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CHAPTER 33 Katharine Kolcaba 659

Type of Comfort
Relief Ease Transcendence

Physical
Context in Which Comfort Occurs Psychospiritual

Environmental

Social

Type of Comfort:
Relief: The state of a patient who has had a specific need met
Ease: The state of calm or contentment
Transcendence: The state in which one rises above one’s problems or pain
Context in Which Comfort Occurs:
Physical: Pertaining to bodily sensations
Psychospiritual: Pertaining to internal awareness of self, including esteem, concept, sexuality,
and meaning in one’s life; one’s relationship to a higher order or being
Environmental: Pertaining to the external surroundings, conditions, and influences
Social: Pertaining to interpersonal, family, and societal relationships
FIGURE 33-1 Taxonomic structure of comfort. (From Kolcaba, K., & Fisher, E. [1996]. A holistic perspec-
tive on comfort care as an advance directive. Critical Care Nursing Quarterly, 18[4], 66–76.)

Four contexts of comfort, experienced by those The taxonomic structure provides a map of the
receiving care, came from the review of nursing lit- content domain of comfort. It is anticipated that
erature (Kolcaba, 2003). The contexts are physical, researchers will design instruments in the future such
psychospiritual, sociocultural, and environmental. The as the questionnaire developed from the taxonomy
four contexts were juxtaposed with the three types of for the end-of-life instrument (Kolcaba, Dowd,
comfort, creating a taxonomic structure (matrix) Steiner, & Mitzel, 2004). Kolcaba includes the steps on
from which to consider the complexities of comfort as her website for adaptation of the General Comfort
an outcome (Figure 33–1). Questionnaire by future researchers.

MAJOR CONCEPTS & DEFINITIONS
In Kolcaba’s theory, those receiving comfort mea- Health Care Needs
sures may be referred to as recipients, patients, stu- Health care needs are comfort needs arising from
dents, prisoners, workers, older adults, communities, stressful health care situations that cannot be met by
and institutions. recipients’ traditional support systems. The needs
Continued