Conclusion

In conclusion, Comfort theory by Katharine Kolcaba was first developed in 1990s, thus, considered to be relatively new. It is a midrange theory that is simple and easy to understand. It is multidisciplinary and can be applied in various settings. However, its uses, importance and application to nursing as well as other disciplines cannot be ignored. This theory does not only benefit the patient, but also the nurse as well as the institution.
 Comfort, according to Kolcaba is the product of holistic nursing art; It is what nurses desire for their patients. Comfort comes in three forms: relief, ease and transcendence. Relief is said to be provided if patient’s specific need is met. Example is giving of pain medicine to post surgery patient who is in pain. Ease is achieved if the patient is in the state of calmness and contentment. It is focused more on the environment and psychological state of the patient, example of which is addressing the anxiety issues of the patient and making him or her at ease. Finally, transcendence comfort is achieved once the patient has risen above the challenges. In in this state, the patient is said to have coped already with the discomfort. The four contexts in which patient comfort can occur are: physical, psychospiritual, environmental, and sociocultural.
The comfort measures that a nurse can use to address the specific need of a patient can be in the form of technical care, coaching and comfort food for the soul. Technical care includes those measures to reduce pain and maintain homeostasis. Coaching involves active listening and relieving anxiety. Comfort food for the soul fortifies the person through back rubs, guided imagery, music therapy and hand-holding.
 Nursing involves the intentional assessment of comfort needs, by observation and by asking the patient, while taking into considerations the intervening variables that are not likely to change and which nurses has little control over; designing of comfort measures to address those needs; and lastly, the reassessment of comfort levels after implementation. If comfort has not been achieved, nursing care plan must be changed accordingly or the patient’s needs must be reassessed. Comfort is what the patient state it is and not only merely the nurse sees it as.
The first part of the theory is focused on increasing the desires comfort level. Pain relief falls on this part. Kolcaba believes that when a patient achieves a certain level of comfort, his sense of achievement and health-seeking behavior is positively affected. The patient then feels strengthened and more likely to engage in positive health-seeking behavior which can be internal (T cells, immune function healing), external (health related activities), or peaceful death. This is the second part of the theory. The third part of the theory constitutes the relationship among comfort, health seeking behavior, and institutional integrity. Institutional integrity, as defined by Kolcaba, is the value, financial stability, and wholeness of health care organizations at the local, regional, state, and national levels. Institutions include Public Health agencies, Medicare and Medicaid programs, Home Care agencies, Nursing Home consortiums. Enhanced hospital integrity happens when specific patient’s needs have been met, hospital stay is shortened, patient is satisfied, and there is cost saving and decreased morbidity rates. When patients do better, hospitals do better as well and vice versa.
Comfort is a universal concept and the opposite of which is suffering. Kolcaba believes that comfort care is efficient and satisfying both to the patient and the nurse. She developed the the general comfort questionnaire developed to measure holistic comfort in the hospital and in the community settings. According to Kolcaba, holistic comfort is defined as the immediate experience of being strengthened through having the needs for relief, ease, and transcendence met in four contexts of experience. She also emphasized the documentation of patient’s comfort and how those needs were addressed.
We, the advocates of this Comfort Theory, believe that comfort is indeed the product of holistic nursing care. The more satisfied and comfortable the patient is, the more satisfied nurses are in the care that they have provided and the more there is institutional integrity.