Comfort Theory 101
Katharine Kolcaba
The University of Akron
College of Nursing
What do we mean by comfort?
• Complex term• Common use• Technical definition
(Kolcaba, 1992)• Strengthening
component (rationale for comforting interventions in both populations)
Dictionary Definitions: Comfort (Webster) • 1. To soothe in distress or sorrow.• 2. Relief from distress (absence of previous
discomfort) (negative sense)• 3. A person or thing that comforts• 4. A state of ease and quiet enjoyment, free from
worry (neutral sense)• 5. Anything that makes life easy • 6. Suggests the lessening of misery or grief by
cheering, calming, or inspiring with hope (positive sense)
• verb, noun, adjective, adverb
ReliefRelief
I need help because I’m lonley.
Ease
I feel totally peaceful.
Transcendence
I did it! (with the help of my coach…)
Research Study: Comfort in LTC setting (Hamilton, 1989)
• Research questions:• What is the residents’ definition of comfort?• What contributes to the residents’ comfort?• What detracts from the residents’ comfort?• How can residents become more comfortable?• (Qualitative study)
Five recurring themes:
Physical Comfort
homeostasis, pain relief,
symptom management
• 2001: Data from more than 2.2 million nursing home staff who usually underestimate true pain burden of residents.
• Woefully inadequate pain management among frail and old population of Americans.
• Positioning– Returning to bed when
requested
– Better seating arrangements
But physical comfort and positioning isn’t the only important type of comfort
• There are three more comfort themes that the participants in this study cited…
Comfort theme of self-esteem (psychospiritual)
Comfort theme of approach and attitudes of staff (sociocultural)
Comfort theme of hospital life (environment).
Definition of Holistic Comfort
Relief Ease Transcendence
Physical
Psycho- Spiritual
Socio-Cultural
Environ-mental
(Kolcaba, 2003)
Technical definition of Comfort (cont)
• The state of being strengthened when needs for relief, ease, and transcendence are met in four contexts of experience: physical, psychospiritual, sociocultural, and environmental
• Nice fit with nursing practice and research!
Comfort Theory (3 parts)
• Comforting interventions enhance patients’ comfort.
• Enhanced patient comfort is positively related to engagement in HSBs – Comfort is strengthening
• When patients (and families) engage in HSBs, institutions have better outcomes– Patient satisfaction, nurse retention, costs down
Practical Application
• Holistic assessment of patients’ comfort needs– Use grid as a guide
• Holistic interventions to meet those needs.– Use grid as a guide
• Relationship of comfort (holistic outcome) to health seeking behaviors (HSBs) – External HSBs: e.g. functional status, rehab progress– Internal HSBs: e.g. healing, t-cell counts, etc.– Peaceful death: perfect for hospice and palliative care
• Holistic instruments to determine outcomes
• Institutional outcomes: increased patient satisfaction, decreased cost, decreased readmissions, etc.
• Don’t forget about comfort of nurses!
• Kolcaba, K. (2003). Comfort Theory and Practice. Springer.
• Available at: – www.uakron.edu/comfort
– www.SpringerPub.com
– www.Amazon.com
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