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• Education:
Bachelor’s degree in home economics
and English from Baylor University of
Waco, Texas , in 1954
2nd bachelor’s degree in nursing from
University of Tennessee in Memphis in
1962
Master’s degree in medical-surgical
nursing and teaching from University of
California, San Francisco, in 1964
PhD in nursing science and rehabilitation
nursing from New York University in New
York City in 1971
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1978: Invitation to speak at a conference in New York on
nursing theory
1978 to 1982 - Participated as a member of the nurse
theorist task force with NANDA
1985 - Traveling research fellow and presented many
papers on her theory of health as expanding
consciousness
1989 & 1990 - Principal investigator exploring the theory
and structure of a professional model of nursing practice
Consultant for her theory of health in more than 40
states & 8 countries
Has served on several editorial review panels
Currently on advisory board of Advances in Nursing
Science
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Fellow in the American Academy of Nursing and has been honored as
an outstanding alumnus by both the University of Tennessee and New
York University in 1975 and 2002
Admitted to hall of fame at University of Mississippi School of Nursing
in 1988
Distinguished Scholar in Nursing Award from New York University in 1992
Founders Award for Excellence in Nursing Research from Sigma Theta Tau
International
E. Louise Grant Award for Nursing Excellence from the University of
Minnesota in 1996
Named Who’s Who in America in 1996
• In the late 70s to the 80s, The public image
and popular opinion of nursing was that of
“traditional womanhood”.
• Nursing was seen as the narrowing of
personal ambition and acceptance of the
stricture of sex role specialization.
• The image of nursing
perceived by Margaret
Newman was that of healer;
to make people well, and to
prevent people from getting
sick.
• Margaret felt that the role of a nurse was mainly to
assist people in utilizing the power within them.
• Newman states, “The task of nursing is not to try to
change the pattern of another person, but to help
client recognize their own patterns,” which opens
the way for transformation to occur.
“Every person in every situation, no matter how
disordered or hopeless it may seem, is part of
the universal process of expanding
consciousness- a process of becoming more
oneself, of finding greater meaning in life, and
of reaching new dimensions of connectedness
with other people and the world.”
• Consciousness: the ability of a
system (human being) to
interact with the environment
• This consciousness is part of a
larger, undivided pattern of
an expanding universe.
• Foundation for viewing health
and illness as a unitary
process moving through
variations in order and
disorder
• From treatment of symptoms to a search for pattern.
• From viewing disease and disruption as negative to viewing
them as part of the self-organizing process of expanding
consciousness.
• From viewing the nursing role as addressing the problems of
disease to assisting people to get in touch with their own
pattern of expanding consciousness.
• Finding your best self no matter what the situation…
• Old rules vs. New rules
Imagine, “the emanating
waves that appear when
two pebbles are thrown
into water. As the waves
radiate...they meet and
interact...[forming] an
interference pattern.”
• Newman believes that, “the goal of nursing is not to make
people well, or to prevent their getting sick, but to assist
people to utilize the power within them as they evolve toward
higher levels of consciousness.”
• Maintaining a direct on-going relationship
• Movement and time are an essential part of nursing
intervention
• Applications in clinical management
• Newman suggests that nursing education should,
“revolve around pattern as a concept, substance,
process, and method.” Education by this method
would enable nursing to be an important resource
for the continued development of health care.
• Pattern recognition allowed researchers to study patterns
of patients with the following conditions and treatment:
– Rheumatoid arthritis
– Coronary heart disease
– COPD
– HIV & AIDs
– Older wife caregivers of husbands with dementia
– Use of music and treating chronic pain
– Women who successfully lose weight and maintain the
loss
– Family members living through sudden death of a
child
Katharine Kolcaba
B
I
O
G
R
A
P
H
Y
• December 8, 1944 in Cleveland, OH
• Received diploma in 1965 from St. Luke’s
School of Nursing
• Practiced med-surge, long-term, and
home-care part time while raising 3 daughters
• Obtain MSN degree in 1987
• After graduation, she joined the University of
Akron College of Nursing while pursuing her
doctorate.
• Developed the “Theory of Comfort”
• Completed PhD in 1997
• Continues to live in Cleveland, OH with her family and
continues to be active in nursing organizations.
