Family Members and Nursing Essay

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Katherine Kolcaba Comfort Theory

Comfort is an obvious objective in providing a level of quality of care in a nursing environment. Yet, at the same time, most concepts of "comfort" are based off subjective or heuristic accounts and not holistically explored. Katharine Kolcaba begin building her theory of comfort during graduate school and received her PhD in 1997; and since that time her theories have taken root among many researchers. Comfort has been defined for nursing as the satisfaction (actively, passively or co-operatively) of the basic human needs for relief, ease or transcendence among from health care situations that are stressful; nursing case is designed to meet or continue meeting needs that fall under the domain of the discipline (Kolcaba, 1994). Kolcaba used this definition to build a framework that could more systematically explore the role of comfort in patients as well as in nursing outcomes. This analysis will provide an overview of Kolcaba's theory, as well as some of the applications that have been studied using the theory of comfort.

Defining Comfort

When Kolcaba began to formulate her theories into what later became comfort theory, there was previous research that had been conducted that began to explore the concepts related to comfort. For example, Kolcaba (1992) had already diagrammed a two-dimensional map and defined the concept of comfort in nursing. Later, Kolcaba (1994) defined comfort for nursing as the satisfaction (actively, passively or co-operatively) of the basic human needs for relief, ease or transcendence among from health care situations that are stressful; nursing case is designed to meet or continue meeting needs that fall under the domain of the discipline (Kolcaba, 1994).

The basic assumptions of the theory of comfort are that (a) human beings have holistic responses to complex stimuli, (b) comfort is a desirable holistic outcome that is germane to the discipline of nursing, and (c) human beings strive to meet, or to have met, their basic comfort needs; these assumptions underpin the theory of comfort and are m concert with an intra-actional perspective m which the components of a whole person response are related and assessed comprehensively (Kolcaba, 1994). There are many different facets to an individual acquiring a level of "comfort" during periods of ill health and these factors must be viewed from a holistic manner. The role of nurses is to minimize patient stress by providing relief, ease, and transcendence in a range of different contexts that coalesce to provide comfort to an individual throughout the duration of their healthcare needs.

Similar to other theories, the health issues are only part of the equation and comfort theory could also consider factors such as social, environmental, and spiritual/psychological aspects of the patients' well-being from a broader context than just the physical or biological issues that are present (Moriber, 2009).

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The first dimension of the model is the relief, ease, and transcendence components. Relief occurs when a specific need is met. For example, if there is pain present in a patient, then they might gain a sense of relief when their pain is mitigated by either repairing the source of the pain, or by masking it pharmacologically. The next component, ease, can be thought of as achieving a sense of peace or serenity. An example of this might include a patient who has recently been told that they can expect a full recovery and this news puts their mind at "ease" or mitigates their stress related to being uncertain about their future. Transcendence is defined as the state in which ordinary powers are enhanced and the characteristic that differentiates transcendence from the other two states, relief and ease, is that the former designates the patient's potential for extraordinary performance as an end (Kolcaba, 1994).

The second dimension of the model deals with the context in which comfort might be provided for the patient. Different interpretations of the person's context might either include their physical position, or a broader awareness of their position in life relative to different factors such as psycho-spiritual issues, awareness of the self, self-esteem, etc. (Kolcaba, 1994). The next set of factors considers the social context and social issues such as family and support networks; it can also include financial support since it is largely a social construct. The final factor includes the basic environmental needs such as light, noise, temperature, and other such factors that exist in the immediate environment. This is typically what people most commonly when they think of comfort.

Research Uses of the Comfort Theory

Researchers have applied the comfort theory to many different specific applications in the world of nursing. One such application that seems to be a popular fit in the literature is applying the comfort theory to end of life care plans. With the rising popularity of nursing homes and long-term care arrangements for elderly patients, comfort theory has become largely enmeshed with various advance care planning (ACP) objectives. One study set out to understand exactly how pervasive comfort care planning is in this environment. First, to investigate the knowledge and attitudes of practicing nurses on comfort care for hospitalized patients, a survey was conducted in 311 registered nurses from a major teaching hospital….....

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