The Comfort Theory By Dr. Katherine Kolkaba RN

Presented by Sangita Maharjan RN

The Nursing Theorist.

Dr. Katherine Kolkaba RN

Founder of Comfort Theory in Nursing

Married with two children and eight grandchildren

Birthdate: December 28, 1944

Education:

Diploma, St. Luke's Hospital School of Nursing, 1965

RN/MSN Case Western Reserve University, 1987

PhD. Nursing Case Western Reserve University, 1997

The Nursing Theorist

Employment History:

Co-Chair of the Theory Development Research Section

Midwest Nursing Research Society

Semi retired from The University of Akron, Associate Professor of Nursing, Emeritus Status

Consultant, The Comfort Line

Field of expertise: gerontology, end of life and long term care interventions, nursing theories, nursing research, comfort studies, instrument development, magnet status and enhancing the work environment for nurses

The Comfort Theory

First proposed comfort as nurse sensitive outcome in 1992.

A midrange theory

A humanistic, holistic theory that is based on patient’s need.

Conceptual Framework of the Theory

Major Concepts of the theory part 1

Health Care Needs: identified by the patient/family in a particular practice setting.

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).

Major Concepts of the theory part 2

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.

Types of comfort

 Comfort as a product of holistic nursing art. ( Kolcaba K, 1995)

Relief – the state of having a specific comfort need met. 

Ease – the state of calm or contentment. 

Transcendence – the state in which one can rise above problems of pain.

Context of Comfort

Physical – bodily sensations, homeostatic mechanisms, immune function, etc. 

Psychospiritual – 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 – the external background of human experience such as temperature, light, sound, odor, color, furniture, landscape etc.

Sociocultural – interpersonal, family, and societal relationships such as finances, teaching, health care personnel, family traditions, rituals, and religious practices etc.

Taxonomic Structure of the Theory

The Metaparadigm Concepts part 1

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.

The goal of nursing: providing comfort.

The Metaparadigm Concepts Part 2

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. 

Four Broad Assumptions & Theoretical Assertions

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 comfort measures, and assess outcomes to support enhanced comfort.

Propositions of Comfort Theory Part 1

If enhanced comfort is achieved, nurse, patients and family members are more:

likely to engage in health-seeking behaviors.

satisfied with health care and have better health-related outcomes.

Contributes to help the institution remain viable and flourish.

agree on desirable and realistic health- seeking behaviors.

Propositions of Comfort Theory Part 2

Nurses identify comfort needs of patients and family members.

 Nurses design interventions to meet identified needs.

Intervening variables are considered when designing interventions.

When interventions are delivered in a caring manner and are effective, and when enhanced comfort is attained, interventions are called “comfort measures”

Conclusion

Applicable to all areas of the healthcare field, nursing practice, nursing education, nursing research to:

improve societal acceptance

appreciation of the institution, 

increase patient satisfaction

comforting the learner or student in an educational environment.

test the benefits of comfort on learning.

Reference

Allysa Wolf (2011).The theory paper. Theory Critique: Comfort. Retrieved from htttp://alyssamif.files.wordpress.com/2011/09/comfort-theory-paper.pdf

Comfort care in nursing (July, 2010).The nursing theorist. Retrieved from http://comfortcareinnursing.blogspot.com/p/nursing-theorist-dr-katharine-kolcaba.html

Dossey, B. M., & Keegan, L. (2013).Holistic nursing: a handbook for practice (6th ed.). Burlington, MA: Jones & Bartlett Learning.

Reference

Erin Carlene ( June 24, 2012).Comfort Theory, Kathy Kolcaba. Retrived from http://www.slideshare.net/KathyKolcaba/erin-kolcaba

Erik Neilson( 2013).What are the main points of the comfort theory? Retrieved from http://www.ehow.com/list_6821213_main-points-nursing-comfort-theory_.html .

Malinowski A, Stamler LL( 2002).National institute of health.Comfort: exploration of the concept in nursing.Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/12207758 .

Nursing theories( 2011).Comfort theory.Retrieved from http://currentnursing.com/nursing_theory/comfort_theory_Kathy_Kolcaba.html .