Identification and validation of the defining characteristics of alteration in comfort: Pain in non-communicative adults

Abstract

The results of this study determined the defining characteristics for the diagnosis Alteration in comfort: pain in patients unable to communicate discomfort due to neurologic injury or administration of anesthesia. Sixty nurse-participants from three New England hospitals completed a written questionnaire, rating 17 literature-based items, identifying how frequently each sign occurs when pain is diagnosed, and the perceived importance of each sign. Using Fehring's (1986) Diagnostic Content Validation (DCV) model, three major defining characteristics were validated: increase in arterial blood pressure, increase in heart rate, and restlessness; and eight minor defining characteristics were validated: increase in respiratory rate, facial mask of pain, resistance to movement, moaning, rigid muscle tone, withdrawal from stimulus, tears/crying and diaphoresis. High rank order correlations in the identified defining characteristics were evident between post-anesthesia recovery and neurologically impaired patients, as well as high correlations between DCV scores and perceived importance scores.