ARCHETYPE Comfort behaviour scale (openEHR-EHR-OBSERVATION.comfort_behaviour_scale.v0)

ARCHETYPE IDopenEHR-EHR-OBSERVATION.comfort_behaviour_scale.v0
ConceptComfort behaviour scale
DescriptionA numerical scale for pain and/or sedation assessment in pediatric ICU patients.
UseUsed for pain and/or sedation assessment in pediatric ICU patients.
MisuseNot to be used for pain and/or sedation assessment in adult populations.
PurposeThe Comfort Behavioural scale is a modification of the original Comfort scale (1992), used for pain assesment in children in ICU and, complementarily, for sedation assessment in nonsurgical pediatric ICU patients.
ReferencesAmbuel B, Hamlett KW, Marx CM, Blumer J. Assessing distress in pediatric intensive care environments: The COMFORT scale. Journal of Pediatric Psychology 17(1):95-109, 1992.
van Dijk M, Peters JWB, van Deventer P, Tibboel P. The COMFORT Behavior Scale: A tool for assessing pain and sedation in infants. American Journal of Nursing 105(1): 33-36, 2005.
Ista E, van Dijk M, Tibboel D, de Hoog M. Assessment of sedation levels in pediatric intensive care patients can be improved by using the COMFORT "behavior" scale. Pediatric Critical Care Medicine 6(1):58-63, 2005.
Copyright© openEHR Foundation(en), openEHR Foundation
AuthorsAuthor name: Alan D. March
Organisation: Hospital Universitario Austral, Pilar, Buenos Aires, Argentina
Email: alandmarch@gmail.com
Date originally authored: 2016-08-31
Other Details LanguageAuthor name: Alan D. March
Organisation: Hospital Universitario Austral, Pilar, Buenos Aires, Argentina
Email: alandmarch@gmail.com
Date originally authored: 2016-08-31
OtherDetails Language Independent{licence=This work is licensed under the Creative Commons Attribution-ShareAlike 3.0 License. To view a copy of this license, visit http://creativecommons.org/licenses/by-sa/3.0/., custodian_organisation=openEHR Foundation, references=Ambuel B, Hamlett KW, Marx CM, Blumer J. Assessing distress in pediatric intensive care environments: The COMFORT scale. Journal of Pediatric Psychology 17(1):95-109, 1992. van Dijk M, Peters JWB, van Deventer P, Tibboel P. The COMFORT Behavior Scale: A tool for assessing pain and sedation in infants. American Journal of Nursing 105(1): 33-36, 2005. Ista E, van Dijk M, Tibboel D, de Hoog M. Assessment of sedation levels in pediatric intensive care patients can be improved by using the COMFORT "behavior" scale. Pediatric Critical Care Medicine 6(1):58-63, 2005., current_contact=Alan D. March , original_namespace=org.openehr, original_publisher=openEHR Foundation, custodian_namespace=org.openehr, MD5-CAM-1.0.1=42E25E6D2E2368E6803922A5926EC175, build_uid=ee679330-780d-4591-bf62-08272420b12c, revision=0.0.1-alpha}
KeywordsComfort Behavioural scale, Comfort B scale, pain, sedation, scale, pediatric
Lifecyclein_development
UIDdf697075-a5b0-46d2-9fa2-ec1e40453abe
Language useden
Citeable Identifier1013.1.2607
Revision Number0.0.1-alpha
AllArchetype [runtimeNameConstraintForConceptName=null, archetypeConceptBinding=null, archetypeConceptDescription=A numerical scale for pain and/or sedation assessment in pediatric ICU patients., archetypeConceptComment=null, otherContributors=, originalLanguage=en, translators=
  • Spanish (Argentina): Alan D. March, Hospital Universitario Austral, Pilar, Buenos Aires, Argentina, alandmarch@gmail.com

  • , subjectOfData=unconstrained, archetypeTranslationTree=null, topLevelToAshis={state=[], contacts=[], details=[], description=[], content=[], provider=[], data=[ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0004], code=at0004, itemType=ELEMENT, level=4, text=Alertness, description=Degree of alertness., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_ORDINAL, bindings=null, values=1: Deeply asleep [Eyes closed, no response to changes in the environment.]
    2: Lightly asleep [Eyes mostly closed, occasional responses.]
    3: Drowsy [Child closes his/her eyes frequently, less responsive to the environment.]
    4: Awake and alert [Child responsive to the environment.]
