KATHARINE KOLCABA’S COMFORT THEORY

KATHARINE KOLCABA’S COMFORT THEORY

KATHARINE KOLCABA’S COMFORT THEORY

Abstract

The paper gives a systematic assessment of the Katharine Kolcaba’s Comfort theory. The basis of the paper is to understand the theorist, and discuss the main concepts related to it. Above all the aim is to identify the theory’s application to clinical situations in institutional settings and its contribution to nursing research and practice. An overview, and the Comfort theory’s propositions, along with its conceptual definitions will be analyzed and studied. Along with certain research articles, Kolcaba’s Comfort theory’s applications, particularly, technical, coaching and comfort food for the soul will be explored. In addition, this paper provides examples where Nurse Practitioners can use Comfort Theory as a framework to provide holistic care to their patients. It is also noticeable that Katharine Kolcaba’s Comfort theory has been used in several institutions by the administration to develop policies and practices, with the interest of improving patient satisfaction and experience during their encounter within the organization.

Introduction

Born and educated in Cleveland, Ohio, Katharine Kolcaba, practiced as a nurse on several nursing units for many years. After completing her masters in nursing, and while working on the dementia unit as head nurse, Kolcaba started theorizing about comfort. During her doctoral studies, Kolcaba further developed her comfort theory study and later published a framework for dementia care. Later she added the operationalized comfort as an outcome of care and contextualized comfort in a middle range theory. Subsequently, Kolcaba tested her theory in varied intervention studies, and based on that she polished her theory to include hospital-based outcomes. Katharine Kolcaba has several and extensive publications where she has documented the process of her theory. She also has published a book Comfort Theory and Practice, where she has assembled her series of publications. Kolcaba currently works as a consultant of her own company, The Comfort Line, which advices health-care agencies in application of her Comfort Theory framework if they choose to apply it within their institutions (Smith & Parker, 2015).

Overview of the Comfort Theory

Comfort, according to Kolcaba, is an outcome of an intentional, patient/family based and focused quality care (Smith & Parker, 2015). Based on holistic care, Kolcaba developed four contexts in which patients can experience comfort, i.e. physical, psychospiritual, sociocultural and environmental. The three distinct types of comfort that Kolcaba focused were-Relief, Ease, and Transcendence. Relief is a feeling where a specific need that provides comfort is given. Ease is the state of being calm and content. Whereas transcendence relates to a state where patients can rise above their difficulties irrespective of life’s circumstances with the help of caregiver intervention. All the four contexts and the three types of comfort are interrelated and have to be viewed holistically to get favorable outcomes. Health needs are those that the patients cannot meet on their own which sprout from varied stressful conditions. Comfort interventions are all the steps considered to tackle the specific health needs.

 

The practical application of Kolcaba’s Comfort Theory was studied in cardiac patients in two case studies (Krinsky, Murillo, & Johnson, 2014). The comfort needs of cardiac patients were defined based on the four domains of Kolcaba’s Comfort theory and the interventions were outlined accordingly centered on the three comfort types. Quiet time intervention which was introduced to these cardiac patients aligned with the Comfort Theory taxonomy framework. Interventions based on physical, psychospiritual, environmental and socio-cultural domains were implemented in the case studies. Improved outcomes were noted in cardiac patients in terms of ease of pain, enhanced sleep, reduced agitation and anxiety, and enriched emotional support through family involvement.

Another study that was conducted at two dialysis centers to determine the relationships between comfort and fluid retention was based on Kolcaba’s Comfort Theory framework (Estridge, Morris, Kolcaba, & Winkleman, 2018). The study found out some interesting facts based on the theory of comfort. The study turned out to be clinically important as patients who pursued comfort interventions showed a greater trend of engaging in healthy behavior. Another fact pointed out was the different comfort needs based on race, religion, gender and lifestyle varied accordingly. In the study the nurses had to investigate distinctive characteristics and comfort needs to plan nursing care based on the comfort theory framework.