This document provides background information on Katharine Kolcaba's Comfort Theory. It begins by outlining Kolcaba's credentials and theoretical influences. It then discusses key concepts in Comfort Theory, including the types of comfort (relief, ease, transcendence), contexts of human experience (physical, psychospiritual, environmental, social), and the taxonomic structure of comfort. The document also presents Kolcaba's conceptual framework and discusses how comfort theory has been empirically tested and measured using comfort questionnaires.

1. Katharine Kolcaba
RN MSN PhD.
Presented by:
Mary Wilther Co
& Mary Grace Monroy

3. Webster (1990)
defined COMFORT in several ways:
 to soothe in distress or sorrow;
 relief from distress;
 a person or thing that comforts;
 a state of ease and quiet enjoyment, free from worry;
 anything that makes life easy; & the lessening of
misery or grief by cheering, calming, or inspiring with
hope.

6. “If your discipline is going to progress as a
science, you must define your central terms
precisely so you can understand each other
& develop ways to conduct research about
them, all disciplines must define their
concepts.” – Dr. Ray Kolcaba
(Kolcaba, 2003)

7. Patient’s Illness Experience & Treatment
Nursing Intervention
+
Empirical Knowledge
= Good Patient Outcome

8. Patient’s Illness Experience & Treatment
Nursing Intervention
+
Empirical Knowledge
= Good Patient Outcome
VS
BETTER Nursing Intervention (COMFORT) +
FORTIFIED Empirical Knowledge (COMFORT)
= Best Patient Outcome (COMFORT)

9. (Siefert, 2002)
 Communication
 Family & Relationships
 Functionality
 Self-characteristics
 Psychosocial & Physical Symptom Relief, States
& Interventions
 Spiritual Activities & States
 Safety & security

10. (as cited in Siefert, 2002)
 A sense of inner peace (Arruda et al., 1992)
 A pleasant experience (Kolcaba, 1992b)
 Feeling cared for (Larson, 1987)
 Relief of symptoms, such as pain relief (McIlveen &
Morse, 1995)
 Reduced suffring (Fleming et al., 1987)
 Decreased disequilibrium (Cameron, 1993)
 Absence of discomfort (Kolcaba, 1991; Morse, 1995)

11. I.Credentials & Background
II. Theoretical Sources
III. Concepts & Definitions
IV. Conceptual Framework
V. Empirical Evidence
VI. Metaparadigm Concepts
VII. Theoretical Assertions
VIII. Acceptance by the Nursing
Community
IX. Further Development
X. Critique
XI. Case Study

12. Stated in Cu, J.E. (2013); Dowd, T. (2010); Kolcaba, K. (2003, 2010);
• 1944 Born in Cleveland, Ohio.
• She received a diploma in nursing & practiced part time for many
years in medical-surgical nursing, long term care, & home
care.
• 1987 Graduated in the first R.N. to M.S.N. class at the Frances
Payne Bolton School of Nursing, Case Western Reserve
University (CWRU), with a specialty in gerontology.
• While in school, she job shared in a head nurse position on a
dementia unit, began theorizing about the outcome of
comfort.
• 1987 Began teaching at The University of Akron College of
Nursing.

13. Stated in Cu, J.E. (2013); Dowd, T. (2010); Kolcaba, K. (2003, 2010);
•1997 Graduated with PhD Nursing from Case Western Reserve
University.
• 1997 Developed web site called The Comfort Line
Email address: kathykolcaba@yahoo.com.
• 2003 Published her book Comfort Theory &
Practice: A Vision for Holistic Health Care &
Research.

14. 1. Historical Background
2. Concept analysis
A. Literature Review
B. Purpose of Conceptual Analysis
3. Types of Comfort
4. Four Contexts of Experience
5. Taxonomic Structure of Comfort

15. 1. Historical Background
(The Concept of Comfort in an Environmental framework)
Discussed in Dowd (2010) and Kolcaba (2003)
• Kolcaba began her exploration of these topics about 15 years
ago, after discovering the concepts through her nursing
practice.
• She began her theoretical work as she diagrammed her nursing
practice early in her doctoral studies.
• Held the position of a head nurse on an Alzheimer’s unit.
• Her practice in dementia care helped her formulate the first
comfort diagram.