    5: Awake and hyper-alert [Exaggerated responses to environmental stimuli.]
    , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0010], code=at0010, itemType=ELEMENT, level=4, text=Calmness/Agitation, description=Degree of calmness or agitation., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_ORDINAL, bindings=null, values=1: Calm [Child appears serene and tranquil.]
    2: Slightly anxious [Child shows slight anxiety.]
    3: Anxious [Child appears agitated but remains in control.]
    4: Very anxious [Child appears very agitated, just able to control.]
    5: Panicky [Severe distress with loss of control]
    , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0016], code=at0016, itemType=ELEMENT, level=4, text=Respiratory response, description=Degree of respiratory response., comment=Score only in mechanically ventilated children., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_ORDINAL, bindings=null, values=1: No spontaneous respiration [No spontaneous respiration.]
    2: Spontaneous and ventilator respiration [Both spontaneous and ventilator respiration.]
    3: Restlessness or resistance to ventilator [Either restlessness or resistance to ventilator.]
    4: Actively breathes against ventilator or coughs regularly [Either actively breathes against ventilator or coughs regularly.]
    5: Fights ventilator [Fights ventilator.]
    , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0022], code=at0022, itemType=ELEMENT, level=4, text=Crying, description=Whether the patient is crying., comment=Score only in spontaneously breathing children., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_ORDINAL, bindings=null, values=1: Quiet breathing, no crying sounds [Quiet breathing, with no crying sounds.]
    2: Occasional sobbing or moaning [Occasional sobbing or moaning.]
    3: Whining (monotonous sound) [Whining (as monotonous sound).]
    4: Crying [Actively crying .]
    5: Screaming or shrieking [Screaming and/or shrieking.]
    , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0028], code=at0028, itemType=ELEMENT, level=4, text=Physical movement, description=Degree of physical movement., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_ORDINAL, bindings=null, values=1: No movement [No movements.]
    2: Occasional slight movements [Occasional, (three or fewer) slight movements.]
    3: Frequen slight movements [Frequent, (more than three) slight movements.]
    4: Vigorous movements limited to extremities [Vigorous movements limited to extremities.]
    5: Vigorous movements including torso and head [Vigorous movements including torso and head.]
    , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0034], code=at0034, itemType=ELEMENT, level=4, text=Muscle tone, description=Degree of muscle tone., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_ORDINAL, bindings=null, values=1: Muscles totally relaxed; no muscle tone [Muscles totally relaxed or no muscle tone.]
    2: Reduced muscle tone [Reduced muscle tone; less resistance than normal]
    3: Normal muscle tone [Normal muscle tone.]
    4: Increased muscle tone and flexion of fingers and toes [Increased muscle tone and flexion of fingers and toes.]
    5: Extreme muscle rigidity and flexion of fingers and toes [Extreme muscle rigidity and flexion of fingers and toes.]
    , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0040], code=at0040, itemType=ELEMENT, level=4, text=Facial tension, description=Degree of facial tension., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_ORDINAL, bindings=null, values=1: Facial muscles totally relaxed [Facial muscles are totally relaxed. ]
    2: Normal facial tone [Normal facial tone.]
    3: Tension evident in some facial muscles (not sustained) [Tension evident in some facial muscles (not sustained).]
    4: Tension evident throughout facial muscles (sustained) [Tension evident throughout facial muscles (sustained).]
    5: Facial muscles contorted and grimacing [Facial muscles contorted and there is grimacing.]
    , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0046], code=at0046, itemType=ELEMENT, level=4, text=Total score, description=Total score, comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_COUNT, bindings=null, values=min: >=6; max: <=30

    , extendedValues=null]], identities=[], other_participations=[], activities=[], protocol=[], credentials=[], events=[ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002], code=at0002, itemType=POINT_EVENT, level=2, text=Any event, description=*, comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=POINT_EVENT, bindings=null, values=null, extendedValues=null]], context=[], relationships=[], target=[], capabilities=[], items=[], source=[], ism_transition=[]}, topLevelItems={data=ResourceSimplifiedHierarchyItem [path=ROOT_/data[at0001]/events[at0002]/data[at0003], code=at0003, itemType=ITEM_TREE, level=2, text=null, description=null, comment=null, uncommonOntologyItems=null, occurencesFormal=1..1, occurencesText=Mandatory, cardinalityFormal=0..1, cardinalityText=optional, subCardinalityFormal=0..*, subCardinalityText=Minimum of 0 items, dataType=ITEM_TREE, bindings=null, values=null, extendedValues=null]}, addHierarchyItemsTo=data, currentHierarchyItemsForAdding=[ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0004], code=at0004, itemType=ELEMENT, level=4, text=Alertness, description=Degree of alertness., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_ORDINAL, bindings=null, values=1: Deeply asleep [Eyes closed, no response to changes in the environment.]
