Comfort Theory in Nursing Practice The word comfort has been intriguing to nursing as its diverse definition denotes

complex and holistic term. A patient might express her gratitude for a well-rounded care and tells that The nurse comforted me well. Similarly, the term could also describe a place of solace, free from stress or anxiety, such as This room is so comfortable. It makes me feel like I never wanna be discharged anymore. It has defined comfort as "the immediate state of being strengthened through having the human needs for relief, ease, and transcendence addressed in four contexts of experience ". It serves as the positive outcome that is desired to empower the patients and their families to engage in health seeking behaviours (HSBs). Assessing patients for their level of comfort utilizing a positive, holistic manner is important for measuring effectiveness of comforting strategies. Comfort Theory , with its inherent emphasis on physical, psychospiritual, sociocultural, and environmental aspects of comfort, will contribute to a proactive, well diverse and articulated, and multifaceted approach to care. It clearly provides a framework for clinical practice guidelines, which state that the provision of holistic care oriented to comfort must be explicit and well- documented. In turn, the desirable outcome of comfort is related to engagement in HSBs that are important to patients, families, and the health care team and to better institutional outcomes which are important to administrators. Relief Mouth sores; Nausea and vomiting; Neuropathy; Diarrhea/Constipation Ease Transcendence

Physical

Comfortable resting position Patient resumes most which facilitates of her ADLs with all the sleep and side effects controlled relaxation to deter fatigue Actual need for Anticipation of reassurance and social stigma support from the towards baldness healthcare team and and skin problems significant others Deviation from aseptic technique and standard precaution; Lack of privacy Need for calm and positive atmosphere which strictly adheres to infection control guidelines; Need for privacy for personal hygienic routine care

Anxiety; Psychospiritual Alopecia; Radiation recall

Cold room; Patients Environmental were cohorted in a single room

Sociocultural

Absence of family

Failure of effective Need for familial

communication due to language barrier

support and reinforcement

Taxonomic Structure of Comfort Needs When nurses are committed to provide satisfyingly holistic comfort care, needs for relief, ease, and/or transcendence are identified routinely throughout the practice. Assessment could go back and forth to relief, ease, and transcendence until the main focus of health care will be identified and be addressed. However as the patients condition varies, it is essential that the nurse identify correctly which context that the patient and his familys concerns entails priority of comfort measures. When comfort needs are addressed in one context, total comfort is enhanced in the remaining contexts. Nurses are the mighty front liners in the health care institution. As active participants on strengthening and enhancing comfort of every patients, they engage themselves on activities to achieve and maintain a certain level of their optimal health. They tend to be the advocates of patients, leading them to be the patients first link to normalcy once they face a frightening or painful experience. Coaching and reassuring the clients towards recovery, safety, and rehabilitation, as health seeking behaviours (HSB). Health Seeking Behaviours are further related to desirable institutional outcomes such as decreased cost, improved family and nurse satisfaction, earlier discharge and low readmission rates. Comfort Interventions

Examples Assessment for development and complaints of the side effects of the chemotherapy (may use Comfort daisies, Comfort behavior, Checklist, etc.); Frequently check vitals and watch out for fever or signs of nosocomial infections Administer medications or treatments to relieve the side effects of chemotherapy

Agent

Standard Comfort

Nurse/Consultation with family and doctors

Coaching

Avoiding the word "pain" upon assessment, obtaining data, and rendering Doctors/Nurses Consultation with health teaching for a pediatric patient family Initiate patient and family

education as needed Practice guided imagery to eliminate factors that could increase physical discomfort Provide privacy as Marie is entering Nurse/Family pubescent stage when she will be concerned about her body image and privacy

Comfort Food for the Soul

Comfort interventions have three categories: (a) standard comfort interventions to maintain homeostasis and control pain; (b) coaching, to relieve anxiety, provide reassurance and information, in still hope, listen, and help plan for recovery; and (c) comfort food for the soul, those extra nice things that nurses do to make children/families feel cared for and strengthened, such as massage or guided imagery.