1. Katharine Kolcaba The University of Akron College of Nursing
Comfort Theory 101
Katharine Kolcaba
The University of Akron
College of Nursing

2. What do we mean by comfort?
Complex term
Common use
Technical definition (Kolcaba, 1992)
Strengthening component (rationale for comforting interventions in both populations)

3. 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

4. Relief
Relief
I need help because I’m lonley.

5. Ease
I feel totally peaceful.

6. Transcendence
I did it! (with the help of my coach…)

7. 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)

8. Five recurring themes:
Physical Comfort
homeostasis, pain relief,
symptom management

9. 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.

10. Positioning Returning to bed when requested
Better seating arrangements

11. 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…

12. Comfort theme of self-esteem (psychospiritual)

13. Comfort theme of approach and attitudes of staff (sociocultural)

14. Comfort theme of hospital life (environment).

15. Definition of Holistic Comfort
Relief
Ease
Transcendence
Physical
Psycho- Spiritual
Socio-Cultural
Physical: preemptive temperature and pain control (heated IV fluids, gas, analgesia pre-operatively), pain neutralized, correct positioning,
Psychospiritual: reassurance, motivation
Social/Cultural: advocacy, information, sensitivity
Environmental: warmth, pillows for body support
Environ-mental
(Kolcaba, 2003)

16. 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!
Throughout lit review, I was struck by the emphasis on holistic care – all the elements of human nature being addressed

17. 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

18. Practical Application
Holistic assessment of patients’ comfort needs
Use grid as a guide
Holistic interventions to meet those needs.
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

19. Institutional outcomes: increased patient satisfaction, decreased cost, decreased readmissions, etc.
Don’t forget about comfort of nurses!

20. Kolcaba, K. (2003). Comfort Theory and Practice. Springer.
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