Herzing University Kolkaba Comfort Theory Essay

Herzing University Kolkaba Comfort Theory Essay


The purpose of the Theory Evaluation Paper is to help you critically evaluate a middle-range nursing theory. This assignment will be completed using the three stages of the theory evaluation process: Theory Description, Theory Analysis, and Theory Evaluation.


  1. Select a Middle-Range Nursing Theory- Select one specific middle-range nursing theory from your textbook that best suits your area of practice. (Ex. Pender’s Health Promotion Model, Kolcaba’s Comfort Theory, Beck’s Postpartum Depression Theory, etc.)
  2. APA Student Title Page- (No Abstract Needed)
  • Include the following information on the Student title page in 7th APA format:
    • Assignment name in Bold Font: (Ex. Theory Evaluation Paper: Swanson’s Theory of Caring)
    • Skip a Line
    • Your Name
    • Name of University
    • Course Number and Name
    • Instructor’s Name
    • Date of Submission (Month, Day, Year)
  1. Introductory paragraph Capture the reader’s attention (ex. Grabbing statistics) and discuss the rationalefor selecting the specific nursing theory for your area of nursing over other nursing theories (Do not write in first person; Include a purpose/thesis statement of what you will describe in the paper as the last sentence of the introductory paragraph.) Next, begin the Body of Paper.
  2. Theory Description (Level 1 Header)
  • Purpose (Level 2 Header); (Designate as Descriptive, Explanatory, Predictive, or Prescriptive; Include Scope-middle-range)
  • Concepts (Level 2 Header); (Introduce and list main concepts)
  • Definitions (Level 2 Header); (Define concepts and other important aspects)
  • Relationship (Level 2 Header); (Describe relationship among concepts)
  • Structure (Level 2 Header); (Describe; Is there a diagram of structure?)
  • Assumptions (Level 2 Header); (beliefs, propositions of the theory)

5. Theory Analysis (Level 1 Header)

  • Theory’s Origin (Level 2 Header); (historical creation and evolution of theory)
  • Unique Focus (Level 2 Header); (distinctive views)
  • Content (Level 2 Header); (include definitions of metaparadigm concepts of person, environment, health, and nursing)

6. Theory Evaluation (Level 1 Header)

  • Significance (Level 2 Header); (usefulness, social significance, cultural significance)
  • Comprehensiveness (Level 2 Header); (of the content, thoroughness, utility)
  • Logical Congruence (Level 2 Header); (consistency and clarity of theory; consistent use of concepts throughout the literature)
  • Credibility (Level 2 Header); (legitimacy, empirical support through research)
  • Contribution to Nursing (Level 2 Header); (usefulness to nursing practice, education, and research)

7. Conclusion (Level 1 Header) Conclusion paragraph with concluding statements to summarize the content and re-state or re-phrase the purpose/thesis statement.

8. APA Reference Page- Please be sure to support your paper with in-text citations. Please use 5 peer-reviewed resources.

Additional Instructions: Your assignment should be typed into a Word or other word processing document, formatted in APA style. Paper should be a minimum of 4-5 pages in length, excluding the title and references pages. You may increase the number of pages of the body of the paper up to 7-8 pages if needed. This is a scholarly paper and should not be written in first person. Paragraphs should have a minimum of 3 sentences. Paraphrasing should be done using in-text citations. Direct quotes should be rare and used only when the content can be said in no other way. If using direct quotes, you must include page or paragraph number.

Estimated time to complete: 8 to 10 hours


Kolcaba’s Theory of Comfort ,

Katherine Kolcaba (2017) wrote that the first step in developing the Theory of Comfort was a concept analysis conducted in 1988 while she was a graduate student. Following a number of steps over several years, the Theory of Comfort was initially published in 1994 and later modified (Kolcaba, 19942001).

Purpose and Major Concepts

Kolcaba (1994) defined comfort within nursing practice as “the satisfaction (actively, passively, or co-operatively) of the basic human needs for relief, ease, or transcendence arising from health care situations that are stressful” (p. 1178). She explained that a client’s needs arise from a stimulus situation that can cause negative tension. Increasing comfort measures can result in having negative tensions reduced and positive tensions engaged.

Comfort is viewed as an outcome of care that can promote or facilitate health-seeking behaviors. It is posited that increasing comfort can enhance health-seeking behaviors. One proposition notes that “if enhanced comfort is achieved, patients, family members and/or nurses are strengthened to engage in HSBs [health-seeking behaviors], which further enhance comfort” (Kolcaba, 2017, p. 200).

Major concepts described in the Theory of Comfort include comfort, comfort care, comfort measures, comfort needs, health-seeking behaviors, institutional integrity, and intervening variables. There are also eight defined propositions that link the defined concepts (Box 11-6) (Kolcaba, 20012017). Figure 11-4 presents the Theory of Comfort.

