Katharine Kolcaba's Comfort Theory

Comfort Care Theory
Nightingale described comfort as first duty of nurses. Since then comfort theory is flourishing in nursing and medical field. The first article on comfort theory was published in 1994 (Oliveira, 2013). Katharine Kolcaba first published her book on comfort care in 2003. This theory has been published and accepted at many health care authorities (Kolcaba & Dimarco, 2005). Kolcaba defined comfort as “the immediate state of being strengthen through having the human needs for relief, ease, and transcendence addressed in four contexts of experience ( physical, psychospiritual, sociocultural, and environmental)” (Kolcaba K. , 2003, p. 251). Kolcaba and Dimarco explained relief as “state of having a discomfort mitigated or alleviated”, ease as “absence of specific discomfort”, and transcendence as
“ability to rise above”. Relief, ease, and transcendence cover all four areas in physical, psychospiritual, sociocultural, and environmental comfort. When these three areas are connected with 4 different contexts, a 12 cell grid called taxonomic structure was created.
It is created upon patient’s specific needs. In “Comfort Theory and its Application to Pediatric” article Kolcaba and Dimarco gives an example of child who have had spinal cord surgery. This child had sociocultural issues which can be resolved by bringing family at bed side and answering questions that 12 year old has regarding her looks after surgery (Kolcaba & Dimarco, 2005). Nurses are primary links to normalise environment in children after a fearful or painful experiences (Kolcaba & Dimarco, 2005). In addition, according to the comfort theory nurses are mentors and advocates on pediatric wards who alleviate pain and worries of parents and ensure safety of sick child (Kolcaba & Dimarco, 2005). There are three types of comfort interventions: standard comfort to keep pain free, coaching comfort to inform or explain procedure, comfort food for the soul method to acknowledge child and caregivers (Kolcaba & Dimarco, 2005). Nurses must recognise meaning of comfort to apply this to their practice (Oliveira, 2013). Comfort theory include critical and effective measures as well as awareness of “stepping in” and “stepping out” of situation as
needed (Oliveira, 2013). Stepping in means intervention to problematic situation, whereas, stepping back is a process when health care provider withdraw intervention or treatment when no longer required (Oliveira, 2013). Stepping back is also considered a positive reaction according to the situation of patient. Stepping in is taken as holistic approach to make patient comfortable (Oliveira, 2013). A nurse must organize her care according patient’s comfort in physical comfort needs like pain relief, sociocultural needs e.g. a teen worried about her looks after surgery, environmental comfort e.g. having parents at bed side for sick children. Oliveira explained, in her article “Comfort Measures: A Concept Analysis”, that comfort theory revolves around holistic care. She further claims that currently our health care focus on physical care (Oliveira, 2013). She urges that health care literature needs to be reviewed time to time on comfort care (Oliveira, 2013).