Comfort and Person-Centered Care: Adaptation and Validation of the Colcaba-32 Scale in the Context of Emergency Services

Abstract

Introduction: Patient comfort is a central concept in nursing practice, and is particularly important in emergency contexts, where clinical complexity and care overload challenge the provision of humanized care. Katharine Kolcaba’s Theory of Comfort offers a robust theoretical framework for assessing and promoting comfort in multiple domains. The main objective is to psychometrically validate the adapted version of Kolcaba’s Comfort Scale—COLCABA-32—in critically ill patients treated in a Portuguese hospital emergency department. Method: A quantitative, descriptive, cross-sectional study was conducted using a sample of 165 adult patients triaged with urgent clinical priority. Data collection was performed through individual interviews. The COLCABA-32 Scale and the Mini-Mental State Examination (MMSE) were used. Statistical analysis included descriptive statistics, principal component analysis (PCA), internal consistency (Cronbach’s alpha), and correlation with clinical priority according to the Manchester Triage. Results: PCA revealed six factors with eigenvalues greater than 1, explaining 59.01% of the total variance of the scale. The dimensions identified were psycho-emotional comfort and autonomy, physical and symptomatic comfort, relational comfort and information, spiritual comfort, environmental comfort and motivational comfort and hope. The overall Cronbach’s alpha was 0.897, indicating excellent internal consistency. Correlations with clinical priority confirmed partial convergent validity. Conclusions: The COLCABA-32 Scale demonstrated adequate psychometric properties for assessing the comfort of critically ill patients in an emergency setting and is a valid, reliable, and sensitive instrument for the multiple dimensions of comfort, as proposed by Kolcaba. Its application can contribute to more person-centered and evidence-based nursing practices.