16. 1. Historical Background
(The Concept of Comfort in an Environmental framework)
Three terms emerged as the foundation of her diagram:
Illustrated in Kolcaba (2003)
•ED (Excess disabilities)
Defined in dementia care as reversible symptoms that are
undesirable & temporary extensions of a specific primary disability
(ex. Agitation, fighting with others, refusal to cooperate, temper
tantrums). Schwab, Rader, & Doan, 1985.
•Facilitative environment
The therapeutic milieu which is adapted to address the needs of
frail patients (Wolanin & Phillips, 1981).
•Optimum function
The ability to engage in special activities on the unit (Wolanin &
Phillips, 1981).

17. 1. Historical Background
(The Concept of Comfort in an Environmental framework)
A Framework of Care for Gerontological Nursing
Facilitative Environment
Prevent/Treat
Psychological Excess
Disabilities
Prevent/Treat
Psysical Excess
Disabilities
Comfort
(Kolcaba, K.,1992a; as cited in Kolcaba, 2003)
Optimum Function

18. 2. Concept Analysis
A. Literature Review
(Kolcaba, 2003)
It started with an extensive study of the literature from
disciplines:
• Nursing
• Medicine
• Psychology
• Psychiatry
• Ergonomics
• Oxford English Dictionary [OED]
From the OED, Kolcaba learned that the original definition of
comfort was “to strengthen greatly.”

19. 2. Concept Analysis
A. Literature Review
Historical accounts for comfort in nursing are
numerous examples (Kolcaba, 2003) :
• Nightingale (1859, p.70) encouraged. “It must never be lost
sight of what observation is for. It is not for the sake of piling up
miscellaneous information of curious facts, but for the sake of
saving life & increasing health and comfort” (as cited in Dowd,
2010).

20. 2. Concept Analysis
A. Literature Review
• According to Kolcaba (1991) the concept of comfort has been recognized in
several nursing theories, but it was not defined clearly (as cited in Siefert,
2002).
Peplau described comfort as a basic need along with food, rest, sleep,
companionship & understanding. (p. 1305)
Orlando discussed assessing physical & mental comfort & delivering
comfort measures. (p. 1304)
Comfort is frequently a variable in caring models such as Watson's
science of caring. (p. 1304)
Roy's adaptation model uses comfort measures to achieve psychological
comfort. (p. 1304)

21. 2. Concept Analysis
B. Purpose of Conceptual Analysis
Contributors who influenced, supported & strengthened
Kolcaba’s Comfort Theory (Kolcaba, 2003) :
• Morse
• Benner
• Rankin-Box
• Donahue
• Arrington & Walborn
• Andrews & Chrzanowski
• Hamilton
• Gropper
• Neves-Arruda
• Larson
• Meleis

22. B. Purpose of Conceptual Analysis
Summary of Insights of the contributors
• Comforting words & actions coming from the nurses & other members of the health
care team are important for the interventions perceived as comfort measures by
patients.
• Comfort is a positive & dynamic state which the health care team can do more to
enhance comfort.
• Better patient outcomes produce with the strengthening properties of comfort.
• To measure comfort one must incorporate its holistic nature.
• Patterns of comfort care must be applied individually.
• Comfort in all human beings is important.
• Comfort-seeking behaviors can be constructive & destructive.
• Health is comfort
• Comfort is contextual
• By enhancing patient’s comfort nurses are proud & makes them experts.
• Manipulation of the environment enhances comfort.
• Coordination of the health care team about comfort care is possible.
New insights about comfort were found and influenced Kolcaba’s work (Kolcaba, 2003)

23. 3. Types of Comfort
Synthesized/Derived from:
(Dowd, 2010)
Kolcaba’s Definition
(Dowd, 2010; Kolcaba, 2003)
Relief – was synthesized from
Orlando’s work (1961), who postulated
that nurses relieved the needs
expressed by patient (as cited in Dowd,
2010).
Relief - The state of a patient who has
had a specific need met.
Ease – synthesized from the work of
Henderson (1966), who described 13
basic functions of human beings to be
maintained during care.
Ease - The state of calm or
contentment.
Transcendence – derived from Paterson
and Zderad (1975), proposed that
patients rise above their difficulties
with help of nurses.
Transcendence - The state in which
one rises above one’s problems or
pain.

