Date of Award

Spring 4-2025

Document Type

Dissertation

Selected Creative Commons License

Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License.

Degree Name

Doctor of Philosophy (Ph.D.) Nursing

Department

Nursing

School

School of Nursing and Health Sciences

First Advisor

Jennifer E. Mannino

Abstract

Background: Pain is multidimensional. It is a physical, psychospiritual, environmental, and sociocultural experience (Ebrahimpour & Hoseini, 2018). Current measures of pain tend to be unidimensional, only focusing on the physical aspect of pain. The entire experience of pain may not be effectively communicated by patients or adequately controlled by interventions (e.g., analgesics, repositioning, physical therapy). Adults in pain may struggle to participate in daily activities and responsibilities. A scale encompassing all pain contexts and comfort levels could provide a more comprehensive view of the patient’s experience. Transitioning from measuring pain to measuring comfort holistically would provide patient satisfaction and improved outcomes in their well-being (Wensley et al., 2020).

Theoretical Framework: Comfort Theory (Kolcaba, 2003).

Purpose: The purpose of this study is to evaluate the psychometric properties of the 13-item Shortened General Comfort Questionnaire (SGCQ) in a population of pre- and post-operative orthopedic surgical patients. Secondly, this study aimed to examine the utility of an existing single-item multidimensional assessment of comfort for use in acute care.

Methods: This study followed a quantitative cross-sectional design to assess the psychometric reliability and validity of the 13-item Shortened General Comfort Questionnaire (SGCQ) and to examine the relationships among the Total Comfort Scale (TCS), the Numeric Rating Scale, and the SGCQ. Data were collected from two large academic health system campuses: one suburban campus and one urban specialty hospital. The investigator collected participant information face-to-face.

Results: Data were collected from 150 participants. The 13-item SGCQ had an acceptable internal consistency and reliability (a = .767). The PCA revealed a three-factor model that explained just over 50% of the variance in comfort levels for this sample. This suggests that three contexts within the 13-item SGCQ provide a multidimensional approach for assessing comfort in preoperative and postoperative orthopedic patients. No significant correlation was noted between NRS and TCS (r = -.135, n = 149, p = .101 two-tailed), suggesting no relationship between NRS and TCS for these participants. A significant, weak, negative correlation was noted between NRS and the Summed 13-item SGCQ (r = -.199, n = 149, p = .015 two-tailed); participants who reported higher pain levels on the NRS also reported lower comfort levels on the TCS. A significant, moderate, positive correlation was noted between TCS and the summed score for the 13-item SGCQ (r = .483, n = 150, p = < .001 two-tailed); participants who reported higher comfort levels on the TCS also reported higher comfort levels on the 13-item SGCQ.

Conclusion: The Comfort Theory (Kolcaba, 2003) introduces a multidimensional approach to assessing pain and discomfort, an essential part of nursing. Using the Comfort Theory in clinical practice guides nurses in providing a holistic approach to assessing comfort. It provides an approach that goes beyond the physical context of pain into psychospiritual, environmental, and sociocultural contexts. It also allows nurses to create holistic and individualized plans for patient care.

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