Department of Evidence Based Practice, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Department of Nursing, Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Spain.
Department of Nursing, Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, Spain; Nursing Management, San Carlos Clinical Hospital, Madrid, Spain.
Aust Crit Care. 2023 Nov;36(6):1025-1034. doi: 10.1016/j.aucc.2022.12.013. Epub 2023 Mar 9.
There is a lack of validated tools to measure comfort in critically ill patients.
The objective of this study was to evaluate the psychometric properties of the General Comfort Questionnaire (GCQ) in patients admitted to intensive care units (ICUs).
A total of 580 patients were recruited, randomising the sample into two homogeneous subgroups of 290 patients for exploratory factor analysis and confirmatory factor analysis, respectively. The GCQ was used to assess patient comfort. Reliability, structural validity, and criterion validity were analysed.
The final version included 28 of the 48 items from the original version of the GCQ. This tool was named the Comfort Questionnaire (CQ)-ICU, maintaining all types and contexts of the Kolcaba theory. The resulting factorial structure included seven factors: psychological context, need for information, physical context, sociocultural context, emotional support, spirituality, and environmental context. A Kaiser-Meyer-Olkin value of 0.785 was obtained, with Bartlett's sphericity test (0.000) being significant, and the total variance explained was 49.750%. The Cronbach's alpha was 0.807, with subscale values ranging from 0.788 to 0.418. Regarding convergent validity, high positive correlations were obtained between the factors and the GCQ score, the CQ-ICU score, and the criterion item GCQ31: "I am content". In terms of divergent validity, correlations were low with the APACHE II scale and with the NRS-O except for physical context (-0.267).
The Spanish version of the CQ-ICU is a valid and reliable tool to assess comfort in an ICU population 24 h after admission. Although the resulting multidimensional structure does not replicate the Kolcaba Comfort Model, all types and contexts of the Kolcaba theory are included. Therefore, this tool enables an individualised and holistic evaluation of comfort needs.
目前缺乏用于评估危重症患者舒适度的有效工具。
本研究旨在评估通用舒适度问卷（GCQ）在重症监护病房（ICU）患者中的心理测量学特性。
共纳入 580 例患者，将样本随机分为两组，每组 290 例，分别进行探索性和验证性因子分析。采用 GCQ 评估患者舒适度，分析其信度、结构效度和效标效度。
最终版 GCQ 保留了 Kolcaba 理论的所有类型和背景，共包含 48 个条目中的 28 个条目，该工具被命名为 ICU 舒适度问卷（CQ-ICU）。新的因子结构包括 7 个维度：心理背景、信息需求、身体背景、社会文化背景、情感支持、精神支持和环境背景。Kaiser-Meyer-Olkin 值为 0.785，Bartlett 球形检验（P=0.000）显著，总方差解释率为 49.75%。Cronbach's α 系数为 0.807，各分量表的范围为 0.788~0.418。在相关性方面，各维度与 GCQ 总分、CQ-ICU 总分和关键条目 GCQ31（“我感到满足”）均呈高度正相关，与 APACHE II 评分和 NRS-O 除身体背景维度外（-0.267）相关性均较低。
24 h 后，CQ-ICU 可用于评估 ICU 患者的舒适度，该量表具有良好的信度和效度。虽然得到的多维结构与 Kolcaba 舒适度模型不完全一致，但包含了 Kolcaba 理论的所有类型和背景，因此，该工具可用于对患者的舒适度需求进行个体化和整体评估。
