Theory in Practice:

Kolcabas Theory of Comfort

Leigh Anne Koonmen

NURS 451

Introduction
Overview

of Kolcabas Theory of Comfort

Patient Centered Care: Knowledge
Strategies to empower patients or families at the
end-of-life
Patient

Centered Care: Skill

Engagement of partnerships to promote health,

safety, and transendence at end-of-life
Patient

Centered Care: Attitude

Designation of partnerships in planning,

implementation, and evaluation of patient care at
throughout end-of-life care
Conclusion

Personal reflection of the content examined

Kolcabas Theory of
Comfort
When

the nurse meets the patients specific needs, the

patient experiences comfort in the form of relief
Example: A patient who is restless and agitated receives an
anxiolytic experiences comfort from relief of anxiety

The

environment is anything in the surroundings the

nurse is able to manipulate to provide the patient and
family relief and comfort
The tenets of nursing under this theory are

Assessment of comfort needs

Implementation of comfort measures
Evaluation of the effectiveness of comfort measures
Involvement of patient and family in plan of care to enhance
comfort

The

whole patient is assessed in order to provide holistic

care that results in comfort through the relief of needs

Patient Centered Care:

Patient and Family Participation
Ideally, the patient/family are involved in decision-making
throughout the comfort care process. Their input should be
obtained prior to the implementation of comfort measures
and their continuous feedback is essential in assessing the
measures effectiveness. Examining all the comfort care
framework components, this feedback is used to determine
if other actions could further enhance total comfort or
whether previously utilized comfort measures should be
repeated.
-Kolcaba & Vendlinski (1997)

Patient Centered Care:

Knowledge
Knowledge

provides the patient and family comfort

through empowerment and allows the patient and
family to participate in the plan of care during the
end-of-life process; it provides a sense of control
during a difficult time.

Education of the patient and family on the end-of-life process

provides comfort through understanding understand
Explaining all care the patient receives provides comfort through
clarity
Addressing the questions of the patient and family provides
comfort through open communication
Listening to the needs expressed by patient and

family provides comfort through the implementation

of measures that will address those needs
The more skilled the nurse becomes in perceiving and
empathizing with the lives of others, the more knowledge or
understanding will be gained (Carper, 1978, p. 27).

Patient Centered Care:

Skill
The

nurse is able to address the health and safety

needs of the patient by demonstrating and explaining
proper care
Example: A bed-ridden patient receiving end-of-life care
desires to be bathed daily and the family would like to
participate in providing this care; the nurse demonstrates
and assists the family with this care, explaining the safety
mechanism behind each step of the process

Transcendence

is achieved by meeting the needs

across all contexts (physical, psychospiritual,
environmental, and social)
Comfort care consists of the process of comforting and the
outcome of enhanced comfort. The process is meaningful
only if it results in the desired outcome (Kolcaba &
Vendlinski, 1997, p. 272-3).

Patient Centered Care:

Attitude
Open

communication between the nurse, patient,

and family promotes collaborative, holistic care
This allows the patient and family to be a part of the plan
of care and participate in providing comfort measures
By listening to concerns and needs, the nurse is able to
work with the patient and family to develop a plan to
address the need
The patient and family further participate by communicating
with the nurse on evaluation of the effectiveness of the initiated
measure

Comfort

measures are implemented after active

decision making or consideration of all contexts by
the patient and family throughout the comfort care
process (Kolcaba & Fisher, 1996, p. 70).

Conclusion:
Reflection
Throughout the completion of this assignment I learned
valuable strategies for providing holistic patient care
under the guidance of theory based practice. Kolcabas
Theory of Comfort is a great basis for the care of patients
and families during the end-of-life stages in that it
provides a framework for nurses to create a care plan that
encompasses the patients needs through involvement of
the patient and family. While this theory is primarily
tailored to end-of-life care, the general philosophy behind
it can be applied to all forms of nursing. Patient and family
involvement in care given is essential to meet the needs
of the patient and provides a means of establishing trust.
Prior to completion of this assignment, I was unsure what
Kolcabas Comfort Theory was comprised of, but now feel I
have gained a greater understanding for how to provide
comprehensive, holistic care.

References
Carper, B.A. (1978). Fundamental patterns of knowing in
nursing. Advances in Nursing Science, 1(1). 13-24.
Kolcaba, K.Y., & Fisher, E.M. (1996). A holistic perspective
on comfort care as an advanced directive. Critical Care
Nursing, 18(4). 66-76.
Nursing Theory. (2013). Retrieved from:
http://nursing-theory.org/theories-and-models/kolcabatheory-of-comfort.php
Vendlinski, S., & Kolcaba, K.Y. (1997). Comfort care: A
framework for hospice nursing. The American Journal of
Hospice & Palliative Care, 1(6). 271-276.