COMFORTneo scale: a reliable and valid instrument to measure prolonged pain in neonates?

Naomi J. Meesters*, Tinne Dilles, Joost van Rosmalen, Gerbrich E. van den Bosch, Sinno H.P. Simons, Monique van Dijk

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Objective: We studied the reliability and validity of the COMFORTneo scale, designed to measure neonatal prolonged pain. Study design: This prospective observational study evaluated four clinimetric properties of the COMFORTneo scale from NICU nurses’ assessments of neonates’ pain. Intra-rater reliability was determined from three video fragments at two time points. Inter-rater reliability and construct validity were determined in five neonates per nurse with the COMFORTneo and numeric rating scales (NRS) for pain and distress. Pain scores using N-PASS were correlated with COMFORTneo scores to further evaluate construct validity. Result: Intra-rater reliability: Twenty-two nurses assessed pain twice with an intraclass correlation coefficient (ICC) of 0.70. Inter-rater reliability: The ICC for 310 COMFORTneo scores together with 62 nurses was 0.93. Construct validity: Correlation between COMFORTneo and NRS pain, distress, and N-PASS was 0.34, 0.72, and 0.70, respectively. Conclusion: The COMFORTneo can be used to reliably and validly assess pain in NICU patients.

Original languageEnglish
Pages (from-to)595-600
Number of pages6
JournalJournal of Perinatology
Issue number5
Early online date6 Feb 2023
Publication statusPublished - May 2023

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© 2023, The Author(s), under exclusive licence to Springer Nature America, Inc.


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