24. 4. Four Contexts of Experience
 Contexts in which comfort occurs (Dowd, 2010; Kolcaba, 2003; Kolcaba, 2010)
• Physical - Pertaining to bodily sensations & functions.
• Psychospiritual - Pertaining to self-esteem, self-concept,
sexuality, meaning in one’s life & one’s relationship to a higher
order or being.
• Environmental - Pertaining to the external surroundings,
conditions & influences.
• Social - Pertaining to interpersonal, family & societal
relationships.

25. 5. Taxonomic Structure of Comfort
(Dowd, 2010; Kolcaba, 2003; Kolcaba, 2010)
Adapted with permission from Kolcaba, K. & Fisher, E. A holistic perspective on comfort care as an advance directive. Crit Care Nurs
Q,18(4):66-76, (c)1996. Aspen Publishers.

26. 5. Taxonomic Structure of Comfort
According to Dr. Ray Kolcaba (Dowd, 2010; Kolcaba, 2003; Kolcaba, 2010)
• A 12-cell grid
• Resulted from juxtaposing
three types of comfort (across
the top) & four contexts of
human experience (down the
left).
• Serves as a guide for nurses
& health care providers.
• Map of the content domain of
comfort.

27. Identified in Dowd (2010) and Kolcaba (2010);
• Health care needs
Needs for comfort that arise from stressful health care situations which the
patient’s natural support system cannot meet. These needs may be:
Physical
Psychospiritual
Sociocultural
Environmental
Acknowledged in Kolcaba (1994) these needs became evident through (as
cited in Dowd, 2010):
Monitoring
Verbal Reports
Nonverbal Reports
Pathophysiological Parameters
Education & Support
Financial Counseling & Intervention

28. Identified in Dowd (2010) and Kolcaba (2010);
• Nursing interventions
Comfort measures design & implement by a nurse targeted to the
health care needs. Enhancing the patient’s immediate comfort &/or
facilitating subsequent desirable health seeking behaviors are the clear
goal by using these interventions
• Intervening variables
Factors that patients bring to the health care situation, they are
interacting forces that nurses cannot change, & have an impact on the
success of the interventions.
Examples are (Kolcaba,1994; as cited in Dowd, 2010):
Past experiences
Age
Attitude
Emotional state
Support system
Prognosis
Finances
Education
Cultural background
Totality of elements in the recipients’
experience

29. Identified in Dowd (2010) and Kolcaba (2010);
• Health seeking behaviors
Internal or external behaviors in which the patient engages that
facilitate health or a peaceful death (Schlotfeldt, 1975).
 Internal behaviors (ex. healing, T-cell formation,
oxygenation, etc.)
 External behaviors (ex. observable behaviors such as working
in therapy, length of stay in hospital, ambulation, functional
status).
• Institutional Integrity
Stability and ethics of any hospital, health care system, region, state, or
country. It produced evidence for best practices and best policies
(Kolcaba, 2001).

30. Identified in Dowd (2010) and Kolcaba (2010);
• Best practices
Evidence based health care intervention use to produce best possible
patient & family outcome.
• Best policies
Ranging from protocols for procedures & medical conditions to access &
delivery of health care. These are from institutional or regional policies.
• Comfort
The immediate experience of being strengthened through having the
needs for relief, ease or transcendence met in the physical,
psychospiritual, environmental & social contexts of experience (General
Comfort Questionnaire).

31. Figure: Conceptual Framework for Comfort Theory. (Copyright Kolcaba, 2007.
Retrieved from www.thecomfortline.com, February 25, 2008).

