Introduction
The theorist Katharine Kolcaba drew attention to patients’ need for comfort, contributing to the emergence of the middle-range Comfort Theory. This paper examines the development of this theory, its key concepts, testing, evaluation, and practical applications. The reason for choosing the Comfort Theory is its wide range of applications in various healthcare settings. Although the theorist initially faced only the task of conceptual analysis, her work ultimately led to the creation of a theory that significantly benefits the practice.
Theorizing
The concept of comfort has always been influential in the nursing discipline. In the past, Florence Nightingale emphasized the importance of patients’ comfort and its role in their overall health (Kolcaba & Crawford, 2020). Moreover, in the 20th century, the ability to provide comfort in care was a testament to nurses’ skill and was one of the critical goals. Although physical comfort initially received more attention, its provision also referred to the psychological aspect – comforting patients. With the development of medicine, family comfort and its correlation with the patient’s comfort have also acquired particular importance.
I, Katharine Kolcaba, have always been passionate about nursing and combined my work with care for my children, which led me to pursue graduate school in my late 30s. My life and career were influenced by my family and upbringing, as well as the death of loved ones – my father and brother (“Frequently asked questions,” n.d.). I believe nursing primarily provides comfort for patients and their families, and secondly, it offers comfort to nurses. However, nursing is not an easy job and cannot be done without empathy, leadership, and compassion.
Initially, I used the concept of comfort when creating a diagram of my practice in the Master of Science in Nursing (MSN) program (“Frequently asked questions,” n.d.). Using this concept, I sought to identify the desired condition for individuals with Alzheimer’s disease. However, at the presentation, I received a question about the conceptual analysis of comfort and understood its need (“Frequently asked questions,” n.d.). Concept’s research and analysis laid the groundwork for the development of the Comfort Theory.
My theory puts patient comfort at the head of care, and medical interventions should support it. Comfort reduces negative tension, contributes to positive cooperation between providers and patients, and promotes health-seeking behavior. When patients receive care that supports their comfort, they are more satisfied with the services, and health outcomes improve. As a result, efforts to provide comfort should guide health care services and interventions.
Syntax
When the need for a conceptual comfort analysis arose, I began researching by consulting dictionaries. I compared the concepts presented in various disciplines; for example, ergonomics suggests that comfort is necessary for better functioning, while in nursing, it is mainly associated with pain (Kolcaba & Crawford, 2020).
Using the ideas discovered, I expanded their features for use in patient treatment. As a result, I also brought out three types of comfort: ease, relief, and transcendence. I realized its provision was necessary considering various dimensions, initially introducing physical and mental, which, after studying literature, expanded into physical, environmental, psychospiritual, and social.
The fundamental concept of my theory, without a doubt, is comfort. It also includes comfort care, health-seeking behavior, comfort needs, intervening variables, comfort measures, and institutional integrity (McEwen & Wills, 2023). Comfort is defined as providing critical patient needs for ease, transcendence, and relief, and as the desired outcome of care. It promotes health-seeking behavior, which aims to address health problems. This behavior, in turn, also enhances patients’ comfort and improves their well-being. The Comfort Theory and its propositions prove their applicability and benefit to the practice.
Theory Testing
Testing the theory is essential to its application since it is necessary to prove its effectiveness. The theory’s propositions can serve as the basis for research, practice, training, and other aspects of nursing. Moreover, several tools have been developed within the framework of the theory of comfort that researchers can utilize, such as questionnaires and the General Comfort Questionnaire (GCQ). As a result, several studies have been conducted to test the Comfort Theory.
One possible direction for applying the Theory of Comfort is to educate patients about potential comfort issues they may encounter during illness or treatment and to teach them how to adapt to achieve maximum comfort. Vicdan (2020) applies the considered theory to creating manuals to educate hemodialysis patients. Following the quantitative design, the researcher tested the application of the approach to people’s training.
