Katharine Kolcaba Theory of Comfort Major Concepts and Definitions: Health care needs: Needs for comfort, arising

from stressful health care situations that cannot be met by recipients traditional support system. In these needs she includes: -Physical -Social -psychospiritual -environmental -education and support -financial counseling Comfort Measures: nursing interventions designed to address specific comfort needs of recipients Intervening Variables: interacting forces that influence recipients perception of total comfort. Variables which are included: -age -past experiences -attitude -emotional state -support system -prognosis -finances Comfort: the state that is experienced by recipients of comfort measures. The three needs being met include relief, ease, and transcendence. These needs should be met physically, psychospiritually, socially, and environmentally. Major Assumptions: 1. 2. 3. 4. 5. Human beings have holistic responses to complex stimuli. Comfort is a desirable holistic outcome that is germane to the discipline of nursing Human beings strive to meet their basic comfort needs or to have them met. Enhanced comfort strengthens patients to engage in health-seeking behaviors of their choice. Patients who are empowered to actively engage in health seeking behaviors are satisfied with their health care. 6. Institutional integrity is based on a value system oriented to the recipients of care.

Theoretical Assertions: 1. Nurses identify unmet comfort needs of their patients, design comfort measures to address those needs, and seek to enhance their patients comfort which is the immediate desired outcome. 2. Enhanced comfort is directly and positively related to engagement in health seeking behaviors, which is the desired outcome. 3. When persons have the proper support to engage fully in health seeking behaviors, institution integrity is enhanced. Three types of comfort interventions: 1. Technical comfort which is interventions managing pain and maintaining homeostasis such as pain medication, monitoring vital signs, and monitoring CBC. 2. Coaching interventions which include interventions designed to relieve anxiety, provide reassurance, instill hope, listen, and realistically plan for recovery. 3. Comfort food which refers to such interventions that make a patient feel strengthened and intangible. These interventions may include massages, music therapy, guided imagery, and hand holding. Critiques 1. Clarity-many articles are difficult to read although they are consistent in terms of definition, assumptions and propositions. All research concepts are defined theoretically and operationally. 2. Simplicity- The theory is simple and goes back to basic nursing care, there are few variables. Its simplicity allows nurses and students to practice the theory. 3. Generality- This theory has been applied to research settings, cultures, and age groups. A limiting factor however is how much commitment nurses are willing to make in meeting comfort needs of their patients.