32. Figure: A closer look at Kolcaba’s conceptual framework. (Retrieved from
http://comfortcareinnursing.blogspot.com/2010/07/closer-look-at-kolcabas-conceptual.
html, July 9, 2010).

33. Explained in Comfort care in nursing (2010); Dowd (2010); and Kolcaba (2003)
• The conceptual framework exhibits the different
concepts interrelated in nursing care.
• The conceptual framework for comfort theory can be
applied as well to other health care disciplines leading to
holistic care for the patients.
• The ones who give comfort measures so client can feel
relief, ease & transcendence are the nurses who play
the central role in comfort care.

34. Figure: A closer look at Kolcaba’s conceptual framework. (Retrieved from
http://comfortcareinnursing.blogspot.com/2010/07/closer-look-at-kolcabas-conceptual.
html, July 9, 2010).

35. 1. Measuring Comfort
A. Comfort Questionnaires
B. Types of Comfort Questionnaires:
• Kolcaba’s CQs
• CQs created by others
• Foreign CQs
2. Summary of Experimental Design
3. Acute Care for Elders: ACE Model
A. Holistic model for geriatric orthopedic
nursing care
B. Research Outcomes

36. 1. Measuring Comfort
A. Comfort Questionnaires
Identified in Dowd (2010) and Kolcaba (2010).
• Chosen base on all attributes of comfort relevant to
the research settings.
• Determine if a specific comforting intervention
enhanced the comfort of a group of patients
assessing each cell in the Taxonomic structure of
comfort (comfort grid).
• Using the Taxonomic Structure (TS) of comfort as a
guide to capture change in comfort over time there
should be at least two measuring points, usually
three.

37. A. Comfort Questionnaires (Dowd, 2010; Kolcaba , 2010).
•From the General Comfort Questionnaire (Kolcaba,
1997, 2003; as cited in Dowd, 2010).
•Results are scored by reversing the coding of the
negative items. For example, if the item states “I am
fatigued” that is not comfort. Persons who respond
strongly agree (6) will be coded (1), persons who
respond (5) will be scored (2) & so on. You can do this
when you enter your data into the data analysis spread
sheet or the computer can specify which questions need
to be reverse coded (Kolcoba, 2010).

38. B. Types of Comfort Questionnaires
Identified in Dowd (2010) and Kolcaba (2010).
• Kolcaba’s CQs
GENERAL COMFORT QUESTIONNAIRE
•Used the Taxonomic Structure of comfort as a basis.
• Filed with the National Quality Measures Clearinghouse for several years.
• Composed of 48 items questions (24- positive questions, 24- negative questions).
• Covered the content domain of comfort (Kolcaba, 2003).
• Items - in the “Present tense”
• Comfort questions were “situational,” “State-specific” related to the present
moment.
• The word comfort was not used to avoid response bias.
• Neutral tone- allowing for a wide range of response. (ex. I am able to walk around
[speaks basic ability])
• Four possible responses (no middle of the road choice).

39. B. Types of Comfort Questionnaires
Identified in Dowd (2010) and Kolcaba (2010).
• Kolcaba’s CQs
SHORTENED GENERAL COMFORT QUESTIONNAIRE
The 28-item GCQ is in the same format as the original GCQ (48 items).
COMFORT BEHAVIORS CHECK LIST
Developed as a last resort, data collectors are used to rate a patient’s apparent
comfort. While not as desirable as actually asking a patient about his or her comfort, the
instrument can fill a gap regarding data collection in comatose, very frail (as in terminal),
or cognitively limited patients.
COMFORT DAISIES
This instrument was designed for use with young children.
PERIANESTHESIA COMFORT QUESTIONNAIRE
RADIATION THERAPY COMFORT QUESTIONNAIRE
URINARY INCONTINENCE AND FREQUENCY COMFORT QUESTIONNAIRE
END OF LIFE COMFORT QUESTIONNAIRE - PATIENT

