The Pediatric Procedural Holistic Comfort Assessment-Revised: A Psychometric Analysis

Background and Purpose: In this article, we present the psychometrics of the Pediatric Procedural Holistic Comfort Assessment-Revised (PPHCA-R). The PPHCA-R is a storybook instrument for children of diverse backgrounds aged 4-8 years. Methods: We recruited 196 children undergoing a nonurgent needle procedure in a pediatric multispecialty care center. Exploratory factor analysis and Pearson's correlations were used to determine evidence of reliability and validity. Results: Thirteen items loaded uniquely on one of three factors: (a) body and surroundings comfort, (b) cognitive and emotional comfort, and (c) comfort play. The PPHCA-R demonstrated acceptable to good internal consistency across factors, as well as evidence of construct validity. Conclusions: The PPHCA-R is a novel measure with implications for the holistic management, measurement, and investigation of pediatric invasive procedures.