Presentation on theme: "Katharine Kolcaba The University of Akron College of Nursing"— Presentation transcript:
1 Katharine Kolcaba The University of Akron College of Nursing Comfort Theory 101Katharine KolcabaThe University of AkronCollege of Nursing
2 What do we mean by comfort? Complex termCommon useTechnical 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 comforts4. A state of ease and quiet enjoyment, free from worry (neutral sense)5. Anything that makes life easy6. Suggests the lessening of misery or grief by cheering, calming, or inspiring with hope (positive sense)verb, noun, adjective, adverb
6 TranscendenceI 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 Comforthomeostasis, 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…
15 Definition of Holistic Comfort ReliefEaseTranscendencePhysicalPsycho- SpiritualSocio-CulturalPhysical: preemptive temperature and pain control (heated IV fluids, gas, analgesia pre-operatively), pain neutralized, correct positioning,Psychospiritual: reassurance, motivationSocial/Cultural: advocacy, information, sensitivityEnvironmental: warmth, pillows for body supportEnviron-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 environmentalNice 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 HSBsComfort is strengtheningWhen patients (and families) engage in HSBs, institutions have better outcomesPatient satisfaction, nurse retention, costs down
18 Practical Application Holistic assessment of patients’ comfort needsUse grid as a guideHolistic interventions to meet those needs.Relationship of comfort (holistic outcome) to health seeking behaviors (HSBs)External HSBs: e.g. functional status, rehab progressInternal HSBs: e.g. healing, t-cell counts, etc.Peaceful death: perfect for hospice and palliative careHolistic 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. Available at: