Transcript Comfort Theory: A Framework for Healthy

Comfort Theory 101
Katharine Kolcaba
The University of Akron
College of Nursing
What do we mean by comfort?
• Complex term
• Common use
• Technical definition
(Kolcaba, 1992)
• Strengthening
component (rationale
for comforting
interventions in both
populations)
Dictionary Definitions: Comfort (Webster)
• 1. To soothe in distress or sorrow.
• 2. Relief from distress (absence of previous
discomfort) (negative sense)
• 3. A person or thing that comforts
• 4. A state of ease and quiet enjoyment, free from
worry (neutral sense)
• 5. Anything that makes life easy
• 6. Suggests the lessening of misery or grief by
cheering, calming, or inspiring with hope (positive
sense)
• verb, noun, adjective, adverb
Relief
I need help because
I’m lonley.
Relief
Ease
I feel totally
peaceful.
Transcendence
I did it!
(with the
help of my
coach…)
Research Study: Comfort in LTC setting
(Hamilton, 1989)
• Research questions:
•
•
•
•
•
What is the residents’ definition of comfort?
What contributes to the residents’ comfort?
What detracts from the residents’ comfort?
How can residents become more comfortable?
(Qualitative study)
Five recurring themes:
Physical Comfort
homeostasis, pain relief,
symptom management
• 2001: Data from more
than 2.2 million
nursing home staff
who usually
underestimate true
pain burden of
residents.
• Woefully inadequate
pain management
among frail and old
population of
Americans.
• Positioning
– Returning to bed when
requested
– Better seating
arrangements
But physical comfort and positioning isn’t the
only important type of comfort
• There are three more comfort themes that
the participants in this study cited…
Comfort theme of self-esteem
(psychospiritual)
Comfort theme of approach and
attitudes of staff (sociocultural)
Comfort theme of
hospital life
(environment).
Definition of Holistic Comfort
Relief
Ease
Transcendence
Physical
PsychoSpiritual
SocioCultural
Environ
-mental
(Kolcaba, 2003)
Technical definition of Comfort (cont)
• The state of being strengthened when needs
for relief, ease, and transcendence are met
in four contexts of experience: physical,
psychospiritual, sociocultural, and
environmental
• Nice fit with nursing practice and research!
Comfort Theory (3 parts)
• Comforting interventions enhance patients’
comfort.
• Enhanced patient comfort is positively
related to engagement in HSBs
– Comfort is strengthening
• When patients (and families) engage in
HSBs, institutions have better outcomes
– Patient satisfaction, nurse retention, costs down
Practical Application
• Holistic assessment of patients’ comfort needs
– Use grid as a guide
• Holistic interventions to meet those needs.
– Use grid as a guide
• Relationship of comfort (holistic outcome) to
health seeking behaviors (HSBs)
– External HSBs: e.g. functional status, rehab progress
– Internal HSBs: e.g. healing, t-cell counts, etc.
– Peaceful death: perfect for hospice and palliative care
• Holistic instruments to determine outcomes
• Institutional outcomes: increased patient
satisfaction, decreased cost, decreased
readmissions, etc.
• Don’t forget about comfort of nurses!
• Kolcaba, K. (2003).
Comfort Theory and
Practice. Springer.
• Available at:
– www.uakron.edu/comfort
– www.SpringerPub.com
– www.Amazon.com