Awards and Recognition
• 1991-92: Pre-doctoral Fellowship in
Interdisciplinary Health from CWRU
• 1997: Marie Haug Student Award for
Excellence in Aging
Studies
• 1997: Honor a Researcher Award
• 2003: Mary Hanna Memorial Journalism
Award in recognition for the article “Care of
the Perianesthesia Nursing”
• 2003: Advancement of Science Award from
Midwest Nursing Research Society, End of
Life, and Palliative Care Nursing
Public’s View of Nursing
during the 1990’s
• Nurses were invisible in the media
• Shortage of nurses
• There was a decline enrollment in
nursing schools
• Nurses did receive recognition for
their participation with the war in the
Middle East.
Kolcaba’s View of Nursing
• Kolcaba says that nurses indentified the patient’s lack
of comfort, and implement nursing interventions to
address those issues.
• However, with her theory and proper support, patients
are engaged in rehabilitation and/or recovery
programs, and the institutional integrity enhances as
well.
• Kolcaba says that patient needs to have a need for
enhanced comfort, that are not achieved by
conventional support systems. These needs include
physical, psychospiritual, social, and environmental
needs.
The Comfort Theory: Intro.
Comfort may be a blanket or breeze,
Some ointment here to soothe my knees;
A listening ear to hear my woes,
A pair of footsies to warm my toes;
A PRN medication to ease my pain,
Someone to reassure me once again;
A call from my doctor, or even a friend.
A rabbi or priest as my life nears the end
Comfort is whatever I perceive it to be,
A necessary thing defined only by me.
-- S.D. Lawrence SN
(Kolcaba, 1995b, p. 289)
Three Types of Comfort
• Relief
• Experience of the patient that has had a specific
comfort need met
• Ease
• A state of calm or contentment
• Transcendence
• A state in which one rises above problems or pain
Four contexts of experience
– Physical
• Pertaining to bodily sensations, homeostatic
mechanisms, immune function, etc.
– Psychosocial
• 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.
Main Concept
• All types of comfort must be met in the four contexts of
experience for total comfort to be fulfilled
• Based on this chart, Kolcaba created a The General
Comfort Questionnaire
A Copy of Kolcaba’s experiment
testing The Comfort Theory
• Early stage breast cancer patients undergoing
radiation therapy
• Guided Imagery audio tapes that describe
radiation therapy as a “friend” whose healing rays
were important for the woman’s health were given
to half of the study group.
• The General Comfort Questionnaire, revised to
relate to radiation therapy, was given before the
start of radiation therapy, in the middle of therapy,
and 3 weeks after therapy ended to measure
comfort.
• Effects of Guided imagery on Comfort of USN
students prior to a presentation
Applying to the Comfort Theory
Health Care +
Needs
Nursing
Interventions
+ Intervening
Variables
->
Enhanced
Comfort
<->
Health
Seeking
Behaviors
Comfort
needs of
USN
Students to
treat
anxiety
Guided
Imagery
+ Age; Sex;
Marital
Status;
Amount of
time
practiced;
Confidence
->
Comfort
<->
related to
USN
students
prior to a
presentation
Functional
Status;
+
Outcome of GI on patients
160
140
120
100
Guided Imagery
80
Control
60
40
20
0
Before RT
Middle RT
3 wks post RT
Comfort Theory in Today’s Healthcare
Environment
• The concept of The Comfort Theory is nursesensitive in today’s healthcare environments,
because it is influenced by nursing
interventions.
• Basically, we can use the framework of the
comfort theory to test if certain nursing
interventions we are using are actually helping
to improve the patients level of comfort
Compare and Contrast
• Newman: focuses on
holistically
empowering the
patient to adjust their
lifestyle to adapt to
an improve way of
living
•
Both theorists believe that
nursing focuses on helping the
patients achieve optimum
satisfaction with their current
state of health.
• Kolcaba: focuses on
empowering the
nurse to provide
interventions to help
the patient achieve
holistic comfort
ANNOTATED BIBLIOGRAPHY
Ellis, J. (2004). Nursing in Today’s World: Trends, Issues, &
Management. Philadelphia , PA: Lippincott Williams & Wilkins.
In this book, Ellis attempts to capture the a summarized history
of nursing including its’ trends, issues, & management primarily
focusing on the mid 1900’s to now. Ellis’ book ranges from
understanding the healthcare environment to health care finance
and control to the political process and the nursing profession.
