Subsequent and Institutional Outcomes
Most nurses want to make their patients and families feel better and intuitively think about pain management and relieving anxiety. A more holistic approach is to think about Comfort as an umbrella term and a positive outcome of nursing care. So the outcome of comfort includes pain and anxiety management. Once nurse researchers adopt a comfort framework, they can design holistic interventions such as healing touch or guided imagery and then measure the effectiveness of their chosen intervention with a corresponding measurement of comfort. (For clinical use with alert adults, patients can rate their comfort from 0 to 10 with 10 being the highest possible comfort in this situation.) The effectiveness of a comfort intervention is measured by tan increase in the outcome of comfort. This relationship is part one of comfort theory and is the most frequently studied.
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Below are pictures of nurses who are deeply embedded in Comfort Theory. The nurses in the first photo produced a wonderful blog about their success utilizing a comfort framework. The second picture shows a comfort quilt on which each nurse applied a square depicting a comfort intervention.
I believe that it is equally important to demonstrate how increased comfort has subsequent and related outcomes called health seeking behaviors (HSBs). These can be externally observed, internally measured with lab reports or imaging, or a peaceful death which is largely observational by staff and family. (See: The Effects of Guided Imagery on Comfort, Depression, Anxiety, and Stress of Psychiatric Patients with Depression). My research team demonstrated that higher comfort was a significant predictor of successful bladder management, the subsequent outcome of interest in that study. (See: The Addition of Coaching to Cognitive Strategies: Interventions for Persons with Compromised Urinary Bladder Syndrome)
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Outcomes directly related to Institutional Integrity include patient satisfaction, cost/benefit analysis, staff turnover, mortality rates, and adverse patient events. These data are most easily accessed by high level nurse managers or statistical support personnel.
