Translation and psychometric properties of the comfort behavioral scale-Persian version

Abstract

Abstract Background Managing pain and the level of sedation of critically ill children admitted to the intensive care unit is a complex process and one of the most basic problems of nurses, which requires the use of an available valid, and reliable scale. The present study aimed to translate the comfort behavioral scale into Persian and check its validity and reliability. Methods This methodological research was carried out in the children’s hospitals of Tehran Province (Iran) from Nov 2023 to Apr 2024. After forward and backward translation, face validity was performed qualitatively and quantitatively. Then, qualitative content validity was checked and the content validity ratio and content validity index were measured. The discriminant validity method was used to determine construct validity, and the nurse interpretation sedation scale and nurse report pain scale were used to check the criterion validity. The concordance correlation coefficient method was used to determine reliability. Results In quantitative face validity, all 30 items received an impact score of more than 1.5. In qualitative content validity, some words were replaced with more concrete words. In the content validity ratio, considering the minimum value of 0.62 for 10 experts, none of the items were excluded. The content validity index for all items was higher than 0.8 and S-CVI/Ave for the whole scale was 0.96. There was a significant difference between the pain score in the painful state (24.87 ± 2.5) and the resting state (20.9714 ± 2.4) (P = 0.000). The correlation between Comfort and criterion instruments (NISS and NRS) in a resting state and during a painful procedure was positively significant (P < 0.05). The kappa agreement coefficient showed values higher than 0.4 and reliability was confirmed. Conclusions The Persian version of the COMFORT behavioral scale has good validity and reliability and can be used as a suitable tool for pain management of hospitalized children with a low level of consciousness and lack of verbal communication. The use of this tool not only helps the clinical, educational, and research process but also leads to an increase in the quality of care and satisfaction of the child and her parents in Iranian hospitals.

Keywords

• Translation
• Validation
• Pediatric intensive care unit
• Pain
• Comfort behavioral scale