When asked to write about “my vision for nursing,” I responded quickly and positively. “It’s my favorite topic and a vision that I have held for years.”  It is articulated in the last chapter of my book published in 2003.  My web site allows me to be more focused and succinct, always a good thing for a theorist!

​So to start us off, I will say simply, that my vision is Comfort Care for All which includes patients (first and foremost), their families, staff, institutions including hospitals, nursing homes, and agencies, student nurses, and communities. I fervently believe that nurses WANT to provide Comfort Care; it is THE reason we choose nursing as our life’s work.

​Comfort Care is defined as a philosophy of health care that focuses on addressing comfort needs recipients in four contexts: physical (including homeostatic mechanisms as well as sensations related to medical problems), psychospiritual, sociocultural, and environmental. Comfort Care has three components: (a) and appropriate and timely intervention, (b) a mode of delivery that projects caring and empathy, and (c) the intent to enhance comfort (Kolcaba, 2003, p. 252). It is a pattern for holistic care, but is individualized for each recipient or group. Comfort is also a universal concept, meaning it is understood across most disciplines and cultures. And, when comfort is enhanced for the recipient(s), they will have better outcomes including patient satisfaction. Nursing satisfaction also is increased.

​One can follow the pattern inherent in the comfort grid (see homepage) for practice, research, and education. The grid is a 12-cell  representation of a complex term or umbrella term under which pain (physical, relief) and anxiety (psychospiritual, relief) are only parts of the whole experience of comfort. The type of comfort named Relief refers to unmet comfort needs, usually of a severe nature. Ease emphasizes the importance of prevention of known risk factors that would keep a person from feeling comfortable. And transcendence addresses the most stubborn cases of persons unable to attain acceptable levels of comfort in any of the cells. The nurse continues to help them “rise above” or “bear with” the acute discomfort. The nurse never gives up, and provides hope -  however hope is defined with the patient.

​In this model of care, administrators have a primary responsibility to provide the resources necessary for nurses to engage in comforting interventions. When the entire agency or institution is engaged in providing comfort care, patients will do better and the facility will benefit from increased patient satisfaction, cost savings, less staff turnover, etc. Please see the conceptual framework for three parts of comfort research on my home page. Those three parts are (1) measuring patients’ comfort before and after comforting interventions, (2) correlating enhanced comfort with health seeking behaviors, and (3) if the researcher has access to institutional data such as patient satisfaction  or other benchmarks additional correlations can be obtained.

​Comfort Care can be applied in the community as in the research question, “What features are important in creating a comfortable community?” Comfort Care, whether explicit or implicit, is essential for end of life and palliative care. In mental health, a challenge for providers is to help patients develop healthy self-comforting strategies to take the place of addictive or self-destructive habits. For these patients, physical pain plays a very small part in their comfort status.