By: Ashley Harris
“Nursing art is defined and a template is
presented for practicing one type of nursing art
called comfort care. Propositions for comfort care
are derived from a theory of comfort. Benefits are
listed for integrating comfort care into practice.
Testimony from a student who learned and
applied comfort care provides support for its
effectiveness as a learning tool. Comfort care is a
holistic, individualistic, creative, and efficient
model.” Katharine Kolcaba 3
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I chose Katharine Kolcaba as my nursing
theorist because it is a theory on comfort. I
work with individuals that have intellectual
disabilities and most are wheelchair bound. It
is my duty to make sure they are as
comfortable in all aspects of their life as
possible.
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Katharine Kolcaba is currently an associate
professor at University of Akron. 1
Specialized in Gerontology, End of Life and Long
Term Care Interventions, Comfort Studies,
Instrument Development, Nursing Theory,
Nursing Research 1
In 2003 she published Comfort Theory and
Practice: a Vision for Holistic Health Care and
Research 2
Her education is as follows: 2
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1965 Diploma, St. Luke's Hospital School of Nursing
1987 RN/MSN Case Western Reserve University
1997 PhD. Nursing Case Western Reserve University
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•The comfort theory is a nursing theory that
was first developed in the 1990s by Katharine
Kolcaba.1
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). 2
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Relief: The state of a patient who has a specific
need met 2
Ease: The state of calm and contentment 2
Transcendence: The state in which one rises
above one's problems or pain 2
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Part 1 states that nurses assess the holistic
(physical, psychospiritual, sociocultural, and
environmental) comfort needs of patients in all
settings. Furthermore, nurses implement a variety
of interventions to meet those needs and measure
or assess patients’ comfort levels before and after
those interventions. This part of comfort theory
also describes positive and negative intervening
patient variables over which the nurse has little
control, but that have considerable impact on the
success of comfort interventions. Examples of
these variables are the patient’s financial situation,
cognitive status, extent of social support, and
prognosis. 4
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Part 2 of Comfort Theory states that enhanced
comfort strengthens patients to consciously or
subconsciously engage in behaviours that move
them toward a state of well-being. These
behaviours are called health-seeking behaviours
and provide rationale for implementing comfort
interventions. For patients in the peri-anesthesia
setting, health-seeking behaviours might include
decreased blood loss, no complications, increased
healing, increased mobility, and the ability to take
oral fluids. Health-seeking behaviours are related
to what is called institutional integrity in Part 3 of
Comfort Theory. 4
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Part 3 of comfort theory states institutional
integrity is defined as the quality or state of
health care organizations in terms of being
complete, sound, upright, professional, and
ethical providers of health care. It is measured
by many indicators, including cost of care;
length of stay; staff turnover rate; and patient,
nurse, and staff satisfaction. 4
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Physical: Pertaining to bodily sensations. 2
Psychospriritual: Pertaining to internal
awareness of self, including esteem, concept,
sexuality, and meaning in one's life; one's
relationship to a higher order or being . 2
Environmental: Pertaining to the external
surroundings, conditions, and influences.
Sociocultural: Pertaining to interpersonal,
family, and social relationships. 2
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Health Care Needs are those identified by the
patient/family in a particular practice setting. 2
Comforting Interventions are nursing
interventions that are designed to address specific
comfort needs of recipients. This includes
physiological, social, financial, psychological,
spiritual, environmental, and physical
interventions. 2
Intervening Variables are interacting forces that
influence recipients' perceptions total comfort.
This includes factors such as past experiences, age,
attitude, emotional state, support system,
prognosis, and finances. 2
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Enhanced Comfort is an immediate desirable outcome
of nursing care, according to Comfort Theory. 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. 2
Health-Seeking Behaviors (HSBs): The concept of HSBs
was first introduced by Scholtfeldt (1975). The
relationships between comfort and health seeking
behaviors are entailed in the second part of Kolcaba's
comfort theory. 2
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Internal: healing, immune function, number of T cells, etc.
External: health related activities, functional outcomes
Peaceful Death
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Institutional Integrity is defined as the values,
financial stability, and wholeness of health care
organizations at local, regional, state, and
national levels. 2
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Best Practices are those protocols and procedures
developed by an institution for specific
patient/family applications (or types of patients)
after collecting evidence.
Best Policies are protocols and procedures developed
by an institution for overall use after collecting
evidence
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Nursing: the intentional assessment of comfort needs
of patients, families or communities; design of comfort
measures to address comfort needs, including reassessment of comfort level after implementation of
comfort measures, compared to a previous baseline. 2
Patient: an individual, family, or community in need of
health care, including primary, tertiary, or preventative
care. 2
Environment: aspects of patient/family/community
surroundings that affect comfort and can be
manipulated to enhance comfort. 2
Health: optimum function of a
patient/family/community facilitated by enhanced
comfort. 2
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Human beings have holistic responses to complex
stimuli. 2
Comfort is a desirable holistic outcome that is
germaine to the discipline of nursing. 2
Human beings strive to meet, or have met, their
basic comfort needs. 2
When comfort needs are met, patients are
strengthened. 2
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General Comfort 2
General Comfort (short version) 2
Comfort Behaviors Checklist 2
Comfort Daisies (For use with children) 2
Perianesthesia 2
Radiation Therapy 2
Urinary Incontinence 2
End of Life (Patient version) 2
End of Life (Family version) 2
Hospice 2
Healing Touch 2
Advance Directives 2
Nurses 2
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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). 1
•The theoretical structure of Kolcaba's comfort
theory has real potential to direct the work and
thinking of all healthcare providers within one
institution. 1
1.
2.
3.
4.
Comfort Theory. Retrieved from
http://currentnursing.com/nursing_theory/comf
ort_theory_Kathy_Kolcaba.html
Katharine Kolcaba: Middle range nursing theorist.
Retrieved from
https://sites.google.com/a/northgeorgia.edu/mi
ddle-range-nursing-theorist-presentation/home.
Kolcaba, K. (1995). The art of comfort care
[Electronic version]. Journal of Nursing Scholarship.
27(4), 287-289.
Katharine Kolcaba’s Theory of Comfort. Retrieved
from http://nursingtheoryreview.blogspot.com/
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I hope this presentation has been educating on
Katharine Kolcaba’s comfort theory.
It has been very educational for myself and I
hope that each and every one of you will be
able to take something away from this.