Psychometric analysis of the comfort scale for family members of people in critical health condition

Meneguin, Silmara; Morais, José Fausto de; Pollo, Camila Fernandes; Benichel, Cariston Rodrigo; Gobbi, Juliana Fratucci de; Garuzi, Miriane; Bettini, Nicole Maria Miyamoto

doi:10.1590/0034-7167-2020-0170

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Revista Brasileira de Enfermagem

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ORIGINAL ARTICLE • Rev. Bras. Enferm. 74 (2) • 2021 • https://doi.org/10.1590/0034-7167-2020-0170 copy

Psychometric analysis of the comfort scale for family members of people in critical health condition

Análisis psicométrico de la escala de confort para famílias de personas em un estado de salud crítico

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objectives:

to assess the reliability and validity of the 46 items version of the comfort scale for family members of people in critical condition.

Methods:

a methodological study, carried out with 278 family members of critically ill patients, admitted to adult and pediatric intensive care units, in a city in the interior of the state of São Paulo, in Brazil. The analyzes were based on the Classical Test Theory and Item Response Theory.

Results:

Horn’s parallel analysis and exploratory and confirmatory factor analysis did not identify the scale’s unidimensionality nor the tridimensionality. The maximum factor loads were positive. The scale proved to be reliable (α=0.93 and Ω=0.63), most item-total correlations were greater than 0.28 and the discrimination coefficients were greater than one.

Conclusions:

the scale showed satisfactory reliability and relative construct validity. However, the recommended tridimensional structure for the scale has not been confirmed.

Descriptors:
Psychometrics; Validation Study; Family; Nursing; Intensive Care Units

Variables	Total		Recruitment site
	(N=278)		Pediatric ICU ^* * ICU - Intensive Care Units;		Adult ICU		p
	n	%	n	%	n	%
Sex
Male	138	49.6	41	58.6	97	46.6
Female	140	50.4	29	41.4	111	53.4	0.112¹ 1 - Pearson Chi-Square2-sided with continuity correction;
Age
Mean (±SD)	42.8(± 15.1)		33.6(± 10.7)		45.9 (± 15.2)		<0.001 ² 2 - t-test for equality of means with equal variances not assumed.
Marital status
Unsteady	53	19.1	15	21.4	38	18.3
Steady	225	80.9	55	78.6	170	81.7	0.685¹ 1 - Pearson Chi-Square2-sided with continuity correction;
Religion
Non Catholic	118	42.4	33	47.1	85	40.9
Catholic	160	57.6	37	52.9	123	59.1	0.436¹ 1 - Pearson Chi-Square2-sided with continuity correction;
Job
Not working	109	39.2	33	47.1	76	36.5
Working	169	60.8	37	52.9	132	63.5	0.153¹ 1 - Pearson Chi-Square2-sided with continuity correction;
Income
Did not answer	12	4.3	0	0.0	12	5.8
< 1700	100	36.0	17	24.3	83	39.9
> 1700	166	59.7	53	75.7	113	54.3	0.003¹ 1 - Pearson Chi-Square2-sided with continuity correction;
Kinship
Direct	174	62.6	51	72.9	123	59.1
Indirect	89	32.0	14	20.0	75	36.1
None	15	5.4	5	7.1	10	4.8	0.042¹ 1 - Pearson Chi-Square2-sided with continuity correction;
Education
Did not answer	1	0.4	0	0.0	1	0.5
Illiterate	6	2.2	0	0.0	6	2.9
Elementary School	119	42.7	20	28.6	99	47.5
High School	109	39.2	45	64.3	64	30.8
Higher Education	43	15.5	5	7.1	38	18.3	<0.001 ¹ 1 - Pearson Chi-Square2-sided with continuity correction;

Statistics	46 items		Safety	ECONF46^* * ECONF - Comfort Scale for Family Members of People in Critical Health Condition; Support	Family/relative interaction
Statistics	Eight Factors	Three Factors	Safety		Family/relative interaction
Number of Items	46	46	22	18	6
KMO^ KMO - Kaiser Meyer Olkin statistic;	0.82	0.82	0.83	0.82	0.72
p value of Bartlett's Sphericity Test.	< 0.001	< 0.001	<0.001	<0.001	<0.001
Numbers of Factors extracted	8	3	1	1	1
% Variation explained by factors	74.9	56.2	48.6	44.9	50.2
% Commonality<0,4	0	13.0	22.7	33.3	50.0
RMSEA^§ § RMSEA - Root Mean Squared Erro.	0.501	0.457	0.209	0.282	0.203