40. B. Types of Comfort Questionnaires
Identified in Dowd (2010) and Kolcaba (2010).
• Kolcaba’s CQs
END OF LIFE COMFORT QUESTIONNAIRE - FAMILY
The family instruments are designed to measure the comfort of the family
member, NOT how they perceive the patient's comfort. The theory is that if the
patient is comfortable, the family member will be comfortable also.
HOSPICE COMFORT QUESTIONNAIRE
HEALING TOUCH COMFORT QUESTIONNAIRE
Adapted from the General Comfort Questionnaire
ADVANCE DIRECTIVES COMFORT QUESTIONNAIRE
This scale correlates with the Healing Touch Comfort Questionnaire. Please
refer to Dowd, T., Kolcaba, K., Steiner, R. , & Fashinpaur, D. (2007). Comparision of
healing touch, coaching & a combined intervention on comfort and stress in younger
college students. Holistic Nursing Practice, 21(4), 194-202.

41. Types of Comfort Questionnaires
Identified in Dowd (2010) and Kolcaba (2010).
• Kolcaba’s CQs
VISUAL DISCOMFORT SCALE QUESTIONNAIRE
NURSES COMFORT QUESTIONNAIRE
Developed after consulting & research surrounding magnet status for facilities.
This tool can be used to measure the nurses' comfort as a result of a
institutional or smaller unit, change.

42. B. Types of Comfort Questionnaires
Identified in Dowd (2010) and Kolcaba (2010).
• CQs by Others
PEDIATRIC COMFORT ASSESSMENT
Developed & used by Intermountain Healthcare.
PSYCHIATRIC COMFORT QUESTIONNAIRE
GLBT COMFORT QUESTIONNNAIRE
This questionnaire is designed to explore issues related to the acquisition of
self-comfort with sexual identity in gay, lesbian, or bisexual adults.
GENERAL COMFORT QUESTIONNAIRE - ADAPTED FOR DEAF CLIENTS
IMMOBILIZATION COMFORT QUESTIONNAIRE
CHILDBIRTH COMFORT QUESTIONNAIRE

43. B. Types of Comfort Questionnaires
Identified in Dowd (2010) and Kolcaba (2010).
• Foreign CQs
• URINARY INCONTINENCE & FREQUENCY COMFORT QUESTIONNAIRE
(TURKISH)
• GENERAL COMFORT QUESTIONNAIRE (TURKISH)
• PSYCHIATRIC COMFORT QUESTIONNAIRE (PORTUGUESE)
• BREAST CANCER CQ (PORTUGUESE)
• CAREGIVERS OF WOMEN W/ TERMINAL CANCER (PORTUGUESE)
• GENERAL COMFORT QUESTIONNAIRE (ITALIAN)
• GENERAL COMFORT QUESTIONNAIRE (SPANISH)
• NURSES COMFORT QUESTIONNAIRE (SPANISH)
• PERIANESTHESIA COMFORT QUESTIONNAIRE (FARSI)
• PRIMIPARA PATIENTS AFTER PERINEAL CARE (VISAYAN)
• COMFORT & ARCHITECTURE (PORTUGUESE)

44. 2. Summary of experimental design
Discussed in Dowd (2010)
• Dissertation - used an experimental design to test her theory. (Kolcaba & fox,
1999; as cited in Dowd, 2010).
• Holistic intervention - guided imagery (supported by a lot of literature).
HOW?- they could listen everyday to an audio tape.
• Adapted the GCQ to measure their comfort at 3 time points.
• Collected 3 sets of data from 36 patients composed of the treatment
group & the control group.
Findings:
She found out that the women who had received the guided imagery had increased
comfort over time had a significant difference than the control group (Kolcaba, 2010,
Video file).

45. 3. Acute Care for Elders: ACE model
Stated in Panno et al (2000).
A. Holistic model for geriatric orthopedic nursing care
• Started at University Hospitals of Cleveland (UHC)
in Ohio (Palmer et al., 1994; as cited in Panno
et al, 2000).
•Holistic model for geriatric orthopedic nursing care
• Provides an effective, proactive, inexpensive,
combining it with Comfort theory (Kolcaba,1994 &
1995; as cited in Panno et al, 2000).