The educational materials cover four comfort contexts defined in theory: sociocultural, environmental, psychospiritual, and physical. As part of the study, the author applied GCQ and identified statistically significant differences in the comfort level before and after training, with higher rates in the trained group (Vicdan, 2020). As a result, the study demonstrates the applicability of Comfort Theory in meeting patients’ comfort needs through education.
Comfort Theory can also help answer questions in the nursing discipline by facilitating data analysis. Following the qualitative research design, Oliveira et al. (2020) conducted several interviews among older patients to determine their needs during hospitalization. Kolcaba’s theory has benefited from the systematization and analysis of data. After studying the interview texts and their coding, the authors identified the essential needs of patients within the four contexts highlighted in the Theory of Comfort (Oliveira et al., 2020). The theory has proven to apply to the systematization and analysis of data for subsequent judgment and decision-making.
Evaluation
Nursing specialists should consider the value of a theory for their practice before applying it to their work. Using questions from the synthesized evaluation method proposed in McEwen and Wills (2023), one can assume the value of the Comfort Theory. In particular, there is an affirmative answer to the question of the social relevance of the theory since it seeks to improve people’s conditions and satisfy their needs during vulnerable situations.
Another question concerns whether theory contributes to the discipline of nursing (McEwen & Wills, 2023). The Comfort Theory offers an approach that helps improve patients’ conditions and change their behavior, inducing trust and significantly contributing to discipline. Finally, another question that testifies to the theory’s value is the evidence of its use by administrators, researchers, and educators (McEwen & Wills, 2023). This paper presents several studies that successfully apply the Theory of Comfort, proving its value.
Numerous studies have demonstrated the effectiveness of Kolcaba’s theory in various practice settings. For example, Puchi et al. (2018) employed this approach in the care plan for older adults in a domiciliary context, thereby contributing to more holistic and person-centered care, as well as increased family involvement. In research by Rustam et al. (2021), applying the theory helped increase the comfort level of Muslim patients by integrating religious rituals. In a study by Can and Hintistan (2021), the approach helped recognize better comfort needs among chemotherapy patients. Thus, the theory under consideration enhances the condition of patients in different contexts.
Conclusion
Thus, the Comfort Theory, developed by Katharine Kolcaba, suggests that patients’ comfort enhances their well-being. A theorist created the theory in response to the need to define comfort as the desired condition for patients. The approach is applicable in various circumstances and contributes to better health outcomes. Many studies have tested the theory and tools developed within its framework, proving the effectiveness and benefits for nursing practice.
References
Can, A., & Hintistan, S. (2021). An assessment of the comfort level of cancer patients with receiving chemotheraphy. Bezmialem Science, 9(3), 310-316. Web.
Frequently asked questions on theoretical comfort. (n.d.). Comfort Line. Web.
Kolcaba, K. & Crawford, C. L. (2020). Comfort. In S. J. Peterson & T. S. Bredow (Eds.). Middle range theories: Application to nursing research and practice (5th ed., pp. 189-209). Wolters Kluwer.
McEwen, M., & Wills, W. (2023). Theoretical basis for nursing (6th ed.). Wolters Kluwer Health.
Oliveira, S. M. D., Costa, K. N. D. F. M., Santos, K. F. O. D., Oliveira, J. D. S., Pereira, M. A., & Fernandes, M. D. G. M. (2020). Comfort needs as perceived by hospitalized elders: An analysis under the light of Kolcaba’s theory. Revista Brasileira de Enfermagem, 73, 1-8. Web.
Puchi, C., Paravic-Klijn, T., & Salazar, A. (2018). The comfort theory as a theoretical framework applied to a clinical case of hospital at home. Holistic Nursing Practice, 32(5), 228-239. Web.
Rustam, J. S., Kongsuwan, W., & Kitrungrote, L. (2021). Effects of nursing comfort care integrating with the daily Islamic rituals on comfort among mechanically ventilated Muslim patients: A randomized clinical trial. Nursing Practice Today, 8(4), 322-332. Web.
Vicdan, K. A. (2020). The effect of training given to hemodialysis patients according to the Comfort Theory. Clinical Nurse Specialist CNS, 34(1), 30–37. Web.