Major Concepts of the Theory

The metaparadigm concepts form Katherine Kolcaba’s Theory of Comfort since it addresses the comfort needs of patients while improving nursing and environment that lead to better health. Accordingly, the conceptual framework consists of three major inputs: the concept of healthcare needs, comforting interventions, and intervening variables (Kolcaba, 2015). Here, healthcare needs of patients and their families are the guiding concepts for comfort organization. The assessment of healthcare needs is a primary necessary tool for diagnostics of specific healthcare situations. Kolcaba (2015) considers a set of parameters like financial possibilities, social situation, and prognosis as the intervening variables, the least controlled by the nursing intervention. The acknowledgment of these variables enables the occurring the comforting interventions (Lima et al., 2016).

Comfort serves the central concept that concerns three health-related feelings (transcendence meaning superiority, ease meaning simplicity, and relief mening facilitation) in four сontexts. The сontexts discussed within the problem are environmental, socio-cultural, physical, and psycho-spiritual ones. All these contexts are the constituents of the enhanced comfort that is another major concept as a result of the mentioned above inputs (Seyedfatemi, Rafii, Rezaei, & Kolcaba, 2014). The detailed classification of the comfort experiences enables to implement the concepts into the hospital models of care in response to the individual healthcare needs (Krinsky, Murillo, & Johnson, 2016). In turn, enhanced comfort reflects the health-seeking behaviors that facilitate healing. The concept of health-seeking behaviors means positive outcomes of the comfort interventions detected in the actions and feelings of patients, as well as all the healthcare members. Institutional integrity makes the success of comfort changes directly dependent on it. The concept of institutional integrity highlights the wholeness of the functioning of the healthcare institution that relies on the evidence-based policies and practices designated for specific needs of patients (Kolcaba, 2015).

Major Propositions of the Theory

The concepts mentioned above, their combination, and interdependence predispose the list of propositions. The continuous chain of propositions aims to detect, assess, plan, and apply comfort to the nursing process. Consequently, the first major proposition concerns nursing assessment and diagnosis. While nursing is a core and a driver of comfort changes, nurses distinguish healthcare needs of patients and their families and generate appropriate interventions (Kolcaba, 2015). The latter involves planning of comfort changes in response to the detected needs. Also, intervening variables enable to implement the needed comfort in the specific conditions with limited resources. In turn, the implementation considers effective comfort interventions with enhanced types of comfort to become comfort measures.

The next group of propositions is the evaluation of effectiveness. Successful interventions mean that patients and their families become engaged in the comfort measures. Positive comfort outcomes lead to the agreement between patients and nurses on the realistic health-seeking behaviors (Lima et al., 2016). Nurses later delegate these effective behaviors to the families of patients, which contribute to the circle of comfort measures and continuous engagement. The latter activities mean that the comfort interventions bring satisfaction and improve health-related results (Kolcaba, 2015). This proposition shows the direct relationship between comfort and healthcare results being a focus of nursing. Reports by Lima et al. (2016) and Seyedfatemi et al. (2014) argue the relationship and its significance.

Finally, patient satisfaction contributes to the institution recognition. In order to repeat the comfort measures, institution recognition reveals the patient satisfaction. Kolcaba (2015) considers public acknowledgment of comfort measures as a supportive tool for a healthcare institution to shape and sustain the holistic practice. Here, a nurse becomes a central figure playing the roles of a change agent, an advisor, a supporter, and a policymaker.

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