Nursing Care: Comfort Theory by Katharine Kolcaba

Introduction of the Nursing Theorist

  • the place of birth is Cleaveland, Ohio
  • the degree is a nursing diploma and graduate diploma
  • currently is Associate Professor of nursing
  • received many awards for her work as a nurse
  • contributed to nursing theory developing comfort theory

Katharine Kolcaba was born in 1944 in Cleveland, Ohio (Katharina Kolcaba-nursing theorist, n.d.). She received a nursing diploma from the School of Nursing in St. Luke’s Hospital. She is currently working as an Associate Professor of Nursing at the University of Akron. Kolcaba received numerous awards, among which is Cushin Robb Prize for outstanding work. In the 1990’s she developed a comfort theory designed for education, research, and nursing practice.

Classification of the Theory

  • the middle-range theory is an intermediate theory
  • links empirical and theoretical knowledge
  • defined as the ideas focused on the phenomenon
  • includes three types: explanatory, descriptive, and predictive
  • development is limited worldwide and nationally

A comfort theory is a middle-range theory, which is defined as an intermediate theory. It occurs due to the researchers’ need for creating a hypothesis that can explain all notions of organization, behavior, and social changes. It links empirical and theoretical knowledge and is also related to a set of ideas that describe specific aspects of the phenomenon. The theory has three types: explanatory, descriptive, and predictive. Despite its usefulness, the development of middle-range theory is limited.

Understanding the Outcomes of Comfort

  • three assumptions related to comfort
  • people give holistic responses to compound stimuli
  • comfort is a desirable outcome in nursing
  • people tend to meet their comfort needs
  • outcomes require an intra-actional approach

There are two basic assumptions of comfort theory. The first one implies that people give holistic responses to compound stimuli (Kolkaba, 1994). For example, people generally feel positive if they receive muscle relaxation. The second and third assumptions are that people give holistic responses to compound stimuli, and comfort is desirable in nursing. To understand the outcomes of comfort, researchers’ outcomes require an intra-actional approach because the interventions enhancing one aspect also enhance another.

Concepts of Comfort Theory

  • descriptive and normative theory for nursing practice
  • implies the existence of negative and positive tension
  • targets interventions to move tension to a positive direction
  • nurses judge whether the comfort needs were met
  • nurses are responsible for facilitating comfort outcomes

The comfort theory is a descriptive and normative theory for nursing practice that explains the needs that result in negative tension and occur from the stimulus situations (Kolkaba, 1994). Negative tension is an imbalance in facilitating and obstructing forces. The theory implies interventions move tension in a positive direction, after which nurses judge whether the comfort needs were met so that they are responsible for facilitating comfort outcomes.

Components of Comfort Theory

  • three parts are relief, ease, and transcendence
  • first requires recognition of specific discomfort
  • second is a positive state of contentment and calm
  • third is an ability to overcome circumstances
  • can exist independently or together

The comfort theory includes three components: relief, ease, and transcendence (Marchuk, 2016). Relief requires recognition of specific discomfort. Treating headaches in patients is an example of relief. Ease is a positive state of contentment and calm. When people are at ease, they are at peace. Transcendence is the ability to overcome circumstances. Working through grief is an example of transcendence. These components can exist independently or together, depending on personal circumstances.

Application of Comfort Theory

  • in end-of-life care in the intensive care unit for neonates
  • implies consideration of neonates’ and families’ comfort needs
  • involves the concept of every neonate uniqueness
  • provides a clear structure of nursing care
  • involves the development of a strong neonate-nurse-family relationship

The comfort theory is used in end-of-life care in intensive care units for neonates, where nurses consider the comfort needs of neonates and families (Marchuk, 2016). The theory states that every newborn is unique, and it provides a clear structure of nursing care. This means that it allows for organizational work that aims not only to treat patients but also to make them feel comfortable. The theory implies the development of a string neonate-nurse-family relationship to fulfill their comfort needs.

Application of Comfort Theory

  • in training given to patients with hemodialysis
  • has shown that training increased patient’s comfort
  • implies giving training that fulfills the patient’s comfort needs
  • implies giving training that affects a patient’s well-being
  • implies increased scores of relief, ease, and transcendence

The comfort theory can be applied in training given to patients with hemodialysis (Vicdan, 2020). The results of the study have shown that training increased patients’ comfort, fulfilling their comfort needs. Training that is conducted according to the comfort theory affects a patient’s well-being by easing diet and weight control. It also implies increased scores of relief, ease, and transcendence.

Application of Comfort Theory

  • in pediatric primary palliative care
  • implies meeting children’s comfort needs
  • comfort interventions are aimed at comfort components
  • implies analyzing demographics: age, gender, diagnosis
  • implies meeting psychospiritual, physical, and environmental comfort needs

The comfort theory can be applied in pediatric primary palliative care. It implies meeting the comfort needs of children with serious illnesses (Lafond et al., 2019). Comfort interventions are aimed at comfort components. The theory also aims to analyze demographic components such as age, gender, and diagnosis and implies meeting psychospiritual, physical, and environmental comfort needs.

Implications for Nursing Research

  • has a great explanatory power than other theories
  • has a high degree of testability and is predictable
  • useful for clinical practice
  • allows for drawing multiple relationships between single concept
  • utilizes terms relevant to nursing practice

The comfort theory can advance nursing practice because it has greater explanatory power than other theories so that it can explain different diseases (Kolcaba, 1994). It has a high degree of testability and is easily predictable, which can be useful in generating hypotheses. It is useful for clinical practice, as can be observed in the therapeutic context. The theory allows for drawing multiple relationships between single concepts and utilizes terms relevant to nursing practice.

Conclusion

  • comfort theory is a basis of nursing practice
  • comfort theory is a middle-range theory
  • comfort theory has three components: relief, ease, transcendence
  • comfort theory can be applied in multiple conditions
  • comfort theory is of higher importance for nursing practice

Comfort theory, designed by Katharine Kolcaba, guides nursing care. It is classified as a middle-range theory, which links empirical and theoretical knowledge. The theory has three components: relief, ease, transcendence. It can be applied in multiple conditions such as training for hemodialysis patients, neonates care, and care after children with serious illnesses. The comfort theory is of higher importance for nursing practice because it has great explanatory power, a high degree of testability, and is relevant to the nursing field.

References

Vicdan, K. A. (2020). The effect of training given to hemodialysis patients according to the comfort theory. Clinical Nurse Specialist, 34(1), 30–37.

Katharine Kolcaba – nursing theorist. (n.d.). 2020. Web.

Kolcaba, Y. K. (1994). A theory of holistic approach for nursing. Journal of Advanced Nursing, 19, 1178-1184.

Lafond, D. A., Bowling, S., Fortkiewicz, J. M., Reggio, C., & Hinds, P. S. (2019). Integrating the comfort theory™ into pediatric primary palliative care to improve access to care. Journal of Hospice & Palliative Nursing, 21(5), 382–389.

Marchuk, A. (2016). End-of-life care in the neonatal intensive care unit: Applying comfort theory. International Journal of Palliative Nursing, 22(7), 321-323.

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