title: The COMFORT behaviour scale detects clinically meaningful effects of analgesic and sedative treatment.
abstract: BACKGROUND
  The COMFORT behaviour scale (COMFORT-B scale) is widely used in paediatric intensive care units to assess young children's pain and distress. It is also used to assess the impact of treatment interventions, but little is known on the scale's sensitivity to detect changes between before and after measurements following an intervention. This study explored the sensitivity to change of the COMFORT-B scale.
  
  
  METHODS
  COMFORT-B scores, originally and prospectively collected as part of standard care, were retrieved from the digital patient data management system. We analysed scores obtained in 747 paired observations, i.e., before and after a pharmacological intervention in 180 paediatric intensive care patients between September 2009 and September 2010.
  
  
  RESULTS
  The mean scores before and after an intervention were 20.0 [standard deviation (SD) 3.7] and 14.1 (SD 4.7), respectively. Multilevel regression analysis showed a 6-point mean decline after an intervention (p < 0.0001). The magnitude of this decline was not statistically significantly related to number and type of interventions or time between assessments. In almost three-quarters of cases (74%), the COMFORT-B score dropped to below 17 after a pharmacological intervention, indicating good responsiveness.
  
  
  CONCLUSIONS
  This is the first study demonstrating that the COMFORT-B scale detects treatment-related changes in pain or distress intensity. This implies that COMFORT-B assessments can effectively guide analgesic and sedation treatment in critically ill children.
authors: Intensive Care and Department of Pediatric Surgery, Erasmus MC - Sophia Children's Hospital, The Netherlands.
authors: A A
authors: AA
authors: Boerlage
authors: E
authors: E
authors: Ista
authors: H J
authors: HJ
authors: Duivenvoorden
authors: S N
authors: SN
authors: de Wildt
authors: D
authors: D
authors: Tibboel
authors: M
authors: M
authors: van Dijk
mesh_terms: D000700:Analgesics / Q000627:therapeutic use*; D016292:Procedural Sedation; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use*; D007223:Infant; D015278:Intensive Care Units, Pediatric; D008297:Male; D010146:Pain / Q000188:drug therapy*; D010147:Pain Measurement / Q000379:methods; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D000700:Analgesics; D006993:Hypnotics and Sedatives