title: Assessing distress in pediatric intensive care environments: the COMFORT scale.
abstract: Managing psychological distress is a central treatment goal in Pediatric Intensive Care Units (PICUs), with medical and psychological implications. However, there is no objective measure for assessing efficacy of pharmacologic and psychological interventions used to reduce distress. Development of the COMFORT scale is described, a nonintrusive measure for assessing distress in PICU patients. Eight dimensions were selected based upon a literature review and survey of PICU nurses. Interrater agreement and internal consistency were high. Criterion validity, assessed by comparison with concurrent global ratings of PICU nurses, was also high. Principal components analysis revealed 2 correlated factors, behavioral and physiologic, accounting for 84% of variance. An ecological-developmental model is presented for further study of children's distress and coping in the PICU.
authors.affiliation: Department of Family Medicine, Medical College of Wisconsin, Waukesha Family Practice Center 53188.
authors.forename: B
authors.initials: B
authors.lastname: Ambuel
authors.forename: K W
authors.initials: KW
authors.lastname: Hamlett
authors.forename: C M
authors.initials: CM
authors.lastname: Marx
authors.forename: J L
authors.initials: JL
authors.lastname: Blumer
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D001143:Arousal; D002648:Child; D002667:Child Reactive Disorders / Q000175:diagnosis* / Q000523:psychology; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015278:Intensive Care Units, Pediatric; D008297:Male; D010552:Personality Assessment / Q000706:statistics & numerical data*; D011594:Psychometrics; D012803:Sick Role; D012931:Social Environment; D013315:Stress, Psychological / Q000150:complications*