title: The COMFORT behavior scale: is a shorter observation period feasible?.
abstract: OBJECTIVE
  The COMFORT behavior scale has been validated for postoperative pain in 0- to 3-yr-old children. Scoring is preceded by a 2-min observation period, which nurses may consider too long. The objective of this study was to test the reliability of a 30-sec observation period.
  
  
  METHODS
  Observational study.
  
  
  METHODS
  One Level III intensive care unit at a university children's hospital.
  
  
  METHODS
  Designated pain specialist and all nursing staff.
  
  
  METHODS
  None.
  
  
  METHODS
  The pain specialist and caregiver nurse each conducted a bedside COMFORT behavior scale assessment and assigned an additional pain rating on the 11-point Numerical Rating Scale.
  
  
  RESULTS
  Total COMFORT behavior Scale score for the 2-min observation was 17 or higher in 19% of the patients and 11% for the 30-sec observation. The mean COMFORT behavior scale score for the 2-min observation was 13.5 (SD 3.8) and 12.7 (SD 3.7) for the 30-sec observation. The mean difference therefore was 0.8 (confidence interval 0.6-1.1, paired t test, p < .001). Sensitivity and positive predictive value for the 30-sec observation were 0.44 and 0.80, respectively.
  
  
  CONCLUSIONS
  A 30-sec COMFORT behavior scale observation increases the risk of underscoring pain. Therefore, the 2-min observation period should be adhered to in the interest of the patients.
authors.affiliation: Intensive Care and Department of Pediatric Surgery, Erasmus MC- Sophia Children's Hospital, Rotterdam, The Netherlands. a.boerlage@erasmusmc.nl
authors.forename: Anneke A
authors.initials: AA
authors.lastname: Boerlage
authors.forename: Erwin
authors.initials: E
authors.lastname: Ista
authors.forename: Marjan
authors.initials: M
authors.lastname: de Jong
authors.forename: Dick
authors.initials: D
authors.lastname: Tibboel
authors.forename: Monique
authors.initials: M
authors.lastname: van Dijk
mesh_terms: D002675:Child, Preschool; D005240:Feasibility Studies; D006801:Humans; D015278:Intensive Care Units, Pediatric; D009730:Nursing Assessment / Q000592:standards*; D015403:Nursing Evaluation Research; D010147:Pain Measurement / Q000379:methods* / Q000451:nursing; D010149:Postoperative Pain / Q000451:nursing*; D010371:Pediatric Nursing / Q000592:standards*; D017410:Practice Guidelines as Topic; D015203:Reproducibility of Results; D013997:Time Factors