Kolcaba Comfort Theory

Kolcaba Comfort Theory

Introduction

The first article about the Theory of Comfort was published in 1994 by Kolcaba. In 2001, a subsequent article provided an expansion of the theory to include institutional outcomes (InO). In 2003, Kolcaba published a comprehensive book about the development, testing, and application of the theory. Comfort Theory has been tested and supported in several patient populations, including psychometric and experimental studies in small samples of women with early stage breast cancer going through radiation therapy (Kolcaba & Fox, 1999), persons with urinary frequency and incontinence (Dowd, Kolcaba, & Steiner, 2000), and persons near end of life (Novak, Kolcaba, Steiner, & Dowd, 2001). Other nurse researchers have utilized the theory in settings such as labor and delivery, peri- and intra-operative care, critical care, burn units, gynecological practice, nursing care of persons with mental or hearing disabilities, emergency air transport, and newborn nurseries. Perianesthesia nurses have developed clinical practice guidelines and advanced care competencies (Wilson & Kolcaba, 2004).

The Theory of Comfort is a mid-range theory for nursing practice and research. It is a mid-range theory because of the limited number of concepts and propositions, low level of abstraction, and ease of application to actual practice (Kolcaba, 2003). In order to use the theory, three steps are required: (a) understanding the technical definition of comfort and its origins, (b) understanding the relationships (propositions) between the general concepts entailed in the theory, and (c) relating the general concepts to specific pediatric problems/settings in order to enlighten practice and generate research questions.

Meanings of Comfort

Webster (1990) defined comfort in several ways: (a) to soothe in distress or sorrow; (b) relief from distress; (c) a person or thing that comforts; (d) a state of ease and quiet enjoyment, free from worry; (e) anything that makes life easy; and (f) the lessening of misery or grief by cheering, calming, or inspiring with hope. In these definitions, comfort can be a verb, noun, adjective, adverb, and it can be negative (absence of a recent discomfort), neutral (ease), or positive (inspiring hope). The origin of comfort is confortare, meaning to strengthen greatly (Kolcaba, 1992). This strengthening property associated with enhanced comfort is especially intriguing for nursing.

By the very diversity of these definitions, we see that comfort is a holistic, complex term. The term comfort also is used in a variety of forms such as comfortable, in comfort, comforting, and comforter. Comfort is also a process ("The nurse comforted me") and a product ("The child felt comforted"). And, the state of comfort is more than the absence of discomfort. Clearly, for standards of care and clinical practice guidelines, a technical definition of comfort is needed so that all practitioners and researchers are "on the same page."

Definition of Holistic Comfort for Nursing

Kolcaba (1994, 2001, 2003) has defined comfort as "the immediate state of being strengthened through having the human needs for relief, ease, and transcendence addressed in four contexts of experience (physical, psychospiritual, sociocultural, and environmental)" (2003, p. 251). The terms relief, ease, and transcendence are ...