ADAPTING THE GCQ TO YOUR POPULATION

Directions for adapting the General Comfort Questionnaire (GCQ) to your population/research question:

Click here to download and print GCQ now to follow along (MS Word format).

1. Delete items from the original GCQ that are not relevant for your population.

2. Place the number of retained items, and whether they are positive or negative, on the taxonomic structure of comfort (Diagram 1). This process creates a map of the items you presently have in the content domain of comfort. [Please remember to cite the origin of the taxonomic structure in your proposals/articles: Kolcaba, K (1991). A taxonomic structure for the concept comfort. IMAGE: Journal of Nursing Scholarship, 23(1), 237-240.]

3. Fill in the map with your own positive and negative items that are specific to your population and/or research problem. You want to achieve a balance across the entire content domain of comfort. If you decide one of the contexts of experience or types of comfort is not important to assess for your population/problem, take that row or column out, but justify the exclusion in your write-up.

4. If you exclude large portions of the content domain of comfort, you should do a pilot test of your instrument (to obtain your own psychometrics). This is because your abbreviated version of the GCQ would probably be considered a new instrument, rather than an adaptation of the original GCQ. If you truly are adapting the GCQ, you can quote the psychometrics (from comfort theory page; with the proper citation). [See Operationalizing comfort....]

5. It is difficult to discern between positive items for relief and ease. I think of the difference as relief being an immediate lifting of an acute discomfort while ease is a longer lasting and positive condition such as contentment, peacefulness, or restfulness. I do not think the distinction is terribly important in the overall picture, however.

6. Scoring is done by reverse scoring the negative items and adding the total. Higher scores indicate higher comfort. You can also create scores for each subscale (Relief, Ease, and Transcendence) using your map of the content to delineate which item belongs in which subscale.

7. My husband, a professor of philosophy, has an article published about persons being in and surrounded by their environment. [See Kolcaba, R. (1997). The primary holisms in nursing. Journal of Advanced Nursing, 25, 290-296.] My comfort instruments are congruent with his views, and therefore my sense of environment in nursing presently means the manipulation of surrounding environmental features (noise, furniture, ambiance, etc.) to enhance patient comfort. This is also Nightingale's view of the environment. Persons and groups of persons possess their own energy fields, as do nurses. While my comfort instruments currently do not address persons' energy fields, I would would love to go in this direction WITH some of you who practice therapeutic touch.

8. Most of the instruments cited above also are available in full text from Cinahl (or will be shortly). They are copyrighted under my name (and my partners' where applicable). Please inform me as to the nature of the study for which the GCQ (or an adaptation) is being used and the psychometric properties revealed in your population. I am also interested in any factor analyses that you perform and will be happy to assist with your articles if you wish (I would request last authorship in those cases). Use my e-mail or snail mail address for communicating your use of and findings with my instruments, please.

9. You can use the Theory of Comfort to design your study [Line 4, Diagram 2 (Comfort Theory Section)] and create your own practice-level theory by substructing one level further.

10. The specific cells in the TS from which items are derived are useful for a guide. A caution is made in my book, which I am repeating here. Please don't try to duplicate exactly the way in which your adapted items fit in the TS with what is already there. I have found that once new questions are generated, they are interrelated and become part of the gestalt of holistic comfort. We all have our own unique ideas about comfort and interpret similar questions differently. Also, it is difficult to discern between some questions under relief versus ease. That is because, once relief from a specific discomfort is achieved, the patient will be in a state of ease. Worry about these details will discourage you unnecessarily.