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.
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: Sebastiaan C Goulooze; Tirsa de Kluis; Monique van Dijk; Ilse Ceelie; Saskia N de Wildt; Dick Tibboel; Elke H J Krekels; Catherijne A J Knibbe Journal: J Clin Pharmacol Date: 2021-09-17 Impact factor: 2.860
Authors: Julia Harris; Anne-Sylvie Ramelet; Monique van Dijk; Pavla Pokorna; Joke Wielenga; Lyvonne Tume; Dick Tibboel; Erwin Ista Journal: Intensive Care Med Date: 2016-04-15 Impact factor: 17.440
Authors: Joseph P Cravero; Rita Agarwal; Charles Berde; Patrick Birmingham; Charles J Coté; Jeffrey Galinkin; Lisa Isaac; Sabine Kost-Byerly; David Krodel; Lynne Maxwell; Terri Voepel-Lewis; Navil Sethna; Robert Wilder Journal: Paediatr Anaesth Date: 2019-06-11 Impact factor: 2.556
Authors: Gerdien A Zeilmaker-Roest; Joost van Rosmalen; Monique van Dijk; Erik Koomen; Nicolaas J G Jansen; Martin C J Kneyber; Sofie Maebe; Greet van den Berghe; Dirk Vlasselaers; Ad J J C Bogers; Dick Tibboel; Enno D Wildschut Journal: Trials Date: 2018-06-13 Impact factor: 2.279
Authors: Emma Olsson; Hanna Ahl; Kevin Bengtsson; Dhashini N Vejayaram; Elisabeth Norman; Matteo Bruschettini; Mats Eriksson Journal: Pain Date: 2021-02-01 Impact factor: 7.926