Issue Archive
Volume 32, Number 5
September/October 2006

Continuing Education
Interrater Reliability of the COMFORT Scale
Lora A. Bear and Peggy Ward-Smith

Pain assessment of the critically ill sedated patient is a challenge. Children who are critically ill may be unable to articulate pain, and they may have a decreased level of consciousness as a result of their disease state and/or analgesic and sedation medications. The COMFORT Scale (Ambuel, Hamlett, & Marx, 1990) can be used to assess psychological distress of critically ill children. This non-experimental comparison study evaluated the interrater (interobserver) reliability of the COMFORT Scale, using correlation techniques. Using the COMFORT Scale, the primary investigator and 29 staff nurse participants assessed 55 pediatric patient participants simultaneously, all of whom were intubated, and had normal musculoskeletal function and stable vital signs. A t-test comparing the COMFORT Scale scores obtained by the primary investigator and each nurse participant determined that there was no statistical significance in those COMFORT Scale scores obtained by the primary investigator and staff nurse participants. Data from this study support the reliability of the COMFORT scale when used among pediatric nurses of varied educational backgrounds and experience.