was concluded that the COMFORT scale was a valid and reliable method of measuring sedation levels of children receiving mechanical ventilation and being sedated in a pediatric critical care unit.
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