The 4 Metaparadigm
Concepts According to
the Comfort Theory
Ferris State University
Ashley Cruz
Kate Galloup
Toni Leaf-Odette
Jaime Stevenson
Nurse
Concepts and Definitions

A nursing theory that was developed by
Katharine Kolcaba in the early 90’s to
help bring comfort back as a leader in
care.
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Kolcaba stated comfort was decided as in
3 forms: relief, ease and transcendence

It was achieved when the patient felt a
physical, psychospiritual, environmental,
and sociocultural state of mind

Relief is achieved when analgesics are
administered to those in pain

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Ease is achieved when a patient has a
comfort state of mind

Transcendence is achieved when a
patient successfully achieves a set goal
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Comfort for nurses: Chitty & Black,
2011
Engagement
Administrative support
Compassionate mentoring
Autonomy
Continuing education
Personal resources
DESCRIPTION OF THE THEORY
ENVIRONMENT
PERSON/PATIENT

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•
•
•
•
•
•
This includes the patient,
their family members and
any social group that helps
define the patient (Kolcaba,
2011).
A community in need of
healthcare (Kolcaba, 2011).

The patient or family
member that can be
influenced by a nurse
or other health
facilitator to help
enhance comfort

Religious beliefs and
general attitude
towards death and
dying (Johnson, 2010).
HEALTH
“Health is considered to be optimal functioning, as defined by the patient, group, family or community”
(Kolcaba).
People need to feel comfortable in their own bodies.
“An evaluation of one’s vulnerability to a condition and the seriousness of that condition” (Black, p.
253).
An evaluation of how effective the healthy maintenance behavior might be” (Black, p. 253).
The presence of a trigger event that precipitates the health maintenance behavior” (Black, p. 253).
It is our responsibility to help people meet their goals.
Society and social groups play a major role.
Improvement of the Health Care
Environment
LOCAL
REGIONAL
Deals directly with the patient,
setting realistic goals that the patient
and staff member agree upon to
establish accurate health goals.
When satisfying more and more
patients at a local level increases
response at a regional level. This is
accomplished by spreading word
through people and conferences.
Use what resources are available at
that time to help decrease discomfort
for the patient and family.
Pain focused treatment → Decrease
complications of pain → Decrease
use of resources = Improved health
(Kolcaba, 2003).
Return to former functioning →
Faster healing = Decreased use of
regional resources
GLOBAL
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.
Economical and effective nursing across all borders.
Comfort Care Just
plain works!!!
Comfort Theory utilizes a variety
of techniques and interventions
to encourage Health Seeking
Behaviors
Comfort care encourages Health
Seeking Behaviors both at
internal and external levels.
Comfort Care encourages
institutional integrity which
improves medical treatments
locally, regionally and globally
by making institutions more
efficient, effective and financially
sound.
“What nursing has to do… is to put
the patient in the best condition for
nature to act upon him” (Florence
Nightengale)
Evidence based practice
Can be based on 4 patterns of knowing that nurses use to determine
the best practice for situations. These 4 levels of knowing were first
developed by Carper in 1978.
This concept of evidence based practice and decision making has been
expanded upon since. (Fawcett)
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).
REFERENCES:
Chitty, K. & Black, B. (2011). Professional Nursing:
Maryland Heights, MO: Saunders Elsevier.
Concepts & Challenges, 6th
ed.
Comfort Theory by Katharine Kolcaba. (2011). Comfort Theory by
Katharine
Kolcaba.
Retrieved June 19, 2014, from http://currentnursing.com/nursing_theory/comfort
Fawcett, J., Watson, J., Neuman, B., Walker, P.H., Fitzpatrick, J.J., (2001).
Nursing theories and evidence. Vol 33:2. P. 115-119. Retrieved from
filr:///C”/Users/user/Downloads/http://digilib.bc.edu-reservesdema- nu417119.pdf
On
Gozalo, A., (2011) Theoretical foundations of nursing. Florence Nightingale.
from www.nursingtheories.weebly.com/Florence-nightinhal.html
Retrieved
nu417-
Johnson, W. (2010, March 19). Four Basic Metaparadigm Concepts in Nursing.
eHow.
Retrieved June 22, 2014, from http://www.ehow.com/list_6106429_four-basicmetaparadigm-concepts-nursing.html
Kolcaba's Theory of Comfort. (2013). - Nursing Theory. Retrieved June 22, 2014,
from
http://nursing-theory.org/theories-and-models/kolcaba-theory-of- comfort.php
th
Kolcaba, K. (2010, May 17 ). The comfort line: Frequently asked questions. Retrieved from
The Comfort Line website: http://www.thecomfortline.com/FAQ.html