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Comfort of new mothers (Lima, Guedes, Silva, Freitas, & Fialho, 2016)

Manipulation of the mother's environment during the transitional period (labor) by eliminating pain factors by promoting relaxation measures

Interventions related to pain control, sleep deprivation, and promoting physical comfort through control of the environment

Comfort of hospital at home patients (Puchi, Paravic-Klijn & Salazar, 2018)

Access to resources needed to provide holistic care

Suitable and stable home environment

Adequate support system at home

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Comfort Theory: Nursing theory developed by Katharine Kolcaba

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Personal experience with death

Clinical experience with dementia patients.

Work from other theorists inspired her conceptualization of her comfort theory (Relief, Ease, Transcendence).

Framework for the basis of her theory was derived from Henry Murray's 1938 book "Explorations in Personality".

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Katharine Kolcaba, (1944-Present), PhD, RN, CNS

Specialized in Gerontology, End of Life and Long-Term Care Interventions, Comfort Studies, Instrument Development, Nursing Theory, Nursing Research.

Currently an associate professor of nursing at the University of Akron College of Nursing.

Published Comfort Theory and Practice: a Vision for Holistic Health Care and Research in 2003.

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Scope of Theory: Middle Range.
Purpose of Theory:  Development of a taxonomic structure to guide assessment, measurement, and evaluation of patient comfort.

Four Major Theoretical Concepts

Six Major Propositions

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All Answers Ltd. (November 2018). The Theory of Comfort by Katherine Kolcaba. Retrieved from https://nursinganswers.net/essays/the-theory-of-comfort-by-katherine-kolcaba-nursing-essay.php?vref=1

Apóstolo, J. L. A., & Kolcaba, K. (2009). The effects of guided imagery on comfort, depression, anxiety, and stress of psychiatric inpatients with depressive disorders. Archives of Psychiatric Nursing, 23(6), 403-411.

Kolcaba, K. (2003). Comfort Theory and Practice. New York: Springer Publishing Company.

Konietzny, C., & Anderson, B. (2017). Comfort Conversations in Complex Continuing Care: Assessing Patients’ and Families’ Palliative Care Needs. Perspectives: The Journal of the Gerontological Nursing Association, 39(4), 14–22.

Lima JVF, Guedes MVC, Silva LF, Freitas MC, Fialho AVM. Usefulness of the comfort theory in the clinical nursing care of new mothers: critical analysis. Rev Gaúcha Enferm. 2016 Dec;37(4):e65022. doi: http://dx.doi.org/10.1590/1983- 1447.2016.04.65022.

Nursing Theories. (2011). Comfort Theory. Retrieved from Current Nursing: http://currentnursing.com/nursing_theory/comfort_theory_Kathy_Kolcaba.html

Puchi, Carolina BN; Paravic-Klijn, Tatiana PhD; Salazar, Alide PhD The Comfort Theory as a Theoretical Framework Applied to a Clinical Case of Hospital at Home, Holistic Nursing Practice: September/October 2018 - Volume 32 - Issue 5 - p 228-239 doi: 10.1097/HNP.0000000000000275

Vendlinski, S., & Kolcaba, K. Y. (1997). Comfort care: A framework for hospice nursing. American Journal of Hospice and Palliative Medicine, 14(6), 271-276

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In today's nursing, Comfort Theory can be applied to:

Patients of all ages and cultures.

Patients' family and/or caretakers.

A wide variety of nursing settings.

Can be applied to palliative care, peri-anesthetic care, oncological care, cardiac care, and maternity.

Evidence of empirical testing:

Focus on dementia care most utilized in providing a broader approach in the delivery of care of dying patients (hospice care).

Conceptually, as health is more than the absence of disease, comfort or the lack of it may be more than the absence of discomfort or pain. Comfort relates to the broader concept of quality of life the main treatment goal for both palliative and dementia care approaches.

Discomfort Scale–Dementia Alzheimer Type.

Research support and Nursing Research

Kolcaba's theory has been tested empirically and has guided research which tested the effectiveness of comfort interventions.

Comfort Theory has also been adopted as a guiding model for services such as Acute Care for Elders and hospice nursing.

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Comfort care entails at least 3 types of comfort measures:

Technical comfort measures: interventions designed to maintain homeostasis and manage pain.

Coaching: Designed to relieve anxiety, provide reassurance and information, instill hope, listen and help plan realistically for recovery, integration, or death in a culturally sensitive way.

Comfort food for the soul: Comfort measure's that are unexpected but very welcomed because they encompass old-fashioned and basic nursing care.

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Born as Katharine Arnold on December 8th, 1944 in Cleveland, Ohio she obtained her diploma in nursing from St. Luke's Hospital School of Nursing in 1965. She graduated from the Frances Payne Bolton School of Nursing, Case Western Reserve University in 1987 and eventually obtained her Ph.D. in nursing and received a certificate of authority clinical nursing specialist in 1997. She published Comfort Theory and Practice: a Vision for Holistic Health Care and Research. Dr. Kolcapa continues to specialize in gerontology, end of life and Long term care interventions, comfort Studies, instrument development, nursing theory, and research.
About the Comfort Theory

Kolcaba conducted a concept analysis of comfort that examined literature from several disciplines including nursing, medicine, psychology, psychiatry, ergonomics, and English

First, three types of comfort (relief, ease, transcendence) and four contexts of holistic human experience in differing aspects of therapeutic contexts were introduced. (Kolcaba KY & Kolcaba RJ, 1991)

A taxonomic structure was developed to guide for assessment, measurement, and evaluation of patient comfort. (Kolcaba, 1991) A broader theory for comfort was introduced (Kolcaba KY,(1994). The theory has undergone refinement and tested for its applicability.

Concepts & Themes

Kolcaba described comfort as existing in 3 forms: relief, ease, and transcendence. Also, Kolcaba described 4 contexts in which patient comfort can occur: physical, psychospiritual, environmental, and sociocultural.

If specific comfort needs of a patient are met, for example, the relief of postoperative pain by administering prescribed analgesia, the individual experiences comfort in the relief sense.

If the patient is in a comfortable state of contentment, the person experiences comfort in the ease sense, for example, how one might feel after having issues that are causing anxiety addressed.

Lastly, transcendence is described as the state of comfort in which patients are able to rise above their challenges.

Major Definitions

Comfort: an immediate desirable outcome of nursing care, according to Comfort Theory

Intervening Variables: factors that are not likely to change and over which providers have little control (such as prognosis, financial situation, the extent of social support, etc).

Health Care Needs: factors that are identified by the patient/family in a particular practice setting.

Nursing: described as the process of assessing the patient's comfort needs, developing and implementing appropriate nursing interventions, and evaluating patient comfort following nursing interventions. Intentional assessment of comfort needs, the design of comfort measures to address those needs, and the reassessment of comfort levels after implementation. Assessment may be either objective, such as in the observation of wound healing, or subjective, such as by asking if the patient is comfortable.

Additional Information & References

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Katharine Kolcaba's Comfort Theory - PSYCH-MENTAL HEALTH NP

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Born as Katharine Arnold on December 8th, 1944 in Cleveland, Ohio she obtained her diploma in nursing from St. Luke's Hospital School of Nursing in 1965. She graduated from the Frances Payne Bolton School of Nursing, Case Western Reserve University in 1987 and eventually obtained her Ph.D.