Major Concepts of Comfort Theory
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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 a concept that has a strong association with nursing. Nurses traditionally provide comfort to patients and their families through interventions that can be called comfort measures. The intentional comforting actions of nurses strengthen patients and their families (who can be found in their own homes, in hospitals, agencies, communities, states, and nations). When patients and families are strengthened by actions of health care personnel (nurses), they can better engage in health seeking behaviors.
Enhanced comfort, is an immediate desirable outcome of nursing care, according to Comfort Theory. Additionally, when comfort interventions are delivered consistently over time, they are theoretically correlated a trend toward increased comfort levels over time, and with desired health seeking behaviors (HSBs). HSBs can be internal (healing, immune function, number of T cells, etc.), external (health related activities, functional outcomes, etc.), or a peaceful death.
Institutional Integrity (InI) is defined as 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.
Best Practices are those protocols and procedures developed by an institution for specific patient/family applications (or types of patients) after collecting evidence.
The Metaparadigm Concepts
Nursing: the intentional assessment of comfort needs, design of comfort measures to address those needs, and re-assessment of patients,' families, or community comfort after implementation of comfort measures, compared to a previous baseline.
Patient: an individual, family, or community in need of health care.
Environment: exterior influences (physical room or home, policies, institutional, etc.) which can be manipulated to enhance comfort.
Health: optimum function of a patient/family/community facilitated by attention to comfort needs.
The Taxonomic Structure of Comfort
Comfort is the immediate experience of being strengthened by having needs for relief, ease, and transcendence met in four contexts (physical, psychospiritual, social, and environmental).
Types of comfort:
Ease – the state of calm or contentment.
Transcendence – the state in which one can rise above problems of pain.
Context in which comfort occurs:
Psychospiritual – pertaining to internal awareness of self, including esteem, identity, sexuality, meaning in one's life, and one's understood relationship to a higher order or being.
Environmental – pertaining to the external background of human experience (temperature, light, sound, odor, color, (furniture, landscape, etc.)
Sociocultural – pertaining to interpersonal, family, and societal relationships (finances, teaching, health care personnel, etc.) Also to family traditions, rituals, and religious practices.
Four Broad Assumptions and Theoretical Assertions
Propositions of Comfort Theory
- Human beings have holistic responses to complex stimuli.
- Comfort is a holistic outcome of effective nursing care.
- Human beings have a need for comfort and will seek comfort wherever possible.
- Nurses are in a position to identify the comfort needs of their patients, design comfot measures, and assess outcomes to support enhanced comfort.
Propositions of Comfort Theory
1. Nurses identify comfort needs of patients and family members.
2. Nurses design interventions to meet identified needs.
3. Intervening variables are considered when designing interventions.
4. When interventions are delivered in a caring manner and are effective, and when enhanced comfort is attained, interventions are called “comfort measures”.
5. Patients and nurse agree on desirable and realistic health- seeking behaviors.
6. If enhanced comfort is achieved, patients and family members are more likely to engage in health-seeking behaviors these further enhance comfort.
7. When patients and family members are given comfort care and engage in health-seeking behaviors, they are more satisfied with health care and have better health-related outcomes.
8. When patients, families, and nurses are satisfied with health care in an institution, public acknowledgment about that institution’s contributions to health care will help the institution remain viable and flourish.
Kolcaba, K. (2010, May 17). The comfort line: Frequently asked questions. Retrieved from The Comfort Line website: http://www.thecomfortline.com/FAQ.html
Kolcaba, K. (2003). Comfort theory and practice: A vision for holistic health care and research. New York, NY: Springer Publishing Company.
McEwan, M. (2010). Outlines & highlights for theoretical basis for nursing. Cram 101 Incorporated.
