Page 685 - alligood 8th edition_Neat

666 UNIT V Middle Range Nursing Theories

Taiwanese, Spanish, Iranian, Portuguese, and Italian Simplicity
(see Kolcaba website), and translation into Turkish is The Theory of Comfort is simple because it is basic to
pending. Comfort of children has been accurately ob- nursing care and the traditional mission of nursing. Its
served and documented in perioperative settings (per- language and application are of low technology, but
sonal communication, Nancy Laurelberry, February 16, this does not preclude its use in highly technological
2008), and the use of Comfort Daisies by children settings. There are few variables in the theory, and se-
who self-report (see website) has been tested in a hospi- lected variables may be used for research or educa-
tal setting (personal communication, Carrie Majka, tional projects. The main thrust of the theory is for
February 28, 2008). nurses to return to a practice focused on the holistic
The Theory of Comfort has been included in elec- needs of patients inside or outside institutional walls.
tronic nursing classification systems such as NANDA It is simplicity that allows students and nurses to learn
(2011), NIC (2008), and NOC (2008). Kolcaba con- and practice the theory easily (Kolcaba, 2003).
sults with hospitals to include comfort management
in their documentation systems. Use of the theory has Generality
made significant contributions to nursing practice Kolcaba’s theory has been applied in numerous
and the discipline. Kolcaba continues to spend time research settings, cultures, and age groups. The only
and energy developing and disseminating the theory limiting factor for its application is how well nurses
through presentations, publications, and discussions and administrators value it to meet the comfort needs
since retirement from full-time teaching. of patients. If nurses, institutions, and communities
The Theory of Comfort is widely usedas an or- are committed to this type of nursing care, the Theory
ganizing framework for Magnet application and of Comfort enables efficient, individualized, holistic
recertification of Magnet Status. Nurses often practice. The taxonomic structure of comfort facilitates
choose this framework themselves because it de- researchers’ development of comfort instruments for
scribes what they want to do for patients and fami- new settings.
lies, and what patients want from nurses during
their hospitalization. An array of possible uses of Accessibility
the framework components is offered to the hospi- The first part of the theory, asserting that effective
tal, such as Comfort Rounds, performance review nursing interventions offered over time will demon-
criteria, methods of documentation, clinical ladder strate enhanced comfort, has been tested and sup-
criteria, and so on. The “value added” benefit when ported with numerous studies. Furthermore, in the
nurses are supported in their comforting interven- study by Dowd, Kolcaba, & Steiner (2000), enhanced
tions can be empirically demonstrated through comfort was a strong predictor of increased health-
measurement of institutional outcomes such as seeking behaviors, meaning when patients are more
patient satisfaction, “Best Hospital” designations, comfortable, they do better in rehab or recovery. This
and cost savings. relationship supports the second and third part of the
comfort theory. The comfort instruments have dem-
Critique onstrated strong psychometric properties, supporting
the validity of the questionnaires as measures of com-
Clarity fort that reveal changes in comfort over time and
Some of the early articles such as the concept analysis support of the taxonomic structure.
(Kolcaba & Kolcaba, 1991) may lack clarity but are
consistent in terms of definitions, derivations, assump- Importance
tions, and propositions. Clarity is much improved in The Theory of Comfort describes patient-centered
the article explicating the theory and subsequent arti- practice and explains how comfort measures matter
cles. Kolcaba applies the theory to specific practices to patients, their health, and the viability of institu-
using academic, but understandable, language. All tions. The theory predicts the benefit of effective
research concepts are defined theoretically and opera- comfort measures (interventions) for enhancing
tionally. comfort and engagement in health-seeking behaviors.