Items	F1	F2	F3	h2^* * h2 - Communality (sum of factorial loads squares);	ITC^ ITC - item-total correlation;	a^ ***** a - alfa,*
Safety dimension
02.Receive information about your relative at any time	0.56	-0.11	0.37	0.56	0.44	2.28
03.Realize that your relative likes the treatment he/she receives	0.70	-0.26	0.27	0.63	0.36	1.63
04.Realize that your relative gets quick treatment when needed	0.46	0.37	0.05	0.49	0.57	1.74
05.Keep your sleeping routine as before your relative's admission	0.45	0.03	0.29	0.40	0.41	1.60
06.Receive a word of support from the team during admission	0.67	0.23	0.09	0.66	0.58	3.01
09.Understand which treatment is being provided to your relative	0.19	0.13	0.59	0.52	0.42	1.58
10.Realize that your relative has received hygiene care	0.86	-0.07	-0.01	0.69	0.46	2.26
11.Realize that the ICU team offers information cordially	0.78	0.01	0.02	0.62	0.48	2.13
12.Keeping emotionally in control	0.19	-0.06	0.78	0.73	0.36	1.77
13.Being able to receive information about your relative when you call	0.46	-0.09	0.25	0.34	0.29	0.89
14.Realize the ICU team is interested in knowing how you are doing	0.66	-0.37	0.44	0.75	0.30	1.87
15.Hear the truth from professionals about your relative's health condition	0.92	-0.19	0.02	0.78	0.48	2.69
16.Be accompanied by a friend or family member during the visit	0.54	-0.06	0.24	0.42	0.31	1.47
17.Have available professionals to help your relative	0.31	0.53	0.10	0.53	0.57	1.60
19.Be advised of modifications in the clinical condition of your relative at home	0.59	0.07	0.21	0.52	0.47	2.12
20.Realize that the team pays attention to your relative's conditions	0.53	0.19	0.36	0.67	0.57	3.69
22.Recognize professional competence in those working in the ICU	0.17	0.17	0.71	0.72	0.44	2.12
24.See your relative out of the visiting hours when needed	0.52	0.27	0.25	0.62	0.56	3.13
27.Keep the routine with your family	0.24	0.11	0.62	0.62	0.38	2.15
28.Receive detailed information about your relative's condition	0.54	0.13	0.21	0.49	0.54	1.87
40.Understand that the best possible assistance is being given	0.48	0.34	0.19	0.58	0.62	2.69
43.Realize that ICU professionals understand your situation	0.11	-0.09	0.51	0.30	0.08	0.73
Support dimension
07.Understand that the ICU offers protection for the recovery of your relative	0.53	0.02	-0.09	0.26	0.40	0.89
21.Realize that professionals do not insist that you leave at the end of the visit	0.63	0.33	-0.45	0.59	0.28	0.81
23.Having a waiting room in the ICU	0.19	0.47	-0.30	0.31	0.36	0.56
25.Feel that the team is interested in the recovery of your relative	-0.13	0.79	0.19	0.65	0.53	0.94
26.Be able to relax and/or be distracted during the hospital stay	-0.15	0.72	0.06	0.48	0.44	0.67
29.Be able to help your relative to face this situation	0.14	0.36	0.61	0.70	0.56	2.49
30.Be treated with kindness at the ICU reception	0.05	0.76	0.26	0.76	0.68	1.69
32.Realize that your relative is responding well to the treatment	0.02	0.66	0.26	0.59	0.54	1.31
33.Have means of distraction in the waiting room (magazine, TV, radio)	0.54	0.37	0.10	0.63	0.55	2.52
34.Believing that faith can help your relative's recovery	0.72	0.23	-0.15	0.62	0.59	1.91
35.Continue the usual activities (study, work, leisure, etc.)	0.34	0.38	0.25	0.51	0.53	1.80
36.Have a phone near the waiting room	0.49	0.48	-0.06	0.60	0.53	1.82
37.Receive information about what will happen to your relative	-0.16	0.82	0.16	0.66	0.60	0.92
38.Understand who are the professionals that can help you when needed	0.63	0.44	-0.30	0.68	0.50	1.49
39.Have comfortable furniture in the ICU waiting room	0.71	0.07	0.13	0.63	0.52	2.96
42.Understand that your relative realizes that you are close	0.09	0.83	0.07	0.78	0.66	1.45
44.Realize that you are calmly served by the team	0.28	0.73	-0.28	0.70	0.53	1.09
46.Greater number of visitors be allowed when needed	0.28	0.24	0.38	0.43	0.40	1.55
Family/relative interaction dimension
01.Realize that there is a chance of recovery of your relative	0.17	-0.05	0.43	0.26	0.32	0.77
08.See your relative able to talk to you	0.01	0.12	0.62	0.43	0.09	0.95
18.Receive daily information from the doctor	0.34	0.11	0.25	0.28	0.39	1.16
31.Have a place to eat at or near the hospital	-0.04	0.28	0.62	0.50	0.32	1.28
41.Realize that the team has patience to listen to family members	0.07	0.31	0.57	0.54	0.42	1.53
45.Receive information from professionals in a way that you can understand	-0.08	0.13	0.81	0.67	0.28	1.26
%Variance explained	24.0	16.2	16.0
%Accumulated explained variance	24.0	40.0	56.2

Dimensions	Number of Items	Cronbach's Alpha	McDonald 's Omega
Safety	22	0,88	0,95
Support	18	0,89	0,93
Family/relative interaction	6	0,72	0,85
General	46	0,93	0,63

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[1] Corresponding author: Silmara Meneguin. E-mail: s.meneguin@unesp.br