Page 679 - alligood 8th edition_Neat

660 UNIT V Middle Range Nursing Theories

MAJOR CONCEPTS & DEFINITIONS—cont’d
may be physical, psychospiritual, sociocultural, or Health-Seeking Behaviors
environmental. They become apparent through mon- Health-seeking behaviors compose a broad category
itoring, verbal or nonverbal reports, pathophysiologi- of outcomes related to the pursuit of health as
cal parameters, education and support, and financial defined by the recipient(s) in consultation with the
counseling and intervention (Kolcaba, 2003). nurse. The category was synthesized by Schlotfeldt

Comfort Interventions (1975) and proposed to be internal, external, or a
Comfort interventions are nursing actions and refer- peaceful death.
rals designed to address specific comfort needs of Institutional Integrity
recipients, including physiological, social, cultural, Corporations, communities, schools, hospitals, re-
financial, psychological, spiritual, environmental, gions, states, and countries that possess the qualities
and physical interventions (Kolcaba, 2001). of being complete, whole, sound, upright, appealing,

Intervening Variables ethical, and sincere possess institutional integrity.
Intervening variables are interacting forces that When an institution displays this type of integrity, it
produces evidence for best practices and best poli-
influence recipients’ perceptions of total comfort. cies (Kolcaba, 2001).
They consist of past experiences, age, attitude, emo-
tional state, support system, prognosis, finances, Best Practices
education, cultural background, and the totality of The use of health care interventions based on evi-
elements in the recipients’ experience (Kolcaba, dence to produce the best possible patient and
1994). Suchintervening variables have an impact on family (institutional) outcomes is known as best
planning and success of patient care interventions. practices.
Comfort Best Policies
Comfort is the state experienced by recipients of Institutional or regional policies ranging from pro-
comfort interventions. It is the immediate, holistic tocols for procedures and medical conditions to
experience of being strengthened when one’s needs access and delivery of health care are known as best
are addressed for three types of comfort (relief, ease, policies.
and transcendence) in four contexts (physical, psy- Figure 33–2 depicts the relationship among these
chospiritual, sociocultural, and environmental) last three concepts.
(Kolcaba, 1994). Types and contexts are depicted in
Figure 33–1.

Use of Empirical Evidence independent, encouraged, worthwhile, and useful.
The seeds of modern inquiry about the outcome of Hamilton concluded, “The clear message is that com-
comfort were sown in the late 1980s, marking a period fort is multi-dimensional, meaning different things to
of collective, but separate, awareness about the con- different people” (p. 32).
cept of holistic comfort. Hamilton (1989) made a leap After Kolcaba developed her theory, she demon-
forward by exploring the meaning of comfort from the strated that changes in comfort could be measured
patient’s perspective. She used interviews to ascertain using an experimental design in her dissertation
how each patient in a long-term care facility defined (Kolcaba & Fox, 1999). In this study, health care
comfort. The theme that emerged most frequently was needs were those (comfort needs) associated with a
relief from pain, but patients also identified good posi- diagnosis of early breast cancer. The holistic interven-
tion in well-fitting furniture and a feeling of being tion was guided imagery, designed specifically for this