46. 3. Acute Care for Elders: ACE model
Stated in Panno et al (2000).
•Nurses & physicians observed that many elders
admitted for an acute health episode or trauma,
experienced a decline in function in
activities of daily livings (ADL) during
hospitalization that leads to the severity of their
conditions. Poor outcomes resulted to a fear that
older adults gave overly optimistic reports of their
health states to avoid hospitalization (Eberle &
Besdine, 1992; as cited in Panno et al, 2000).

47. 3. Acute Care for Elders: ACE model
Stated in Panno et al (2000).
B. Research Outcomes
• The pilot study at UHC demonstrated that patients who
received the ACE intervention were more functional at
discharge than patients discharged from a traditional unit
(Landefeld et al., 1995; as cited in Panno et al, 2000).
• Study was repeated in a larger population in both UHC
& in a community hospital setting in Akron, OH (Summa
Health System) because of the promising results
gathered.

48. 3. Acute Care for Elders: ACE model
Stated in Panno et al (2000).
B. Research Outcomes
• Physicians, nurses & patients were more satisfied with
the care they had provided on the ACE unit (Counsell et
al., 1997; as cited in Panno et al, 2000).
• Physicians more often rated the ACE Unit staff
compared to usual care staff as excellent in caring for
older patients & meeting the needs of older patients &
planning for discharge (see Figures 2 & 3).

49. 3. Acute Care for Elders: ACE model
Stated in Panno et. al. (2000).
B. Research Outcomes

50. 3. Acute Care for Elders: ACE model
Stated in Panno et al (2000).
B. Research Outcomes

52. Nursing is the intentional assessment
of comfort needs, the design of
comfort interventions to address
those needs, and reassessment of
comfort levels after implementation
compared with a baseline.

53. Recipients of care may be
individuals, families, institutions,
or communities in need of health
care.

54. The environment is any aspect of
patient, family, or institutional setting
that can be manipulated by nurses,
loved ones, or the institution to
enhance comfort.

55. Health is optimal functioning of a
patient, family, health care provider, or
community as defined by the patient or
group.

57. States that comforting interventions, when
effective, result in increased comfort for
recipients (patients and families), compared
to a pre-intervention baseline. Care providers
may also be considered recipients if the
institution makes a commitment to the
comfort of their work setting.

58. States that increased comfort of
recipients of care results in increased
engagement in health seeking
behaviors (HSBs) that are negotiated
with the recipients.

59. States that increased engagement in
health seeking behaviors results in increased
quality of care, benefiting the institution and its
ability to gather evidence for best practices
and best policies. She proposes that this type
of comfort practice promotes greater nurse
creativity and satisfaction, as well as high
patient satisfaction.

60. ◦ Comfort management or comforting
care includes interventions, comforting
actions, the goal of enhanced comfort,
and the selection of appropriate health
seeking behaviors by patients, families,
and their nurses.

62. This theory has been selected
frequently by students and nurse
researchers as a guiding frame for
their studies in such areas as nurse
midwifery, labor and delivery, cardiac
catheterization, critical care, hospice
etc.

63. For clinical practice, Kolcaba
recommends asking patients or family
members to rate their comfort from 0 to
10, with 10 being the highest possible
comfort in their situation. This verbal
rating scale is sensitive to changes in
comfort over time.

64. The theory is appropriate for
students to use in any clinical
setting, and its application can be
facilitated by the use of Comfort
Care Plans available on Kolcaba's
website.
http://www.thecomfortline.com/

65. The theory also provided ways for students to
obtain relief from their heavy course work (by
knowing where to find answers to their
questions and clinical problems), to maintain
ease with their curriculum (through trusting
their faculty members), and to achieve
transcendence from their stressors (with the
use of self-comforting techniques).

66. An entry in The Encyclopedia of Nursing
Research speaks to the importance of
measuring comfort as a nursing-sensitive
outcome (Kolcaba, 1992a). Nurses can provide
evidence to influence decision making at
institutional, community, and legislative levels
through comfort studies that demonstrate the
effectiveness of holistic comforting care.
Measurement of comfort in large hospital and
home care data sets is essential to add to the
literature on outcomes research (Kolcaba,
1997, 2001).