    2: Lightly asleep [Eyes mostly closed, occasional responses.]
    3: Drowsy [Child closes his/her eyes frequently, less responsive to the environment.]
    4: Awake and alert [Child responsive to the environment.]
    5: Awake and hyper-alert [Exaggerated responses to environmental stimuli.]
    , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0010], code=at0010, itemType=ELEMENT, level=4, text=Calmness/Agitation, description=Degree of calmness or agitation., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_ORDINAL, bindings=null, values=1: Calm [Child appears serene and tranquil.]
    2: Slightly anxious [Child shows slight anxiety.]
    3: Anxious [Child appears agitated but remains in control.]
    4: Very anxious [Child appears very agitated, just able to control.]
    5: Panicky [Severe distress with loss of control]
    , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0016], code=at0016, itemType=ELEMENT, level=4, text=Respiratory response, description=Degree of respiratory response., comment=Score only in mechanically ventilated children., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_ORDINAL, bindings=null, values=1: No spontaneous respiration [No spontaneous respiration.]
    2: Spontaneous and ventilator respiration [Both spontaneous and ventilator respiration.]
    3: Restlessness or resistance to ventilator [Either restlessness or resistance to ventilator.]
    4: Actively breathes against ventilator or coughs regularly [Either actively breathes against ventilator or coughs regularly.]
    5: Fights ventilator [Fights ventilator.]
    , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0022], code=at0022, itemType=ELEMENT, level=4, text=Crying, description=Whether the patient is crying., comment=Score only in spontaneously breathing children., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_ORDINAL, bindings=null, values=1: Quiet breathing, no crying sounds [Quiet breathing, with no crying sounds.]
    2: Occasional sobbing or moaning [Occasional sobbing or moaning.]
    3: Whining (monotonous sound) [Whining (as monotonous sound).]
    4: Crying [Actively crying .]
    5: Screaming or shrieking [Screaming and/or shrieking.]
    , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0028], code=at0028, itemType=ELEMENT, level=4, text=Physical movement, description=Degree of physical movement., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_ORDINAL, bindings=null, values=1: No movement [No movements.]
    2: Occasional slight movements [Occasional, (three or fewer) slight movements.]
    3: Frequen slight movements [Frequent, (more than three) slight movements.]
    4: Vigorous movements limited to extremities [Vigorous movements limited to extremities.]
    5: Vigorous movements including torso and head [Vigorous movements including torso and head.]
    , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0034], code=at0034, itemType=ELEMENT, level=4, text=Muscle tone, description=Degree of muscle tone., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_ORDINAL, bindings=null, values=1: Muscles totally relaxed; no muscle tone [Muscles totally relaxed or no muscle tone.]
    2: Reduced muscle tone [Reduced muscle tone; less resistance than normal]
    3: Normal muscle tone [Normal muscle tone.]
    4: Increased muscle tone and flexion of fingers and toes [Increased muscle tone and flexion of fingers and toes.]
    5: Extreme muscle rigidity and flexion of fingers and toes [Extreme muscle rigidity and flexion of fingers and toes.]
    , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0040], code=at0040, itemType=ELEMENT, level=4, text=Facial tension, description=Degree of facial tension., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_ORDINAL, bindings=null, values=1: Facial muscles totally relaxed [Facial muscles are totally relaxed. ]
    2: Normal facial tone [Normal facial tone.]
    3: Tension evident in some facial muscles (not sustained) [Tension evident in some facial muscles (not sustained).]
    4: Tension evident throughout facial muscles (sustained) [Tension evident throughout facial muscles (sustained).]
    5: Facial muscles contorted and grimacing [Facial muscles contorted and there is grimacing.]
    , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0046], code=at0046, itemType=ELEMENT, level=4, text=Total score, description=Total score, comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_COUNT, bindings=null, values=min: >=6; max: <=30

    , extendedValues=null]], minIndents={}, termBindingRetrievalErrorMessage=null]