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Katharine Kolcaba's Theory of Comfort

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Katharine Kolcaba's Theory of Comfort
Katharine Kolcaba's Theory of Comfort

Kelly Ferreira

Summer, 2004.

In the early part of the 20th century, comfort was the central goal of nursing and medicine. Comfort was the nurse's first consideration. A "good nurse" made patients comfortable. In the early 1900's, textbooks emphasized the role of a health care provider in assuring emotional and physical comfort and in adjusting the patient's environment. For example, in 1926, Harmer advocated that nursing care be concerned with providing an atmosphere of comfort.

In the 1980's, a modern inquiry of comfort began. Comfort activities were observed. Meanings of comfort were explored. Comfort was conceptualized as multidimensional (emotional, physical, spiritual). Nurses provided comfort through environmental interventions.
It was in this decade that Kolcaba began to develop a theory of comfort when she was a graduate student at Case Western Reserve in Cleveland, Ohio. She is currently a nursing professor at the University of Akron in Ohio.

Kolcaba's (1992) theory was based on the work of earlier nurse theorists, including Orlando (1961), Benner, Henderson, Nightingale, Watson (1979), and Henderson and Paterson. Other non-nursing influences on Kolcaba's work included Murray (1938). The theory was developed using induction (from practice and experience), deduction (through logic), and from retroaction concepts (concepts from other theories).

The basis of Kolcaba's theory is a taxonomic structure or grid that has 12 cells (Kolcaba, 1991; Kolcaba & Fisher, 1996). Three types of comfort are listed at the top of the grid and four contexts in which comfort occurs are listed down the side of the grid. The three types are relief, ease and transcendence. The four contexts are physical, psycho-spiritual, sociocultural and environmental.

Kolcaba does not believe that a focus on comfort is unique to nursing and she believes that her theory can be interdisciplinary. She



References: Dowd, T. (2002). "Theory of Comfort." In A.M. Tomey & M.P. Alligood (Eds., P. 434- 450). Nursing Theorists and their Works. St. Louis: Mosby. Dowd, T., Kolcaba, K., Steiner, R. (2000). Using cognitive strategies to enhance bladder control and comfort. Journal of Holistic Nursing Practice, 14(91-103). Kolcaba, K Kolcaba K. (1992). Holistic comfort: Operationalizing the construct as a nurse-sensitive outcome. Advances in Nursing Science, 15(1):1-10 Kolcaba K Kolcaba, K. (1995). The art of comfort care. Image, 27(4), 287-9. Kolcaba, K. (1997). The primary holisms in nursing. Journal of Advanced Nursing, 25, 290-6. Kolcaba, K Kolcaba, K. & Fisher, E. (1996). A holistic perspective on comfort care as an advance directive. Critical Care Nursing Quarterly, 18, 66-76. Kolcaba K., & Fox C., (1999). The effects of guided imagery on comfort of women with early stage breast cancer undergoing radiation therapy. Oncology Nursing Forum, 26(1): 67-71. Kaplow, R. (2000). Use of nursing resources and comfort of cancer patients with and without do-not-resuscitate orders in the intensive care unit. American Journal of Critical Care, 9(2), 87-95. Orlando, I. (1961). The dynamic nurse-patient relationship: Function, process and principles. New York: Putnam Press. Vendlinski, S. & Kolcaba, K. (1997). Comfort care: A framework for hospice nursing. American Journal of Hospice and Palliative Care, 14(6), 271-6. Watson, J

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