69. The methodical development of the
concept resulted in a strong, clearly
organized, and logical theory that is
readily applied in many settings for
education, practice, and research.
Kolcaba has developed templates for
instrument development to facilitate
measures of comfort in additional new
settings.

71. Some of the early articles such as the
concept analysis (Kolcaba, 1991) may
lack clarity but are consistent in terms
of definitions, derivations,
assumptions, and propositions.

72. The Theory of Comfort is simple
because it is basic to nursing care and
the traditional mission of nursing.

73. Kolcaba's theory has been applied in
numerous research settings, cultures,
and age groups. The only limiting
factor for its application is how well
nurses and administrators value it to
meet the comfort needs of patients.

74. The comfort instruments have
demonstrated strong psychometric
properties, supporting the validity of
these questionnaires as measures of
comfort that reveal changes in comfort
over time and support of the taxonomic
structure.

75. The theory predicts the benefit of
effective comfort measures
(interventions) for enhancing comfort
and engagement in health seeking
behaviors. The Theory of Comfort is
dedicated to sustaining nursing by
bringing the discipline back to its roots.

76. Institutions have recognized the value of
designing comfort environments for both
their patients and their staff. Through
Kolcaba's publications & Internet activities,
the Theory of Comfort is known worldwide.

78. A 32-year-old African-American mother of 3 toddlers who is 28
weeks pregnant is admitted to the high-risk pregnancy unit with
regular contractions. She is concerned because plans for her
family are not finalized. She has many comfort needs (1st table).
TAXONOMIC STRUCTURE OF COMFORT NEEDS FOR CASE STUDY
Context of Comfort Relief Ease Transcendence
Physical Aching back, early
strong contractions
Restlessness and
anxiety
Patients thinking, “What
will happen to my
family and to my
babies?”
Pshycospiritual Anxiety and cension Uncertainty about
prognosis
Need for emotional and
spiritual support.
Environmental Roommate is a
primigravida, room
small, clean, and
pleasant
Lack of privacy, phone
in room, feeling of
confinement with bed
rest
Need for calm, familiar
environmental elements
and accessibility of
distraction.
Sociocultural Absence of family and
culturally sensitive care
Family not present,
language barriers
Need for support from
family, need for
information,
consultation

79. Types of Comfort
Care
Action or
Intervention
Example
Standard comfort
interventions
Vital signs
Laboratory test results
Patient assessment
Medications and treatment
Social worker
Coaching Emotional support
Reassurance
Education
Listening
Clergy
Comfort food for the
soul
Energy therapy such as healing touch if it is culturally
acceptable
Music therapy or guided imagery (patient’s choice of
music)
Spending time
Personal connections
Reduction of environmental stimuli

80. :
Comfort Care in Nursing. (2010, July 9) A closer look at
Kolcaba's conceptual framework [Web log post] Retrieved
from http://comfortcareinnursing.blogspot.com/2010/07/closer-look-at-kolcabas-conceptual.html
Cu, J. E. (2013, June 27) Biography[Web log post] Retrieved from
http://2013upoujohanearlman.wordpress.com/2013/06/27/biography-2/
Dowd, T. (2010). Theory of comfort. In M.R. Alligood & A.M. Tomey (Eds),
Nursing theorists and their works, seventh edition (pp. 706-721). Missouri:Mosby Elsevier
Kolcaba, K. (2003). Comfort theory and practice: a vision for
holistic health care and research. Retrieved from
http://www.google.com.ph/books?hl=en&lr=&id=nduGie_ouQkC&oi=fnd&pg=PR11&dq=katharine+kolc
aba%27s+theory+of+comfort&ots=S8Z1zHPdHg&sig=5QFcYBXReQ6Ucll1kCY35ED8HMA&redir_esc
=y#v=onepage&q=katharine%20kolcaba's%20theory%20of%20comfort&f=true
Kolcaba, K. (2010). Design and sample [Video file]. Retrieved
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