Box 11-6 Propositions of Comfort Theory

1. Nurses and members of the health care team identify comfort needs of patients and family members.

2. Nurses design and coordinate interventions to address comfort needs.

3. Intervening variables are considered when designing interventions.

4. When interventions are delivered in a caring manner and are effective, the outcome of enhanced comfort is attained.

5. Patients, nurses, and other health care team members agree on desirable and realistic health-seeking behaviors.

6. If enhanced comfort is achieved, patients, family members, and/or nurses are more likely to engage in health-seeking behaviors; these further enhance comfort.

7. When patients and family members are given comfort care and engage in health-seeking behaviors, they are more satisfied with health care and have better health-related outcomes.

8. When patients, families, and nurses are satisfied with health care in an institution, public acknowledgment about that institution’s contributions to health care will help the institution remain viable and flourish. Evidence-based practice or policy improvements may be guided by these propositions and the theoretical framework.

Sources: Kolcaba (20012017).

Figure 11-4The conceptual framework for the Theory of Comfort.
(© Kolcaba [2007]. Used with permission. http://thecomfortline.com.)

Context for Use and Nursing Implications

Comfort Theory observes that patients experience needs for comfort in stressful health care situations. Some of these needs are identified by the nurse, who then implements interventions to meet the needs (Kolcaba, 1995). Kolcaba (2017) stated that “Comfort Theory can be adapted to any health care setting or age group . . . ” (p. 200). Understanding of comfort can promote nursing care that is holistic and inclusive of physical, psychospiritual, social, and environmental interventions. It is noted that any actually unhappy, unhealthy, or unwell patients can be made more comfortable (Kolcaba, 1994). Finally, outcomes of comfort can be measurable, holistic, positive, and nurse sensitive.

Evidence of Empirical Testing and Application in Practice

The General Comfort Questionnaire (GCQ) is a 48-item Likert-type scale that was developed to measure concepts and propositions described in the theory. The GCQ has been modified to be used for different populations in a number of studies, and a shortened GCQ (28 items) is also in use (Kolcaba, 2017).

Kolcaba (2017) described development of other tools to assist in research and practice application for the Theory of Comfort. These include the Verbal Rating Scale Questionnaire, the Radiation Therapy Comfort Questionnaire, the Hospice Comfort Questionnaire, the Urinary Incontinence and Frequency Comfort Questionnaire, and the Healing Touch Comfort Questionnaire. In addition, the Comfort Behaviors Checklist was developed to measure comfort in patient who can’t use traditional questionnaires or other instruments.

A number of research studies have been conducted by Kolcaba and her colleagues using the instruments listed earlier. For example, Andersen, Jylli, and Ambuel (2014)used Kolcaba’s Comfort Behaviors Checklist to evaluate the comfort care provided by a group of health providers and Seyedfatemi, Rafii, Rezaei, and Kolcaba (2014) used her instruments to study comfort and hope among preoperative patients.

Whitehead, Anderson, Redican, and Stratton (2010) reported using Kolcaba’s instruments to study the effects of an end-of-life nursing education program on nurses’ death anxiety, knowledge of the dying process, and related concerns. Also examining nursing care at the end of life, Murray (2010) used Kolcaba’s instruments to assess spiritual beliefs and practices of nurses caring for patients at the end of life, along with similarities and differences in spiritual beliefs and practices comparing hospice nurses and nurses working on oncology and other special care units.

In practice-specific examples, Marchuk (2016) described how Comfort Theory can be applied in end-of-life care in the neonatal intensive care unit (NICU), and Krinsky, Murillo, and Johnson (2014) explained how comfort measures can be used to improve nursing care for cardiac patients. Finally, Boudiab and Kolcaba (2015) presented a comprehensive look at the application of Comfort Theory in directing holistic, quality care for veterans and their families.

Lenz and Colleagues’ Theory of Unpleasant Symptoms

The Theory of Unpleasant Symptoms was developed by a group of nurses interested in a variety of nursing issues, including symptom management, theory development, and nursing science (Lenz, Pugh, Milligan, & Gift, 2017). The theory was initially published in the nursing literature in the mid-1990s (Lenz et al., 1995) and then updated a few years later (Lenz et al., 1997). The theory was based on the premise that there are commonalities in experiencing different symptoms among different groups and in different situations. The theory was developed to integrate existing knowledge about a variety of symptoms to better prepare nurses in symptom management.

Purpose and Major Concepts

The purpose of the Theory of Unpleasant Symptoms is “to improve understanding of the symptom experience in various contexts and to provide information useful for designing effective means to prevent, ameliorate, or manage unpleasant symptoms and their negative effects” (Lenz & Pugh, 2014, p. 166). Lenz and colleagues (1997) reported that the theory has three major components: (1) the symptoms that the individual is experiencing, (2) the influencing factors that produce or affect the symptom experience, and (3) the consequences of the symptom experience.

Within the theory, symptoms are described in terms of duration, intensity, distress, and quality. Influencing factors can be physiologic factors, psychological factors, and/or situational factors. Performance is described in terms of functional status, cognitive functioning, or physical performance (Lenz et al., 2017). Figure 11-5depicts the Theory of Unpleasant Symptoms