Comfort Theory Katharine Kolcaba

Comfort Theory

Katharine Kolcaba

This page was last updated on November 13, 2010

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INTRODUCTION The comfort theory is a nursing theory that was first developed in the 1990s by Katharine Kolcaba. Comfort Theory is middle range theory for health practice, education, and research. Kolcaba's theory has the potential to place comfort once again in the forefront of healthcare.(March A & McCormack D, 2009). BACKGROUND OF THE THEORIST Born as Katharine Arnold on December 8th 1944, in Cleveland, Ohio Diploma in nursing from St. Luke's Hospital School of Nursing in 1965 Graduated from the Frances Payne Bolton School of Nursing, Case Western Reserve University in 1987 Graduated with PhD in nursing and received certificate of authority clinical nursing specialist in 1997 Specialized in Gerontology, End of Life and Long Term Care Interventions, Comfort Studies, Instrument Development, Nursing Theory, Nursing Research Currently an associate professor of nursing at the University of Akron College of Nursing Published Comfort Theory and Practice: a Vision for Holistic Health Care and Research CONCEPTS AND DEFINITIONS ( Kolcaba, 2010) Kolcaba described comfort as existing in 3 forms: relief, ease, and transcendence. Also, Kolcaba described 4 contexts in which patient comfort can occur: physical, psychospiritual, environmental, and sociocultural. Kolcaba described comfort as existing in 3 forms: relief, ease, and transcendence. If specific comfort needs of a patient are met, for example, the relief of postoperative pain by administering prescribed analgesia, the individual experiences comfort in the relief sense. If the patient is in a comfortable state of contentment, the person experiences comfort in the ease sense, for example, how one might feel after having issues that are causing anxiety addressed. Lastly, transcendence is described as the state of comfort in which patients are able to rise above their challenges. Health Care Needs are those identified by the patient/family in a particular practice setting. Intervening Variables are those factors that are not likely to change and over which providers have little control (such as prognosis, financial situation, extent of social support, etc). Comfort is an immediate desirable outcome of nursing care, according to Comfort Theory Health Seeking Behavior (HSBs): Institutional Integrity - the values, financial stability, and wholeness of health care organizations at local, regional, state, and national levels. Best Policies are protocols and procedures developed by an institution for overall use after collecting evidence. DEVELOPMENT OF THE THEORY Kolcaba conducted a concept analysis of comfort that examined literature from several disciplines including nursing, medicine, psychology, psychiatry, ergonomics, and English First, three types of comfort (relief, ease, transcendence) and four contexts of holistic human experience in differing aspects of therapeutic contexts were introduced. (Kolcaba KY & Kolcaba RJ, 1991) A taxonomic structure was developed to guide for assessment, measurement, and evaluation of patient comfort. ( Kolcaba, 1991) Comfort as a product of holistic nursing art. ( Kolcaba K, 1995) A broader theory for comfort was introduced ( Kolcaba KY,(1994). The theory has undergone refinement and tested for its applicability. DESCRIPTION OF THE THEORY Nursing Nursing is described as the process of assessing the patient's comfort needs, developing and implementing appropriate nursing interventions, and evaluating patient comfort following nursing interventions. Intentional assessment of comfort needs, the design of comfort measures to address those needs, and the reassessment of comfort levels after implementation. Assessment may be either objective, such as in the observation of wound healing, or subjective, such as by asking if the patient is comfortable. Health Health is considered to be optimal functioning, as defined by the patient, group, family or community Person/Patient Patients can be considered as individuals, families, institutions, or communities in need of health care. Environment Any aspect of the patient, family, or institutional surroundings that can be manipulated by a nurse(s), or loved one(s) to enhance comfort. CONCLUSION Holistic comfort is defined as the immediate experience of being strengthened through having the needs for relief, ease, and transcendence met in four contexts of experience (physical, psychospiritual, social, and environmental) (Kolcaba, 2010) The theoretical structure of Kolcaba's comfort theory has real potential to direct the work and thinking of all healthcare providers within one institution. (March A & McCormack D, 2009). REFERENCES Kolcaba, K. (2010). An introduction to comfort theory. In The comfort line. Retrieved November 10, 2010, from http://www.thecomfortline.com/ March A, McCormack D (2009). Nursing Theory-Directed Healthcare: Modifying Kolcaba's Comfort Theory as an Institution-Wide Approach. Holistic Nursing Practice; 23:2;75-80. Kolcaba, K. Y., & Kolcaba, R. J. (1991). An analysis of the concept of comfort. Journal of Advanced Nursing, 16(11), 1301-1310. Kolcaba, K. Y. (1991). A taxonomic structure for the concept comfort. Image: Journal of Nursing Scholarship, 23(4), 237-240. Kolcaba, K. (1995). Comfort as process and product, merged in holistic nursing art. Journal of Holistic Nursing, 13(2), 117-131. Kolcaba, K. Y. (1994). A theory of holistic comfort for nursing. Journal of Advanced Nursing, 19(6), 1178-1184. Kolcaba, K., & Steiner, R. (2000). Empirical evidence for the nature of holistic comfort. Journal of Holistic Nursing, 18(1), 46-62. Kolcaba, K. (2003). Comfort theory and practice: a vision for holistic health care and research. Springer Publishing Company, New York.