Sensitivity and Specificity of the Comfort Scale to Assess Pain in Ventilated Critically Ill Adult Patients in Intensive Care Unit
Abstract: Pain is a common
phenomenon experienced by ventilated and critically ill adult patients. It is
urgent to measure the pain among these patients since they are unable to report
their pain verbally. Comfort Scale is one of the instruments used to measure
pain in adult patients. The scale is used to measure pain among children
patients with fairly high sensitivity and specificity.
Purpose: This study aimed to examine the sensitivity and specificity of
the Comfort Scale to measure pain in the ventilated critically ill adult
patients in the ICU.
Methods: This study employed a cross-sectional design with 66 ventilated
adult patients in the ICUs of two hospitals in Semarang. The pain assessment
was administered to the patients in 2 duplo periods by two observers comparing
with the Comfort Scale and Critical Care Pain Observational Tool (CPOT) as a
gold standard instrument during the pre and post positioning procedures. The
data were analyzed using the receiver operating curve (ROC).
Result: The results showed that in the pre-positioning procedure, the
Comfort Scale had the sensitivity value of 69% and the specificity value of
81%. Meanwhile, in the post-positioning procedure, the values were decreasing
(the sensitivity of 45%, the specificity of 67%). This indicated that the
sensitivity value of the comfort scale decreased and could be interpreted that
the ability of the instrument to detect pain remained low. Meanwhile, the
decrease of the specificity value of the instrument between the pre and post
administration was not far different, so it could be interpreted that the
instrument can correctly identify the patient without pain.
Conclusion: The Comfort Scale had a lower value of sensitivity and
specificity in the post-positioning than that in the pre-positioning procedure.
It is recommended that further studies should focus on the relationship between
sedation and pain by using instruments of pain studies for adult patients
(CPOT). Additionally, the hospital policy makers, that is Pain Task Force is
expected to give education and training through workshops and seminars about
the nurse skills in pain management on critical areas as part of the
multidisciplinary team.
Keywords: Comfort scale;
sensitivity; specificity
Author: Indah Sri
Wahyuningsih, Awal Prasetyo, Reni Sulung Utami
Journal Code: jpkeperawatangg170006