Nursing in Today’s World: Trends, Issues, & Management was
really helpful as she provided very in-depth details about the
nursing profession in a concise manner. I was very fond of the
information she provided about the 1990’s, about how the public
portrayed the image of nursing.
Kalisch, B J, & Kalisch, P A. (1983). Anatomy of the image of the nurse:
dissonant and ideal models. Truthaboutnursing, 3-23(G-Retrieved from
http://www.truthaboutnursing.org/images/kalisch/anatomy_of_the_
image_of_the_nurse_ocr.pdf doi: 6556020.
The book depicts the image of nursing perceived by Margaret Newman,
which was to make people well, and to prevent people from getting
sick, but Margaret felt that the role of a nurse was not simply to heal or
prevent sickness, but mainly to assist people in utilizing the power
within them. The book also expressed Newman’s belief, which was that
the task of nursing was not to try to change the pattern of another
person, but to recognize it, as information, that depicts the person as a
whole, and relates to it, as it unfolds.
Newman states that to practice her theory of health as expanding
consciousness, the nurse must understand their own patterns and
values. It is then the nurses responsibility to establish a relationship
with the client to help them identify meaningful patterns within their
lives. Education should revolve around pattern as a concept, substance,
process, and method. Through this, an individual's personal experience
will be the core of not just teaching and practice, but research as well.
Research is focused around assisting clients in pattern recognition. This
method allows the pattern of personal environment to reveal itself
without disturbing the unity of the pattern.
Kolcaba, K. (2003). Comfort theory and practice. New York, NY:
Springer Publishing Company.
In this nonfictional book written by Katharine Kolcaba, she explains her vision for holistic
healthcare and research on Comfort Theory and practice. The book provides a layout for
the application of Comfort in practice, education, research, and quality improvement. Dr.
Kolcaba explains how comfort incorporates emotional, spiritual, and physical aspects of
patient care. The Comfort Theory model offers nurses and other health care team
members a guideline for holistic assessment and a design for intervention, evaluation, and
for patient care planning.
The book Comfort Theory and Practice is a detailed idea of how to approach the element
of comfort in today’s healthcare environment. This book was well organized, provided
many illustrations to support this theory, yet gave the impression of redundancy. This book
was a helpful source for our presentation project.
Kolcaba, k. (2009, December 22). The Comfort line. Retrieved from
http://thecomfortline.com/
On this online website written by Katharine Kolcaba, she explains her vision for holistic
healthcare and research on Comfort Theory and practice. The website provides a layout
for the application of Comfort in practice, education, research, and quality improvement.
Dr. Kolcaba explains how comfort incorporates emotional, spiritual, and physical aspects of
patient care. The Comfort Theory model offers nurses and other health care team
members a guideline for holistic assessment and a design for intervention, evaluation, and
for patient care planning. This website is easily accessible and highly user friendly. The
website was a helpful source for our presentation project.
Newman, M. A. (2010). Health as expanding the consciousness.
Retrieved from http://healthasexpandingconsciousness.org
In her website, Margaret A. Newman attempts to make clear her
philosophy of health as expanding consciousness. In the various articles
displayed in the website, Newman gives readers a chance to delve into
her mind and explore the concepts behind her theory. She provides
background about her life, displays her core values about health as an
expanding consciousness, gives history about the predecessors who
helped influence her theory, posts up-to-date news articles about her
work, and provides information about the books she has written.
As an experienced nurse of 48 years, and an extensive life-long learner,
Newman was aware of the importance, dedication, and the various
aspects of the nursing profession. She clearly states her opinions in a
proficient manner, while providing readers with a wealth of knowledge
on the topic. Her website is organized with a congruent approach and is
likely to help any person interested in researching the topic.
Tomey , A.M., & Alligood, M.R. (Ed.).
(2002). Nursing theorists and their work. St. Louis,
Missouri: Mosby.
In Katharine Kolcaba’s theory section of the book illustrates her
own approach to providing care for her patients which involves
the physical, psycho spiritual, social and environmental needs. I
found that Kolcaba is simply taking comfort and breaking it
down
to a science, furthermore combining what previous nursing
theorist have already stated into her own words.
This section of the book highlights the significant events of the
life of Margaret A. Newman in chronological order which
include her education and work background and her
accomplishments. These events gave me a general image of
what her life involves and her devotion in nursing.