Page 108 - Encyclopedia of Nursing Research

CoMFoRT THEoRY n 75

of authorship, solutions for potential change provides precision for assessment, interven-
in dynamics of team membership (illness/ tion, and evaluation of interventions that go
move), and methods for conflict resolution. beyond technical nursing skills and physi- C
cian orders. The importance and effective-
Kaye Wilson-Anderson ness of comforting interventions, such as
Joanne Warner coaching, encouragement, guided imagery,
environmental manipulation, back massage,
therapeutic presence and listening, and so
forth, may be quantifiable and visible within
CoMFort theory the patient record. From analysis of these
data, evidence for best practices and policies
may be derived.
Providing comfort to patients has a long his- Kolcaba (2003) provides a theoretical
tory within the mission of nursing. Comfort framework for practicing comforting care
has been conceptualized as a holistic outcome and for generating nursing research about
of nursing care. It has been defined as “the comfort. The theory states that interventions
experience of being strengthened by hav- should be designed and implemented to
ing needs for relief, ease, and transcendence address unmet comfort needs of patients and
addressed or met in four contexts of experi- their families. An assumption is that comfort
ence: physical, psychospiritual, environmen- is a basic human need; therefore, patients and
tal, and sociocultural.” These four contexts families often assist efforts toward enhanc-
for experiencing comfort are derived from ing comfort.
the literature on holism (Kolcaba, 2003). The The effectiveness of comforting inter-
rationale for providing comfort to patients ventions is dependent on the context of
and their families comes from (a) the histor- existing intervening variables. Intervening
ical mission of nursing to provide comfort, variables are factors that recipients bring to
(b) the satisfaction that this kind of care gives the situation and upon which team members
recipients and the deliverers of care, (c) the have little influence, such as financial status,
efficiency of using a consistent pattern for existing social support, prognosis, and reli-
care planning, and (d) the strengthening gious beliefs. Enhanced comfort strengthens
component of comfort which is derived from patients and their families during stressful
its original meaning (Kolcaba, 2003). health care situations, thereby facilitating
Comforting care consists of goal- health-seeking behaviors (HSBs).
directed activities (the process of comfort- Institutional integrity was defined by
ing) through which enhanced patient and/ Kolcaba (2003) as the quality or state of
or family comfort (the desired end product health care organizations being complete,
or outcome) is achieved. The process is ini- whole, sound, upright, professional, and eth-
tiated by the nurse and/or other team mem- ical providers of health care. When patients/
bers after an assessment of the comfort needs families engaged in HSBs, they heal faster,
of the patient/family. Because the specified learn more, and increase their functional
product or goal is enhanced comfort, the status. Thus, comfort theory (CT) states
process is evaluated by comparing comfort that institutions such as hospitals, agencies,
levels before and after interventions that and private practices would demonstrate
are targeted toward comfort. The process is improvements in institutional outcomes,
incomplete until the product of enhanced such as fewer readmissions or recurrences
comfort is achieved (Kolcaba, 2003). of health problems, higher patient satisfac-
Within the structure of nursing knowl- tion, and desirable cost–benefit ratios. Also,
edge, the technical definition of comfort institutions that provided sufficient support