Strengths
One of the main strengths one can identify in Kolcaba’s theory is its logical presentation. The original 1994 article contained the major concepts outlined in a grid at the top of which were the forms of comfort sought by the clients (Kolcaba, 1994). Since its inception, therefore, the theory was aiming at being understandable and applicable.
The author insists that the theory applies to a multitude of disciplines, with nursing as its major focus (Kolcaba, 1994). For that sake, she has provided a clear definition of nursing and the role of nurses in addressing the patients’ comfort needs. She unambiguously described what is expected from nurses at every stage of treatment within the framework of her theory. At that, the theory correctly states that the underlying purpose of medicine as an applied science is to willingly handle the clients’ comfort needs. From an ethical point, the assumptions of the theory are relevant.
Another and more evident advantage of the theory is its perfect applicability for clinical research. Clinical trials are facilitated by the fact that the Comfort theory operates with the clients’ responses to various stimuli alternating their physical, spiritual, socio-cultural, and environmental experiences. Such variables are observable and measurable, which means that the design and implementation of new interventions can be fully controlled and the generated data is used for future research.
Lastly, definitions – any definitions provided by any theory – have a tendency to change with time. The fact that Katharine Kolcaba is currently active and is capable of alternating and expanding her doctrine is yet another strong point to the Comfort theory.
Limitations
What one would expect from a nursing theory such as this is the notion of comfort intertwined with the basic notions of health. One of the main weaknesses of the Comfort theory, therefore, is that the conceptual framework is not entirely intact. That is to say, the concepts and definitions are rather poorly aligned. For instance, the definition of health that the author provides does not agree with other components of the theory. To take another example, the concept of “functioning” is nowhere to be seen in Kolcaba’s reasoning (Alligood & Tomey, 2013).
The notion of the patient provided by the theory is another instance to potentially cause misunderstanding. The author defines “patient” as the one to receive healthcare. Considering the major assumption of the theory (that people’s comfort is consistent with their physical, spiritual, socio-cultural, and environmental experiences), it seems that the patient is likely to seek medical help. From the definition provided by Kolcaba, however, it is unclear if a patient is going to participate in their care or not (Alligood & Tomey, 2013). Neither does the definition specify if the patient is going to interact with the surroundings, allotting them the role of a passive observer. That human beings are basing their experience primarily on what they perceive is not regarded by the theory.
A final weak point concerns the relationship between addressing the client’s comfort needs and promoting health-seeking on institutional levels. Kolcaba specifies that experiences leading to comfort motivate clients to seek medical help, which makes sense. The author, however, fails to provide a detailed account of how health-seeking behaviors can be promoted on insurance, workplace, and other levels. Thus, despite the author’s assurance of the wide applicability of the theory, it does not subsume any ways to use it outside of the nursing practice.
References
Alligood, M. R., & Tomey, A. M. (2013). Nursing Theorists and Their Work. (7th ed.). Maryland Heights, MO: Elsevier.
Kolcaba, K. Y. (1994). A theory of holistic comfort for nursing. Journal of Advanced Nursing, 19(6), 1178-1184.