Comfort Theory 101

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Comfort Theory 101

• Katharine Kolcaba
• The University of Akron
• College of Nursing

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What do we mean by comfort?

• Complex term
• Common use
• Technical definition (Kolcaba, 1992)
• Strengthening component (rationale for comforting
  interventions in both populations)

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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

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Relief
Relief
I need help because Im lonley.
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Ease
I feel totally peaceful.
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Transcendence
I did it! (with the help of my coach)
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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)

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Five recurring themes
Physical Comfort homeostasis, pain relief,
symptom management

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• 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.

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• Positioning
• Returning to bed when requested
• Better seating arrangements

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But physical comfort and positioning isnt the
only important type of comfort

• There are three more comfort themes that the
  participants in this study cited

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Comfort theme of self-esteem (psychospiritual)
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Comfort theme of approach and attitudes of staff
(sociocultural)
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• Comfort theme of hospital life (environment).

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Definition of Holistic Comfort
Relief
Ease
Transcendence
Physical
Psycho- Spiritual
Socio-Cultural
Environ-mental
(Kolcaba, 2003)
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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!

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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

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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

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• Institutional outcomes increased patient
  satisfaction, decreased cost, decreased
  readmissions, etc.
• Dont forget about comfort of nurses!

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• Kolcaba, K. (2003). Comfort Theory and Practice.
  Springer.
• Available at
• www.uakron.edu/comfort
• www.SpringerPub.com
• www.Amazon.com