Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2011 Sep;152(9):2059-2064.
doi: 10.1016/j.pain.2011.05.001. Epub 2011 Jun 2.

The COMFORT-behavior scale is useful to assess pain and distress in 0- to 3-year-old children with Down syndrome

Abraham J Valkenburg  1 , Anneke A Boerlage, Erwin Ista, Hugo J Duivenvoorden, Dick Tibboel, Monique van Dijk
Affiliations
Comparative Study

The COMFORT-behavior scale is useful to assess pain and distress in 0- to 3-year-old children with Down syndrome

Abraham J Valkenburg et al. Pain. 2011 Sep.

Abstract

Many pediatric intensive care units use the COMFORT-Behavior scale (COMFORT-B) to assess pain in 0- to 3-year-old children. The objective of this study was to determine whether this scale is also valid for the assessment of pain in 0- to 3-year-old children with Down syndrome. These children often undergo cardiac or intestinal surgery early in life and therefore admission to a pediatric intensive care unit. Seventy-six patients with Down syndrome were included and 466 without Down syndrome. Pain was regularly assessed with the COMFORT-B scale and the pain Numeric Rating Scale (NRS). For either group, confirmatory factor analyses revealed a 1-factor model. Internal consistency between COMFORT-B items was good (Cronbach's α=0.84-0.87). Cutoff values for the COMFORT-B set at 17 or higher discriminated between pain (NRS pain of 4 or higher) and no pain (NRS pain below 4) in both groups. We concluded that the COMFORT-B scale is also valid for 0- to 3-year-old children with Down syndrome. This makes it even more useful in the pediatric intensive care unit setting, doing away with the need to apply another instrument for those children younger than 3.

PubMed Disclaimer

References

    1. Ambuel B, Hamlett KW, Marx CM, Blumer JL. Assessing distress in pediatric intensive care environments: the COMFORT scale. J Pediatr Psychol. 1992;17:95-109.
    1. Breau LM, Finley GA, McGrath PJ, Camfield CS. Validation of the non-communicating children’s pain checklist—postoperative version. Anesthesiology. 2002;96:528-535.
    1. Carnevale FA, Razack S. An item analysis of the COMFORT scale in a pediatric intensive care unit. Pediatr Crit Care Med. 2002;3:177-180.
    1. Duivenvoorden HJ, Tibboel D, Koot HM, van Dijk M, Peters JW. Pain assessment in profound cognitive impaired children using the Checklist Pain Behavior; is item reduction valid? Pain. 2006;126:147-154.
    1. Fleiss JL, Cohen J, Everitt BS. Large sample standard errors of kappa and weighted kappa. Psychol Bull. 1969;72:323-327.

Publication types