The Comfort Theory By Katharine Kolcaba “Comfort Theory proposes that, when patients and their families are more comfortable, they engage more fully in health-seeking behaviors that include internal behaviors, external behaviors, or a peaceful death.”

Introduction Patients desire and deserve comfort while healing from surgery, child birth, trauma or self-inflicted wounds. Comfort during rehabilitation can improve outcomes while a patient returns to former functional levels. We will discuss Katherine Kolcaba’s Comfort Theory and how it relates to evidence based practice, metaparadigm concepts and the contemporary healthcare environment.

Evidence-Based Practice As new comfort methods are created they can be tested by nursing researchers using evidence based practice. Successful methods can be taught by nurse educators. “Evidence-based practice must be welcomed as part of the general move to improve the quality and cost-effectiveness of health promotion interventions” (Green, 2000). Katharine Kolcaba believes “interdisciplinary health care is the future”(Kolcaba, 2003, pg.16). The comfort theory is designed to be used by all health care disciplines, not just nurses. If interdisciplinary health care is the future, then comfort care can be used by all disciplines. As evidence about the benefits of healing environments accumulates, healthcare organizations are starting to incorporate features into hospital design that reduce stress and promote healing.

Metaparadigm Concepts Person- the patient and their family with the physical, psychospiritual, sociocultural, and environmental need (Kolcaba, 2006, para 7). Health- acquiring relief, ease, and transcendence to obtain desired or optimum level of health. Environment- “exterior influences (physical room or home, policies, institutional, etc.) which can be manipulated to enhance comfort”. Nurse- to assess comfort needs to help the patient and family to achieve relief, ease, and transcendence. (Kolcaba, 2006, para 6).

The aspects of relief and ease in contemporary health care related to the metaparadigm concepts Person- Patients desire and deserve comfort while healing from surgery, child birth, trauma, or self-inflicted wounds. A dignified, pain free death is vital for a patient and families. Health- Comfort during rehabilitation can improve outcomes while a patient returns to former functional levels. Environment- Positive influences on patient comfort include: Private rooms, acuity- adaptable rooms, less noise, lounges/waiting rooms, and bringing nature to the environment via windows, indoor gardens, or aquariums. Environmental aides to improve comfort: safety bars or handrails on the walls, clocks, calendars, and elder- friendly furniture in the rooms, and more! Nurse- Successful comfort measures can be taught to other nurses or health care providers. Patients who have achieved desired level of comfort achieve their health care goals faster, which in turn reduces healthcare cost (Kolcaba, 2003, pg. 16).

Contemporary Healthcare Environment Local: The comfort theory provides nursing interventions that are designed to address the comfort needs of patients that will have a positive impact on healing, immunity and functional outcomes. Improved health-seeking behaviors can result with social relationships that become healthy communities. This leads to best practice and best policies and protocols developed by nursing committees after collecting evidence from use of comfort care. Regional: The goal of the nurse is to help the patient find comfort in their time of illness. Facilities are awarded accreditations by agencies that get high ratings by their patients. If the patients achieve desired level of comfort then they are more satisfied. Global: “Comfort care can unify health care practice because it is oriented to the one thing those disciplines have in common: patients”(Kolcaba, 2003,pg. 16). Comfort care does not have restrictions based on location. Comfort theory can be applied while still respecting cultural norms.

Green, J. (2000). The role of theory in evidence- based health promotion practice. Health Education Research, 15(2), 125-129. dio:10.1093/her/15.2.125 Kolcaba, K. (2003). Comfort Theory and Practice: A Vision for Holistic Health Care and Research. New York, NY. Springer Publishing Company. Retrieved from: http://books.google.com Kolcaba, K. (2010). Frequently Asked Questions: Theoretical Developments. Retrieved from http://www.thecomfortline.com/home/faq.html Kolcaba, K., Tilton, C., & Drouin, C. (2006). Comfort Theory: A unifying framework to enhance the practice environment. JONA Journal of Nursing Administration. 36, 538-544. Retrieved from: http://0-ovidsp.tx.ovid.com.libcat.ferris.edu/ Rau, J. (2011). Medicare to begin basing hospital payments on patient satisfaction scores. Retrieved from http://www.kaiserhealthnews.org/stories/2011/april28/medicare Medicare.gov. (2014). Linking quality to payment. Retrieved from http://www.medicare.gov/hospitalcompare/Data/hospital-vbp.html References