Adaptación transcultural y validación psicométrica de la escala de Sedacion Comfort (Comfort Scale)

Abstract

Approximately 2% of all children admitted to the hospital require management in the pediatric intensive care unit, and between 20 to 64% (1) requires the use of mechanical ventilation, therefore sedation is very important in order to provide them with well-being , relieve pain, reduce anxiety due to confinement and the presence of unknown persons, prevent discomfort caused by the high level of noise that can alter the sleep pattern and ensure adequate invasive monitoring. (2). In some circumstances, sedation and analgesia have therapeutic use. It should be remembered that high doses of sedation can increase morbidity and even affect the recovery of patients. The management of the critical patient focused on the disease cause of admission makes it tend to use multiple sedative drugs without considering the long-term consequences. This is why it is very important to objectively evaluate sedation goals in order to avoid excessive or deficient use of this, resulting in greater morbidity. The measurement is made by means of scales or instruments designed and validated to evaluate the sedation in intensive care units, based on the observation of clinical signs, allowing systematic sedation assessments, which must be interpreted in a similar way independently of the person of the team of health that uses it. There are multiple sedation scales, the COMFORT sedation scale is the most accepted due to its validity, reliability and ease of application (1); Ambuel and his collaborators (1990) developed the COMFORT Scale to assess the psychological distress of critically ill children; additionally, it was determined that the COMFORT scale is useful in determining whether a child is optimally sedated or not (3). This tool is considered a pain assessment instrument using the behavioral or physiological parameters often associated with pain. This was designed and validated in the United States (1994), has been translated and validated in Porto Alegre Brazil, (4); no validations were found for Spanish language in South America or Colombia. The purpose of this research is to perform the translation or linguistic equivalence of the scale from English to Spanish according to the international standards in force given by the International Society for Pharmacoeconomics and Outcomes Research (ISPOR), and the validation of the scale in Spanish for Colombia.