Jan 16, 2020 in Sociology

Concept Analysis of Comfort

Summary

The concept of comfort is crucial to the practice of nursing. Relieving discomfort and pain are considered crucial to good nursing practice.  As a result, nurses are evaluated based on their ability to make the patient mentally and physically comfortable. Currently, health practitioners are of the belief that they have a firm understanding of what it entails to be comfortable and how this state can be achieved for patients. Nevertheless, despite the exponential expansion of nursing knowledge base, no general consensus exists with regard to the concrete meaning of comfort. This paper performed a concept analysis of comfort with the aim of developing a clear understanding of the concept of comfort to facilitate its effective integration into nursing practice and help advance nursing knowledge. The concept of comfort appears to have a comprehensive description and well-developed primarily because of the immense attention from scholars. Nevertheless, a deeper examination into the concept points out inconsistent definitions, as is the case with the concept of comfort. The attributes of comfort identified in the paper include cultural resonance, spiritual sourcing, intra-personal resources, interpersonal communication, family involvement, and holistic intervention. Antecedents were also outlined, which included sense of personal control, trusting care givers, and receiving the required treatment. The consequences of comfort identified in the literature included absence of discomfort, satisfied patient needs, a higher sense of personal control, relief from harmful stimuli, a heightened sense of cultural integrity, lower sense of suffering in the patient, and a higher sense of being cared about and for.  There is no universal instrument for measuring the comfort. 

Concept Analysis of Comfort

Comfort is a fundamental value of nursing practice. Cutcliffe and McKenna points out that the historical significance of comfort in nursing can be traced back to the time of Florence Nightingale. Even in contemporary nursing, comfort remains an important concept in nursing, often used to denote a desirable consequence of care. From the moment of conception, individuals desire comfort, which is an essential need throughout one’s life. Comfort is also considered a crucial aspect of holistic nursing care. Although the concept of comfort is widely used in nursing literature, it lacks a consistent definition. To this end, this paper performs a concept analysis of comfort.

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Purpose of Analysis

The aim of this analysis is to develop a clear understanding of the concept of comfort to facilitate its effective integration into nursing practice. Also, a clear meaning and definition of comfort is required to facilitate the empirical use of the concept to help in advancing nursing knowledge. The process of concept analysis elucidated by Walker and Avant guided the analysis of the concept of comfort. Walker and Avant recommended performing a review of the literature to identify the attributes, consequences and antecedent of a concept. To this end, the attributes, antecedents and consequences, and model, similar and otherwise cases, and empirical methods of the concept of comfort are presented in this paper.

Uses of the Concepts

Possible Definitions

The word “comfort” comes from the Latin word comfortare, which means to ‘strengthen greatly.’ Comfort is viewed as a process, a dynamic, philosophy, a state, and sometimes even an outcome or a goal. In clinical care settings, comfort is instrumental since nurses emphasize optimizing the comfort of patients each day. In the literature, various authors suggest that comfort and its attributes are dynamic and change over time. This dynamic nature is primarily because of advancements witnessed in bio-psychosocial sciences and technology as well as the increasing perception that the patient is a consumer.

Since comfort is a dynamic concept, its historical perspective in nursing beneficial to its understanding. As of 1869, nursing was considered both a science and art although nursing as a science was not well defined and developed. Numerous forms of comfort were utilized in describing the art of nursing. For instance, Florence Nightingale stated that nursing was practiced not only for the sake of saving life and improving health but also enhancing comfort. Most of Nightingale’s publications emphasized the importance of nurses providing comfort to patients by constantly observing the patient with the aim of providing means to achieve the elusive state of comfort. Despite the advancement in nursing knowledge, a firm, precise definition of comfort is inexistent in nursing.

Possible Disciplines

Comfort has diverse uses including to offer protection, to provide, to cheer and sooth among others. Comfort takes many forms including a continuum, a process, a goal/outcome, an intervention, a condition, and s state. In the context of nursing, there are multiple opinions concerning the application of comfort. Although a firm definition of comfort is inexistent, one of the core attributes associated with human nature is the capacity to offer comfort. Cutcliffe and McKenna outlined six uses (meanings) associated with the word comfort based on numerous thesauruses and dictionaries. The first meaning of comfort is a “cause relief from discomfort and the state of discomfort”. In this respect, comfort should result in comfort as an effect (state). The second meaning of comfort is s state of peaceful contentment and ease. The state of comfort is characterized by the absence of conditions that contribute to discomfort such as suffering, trouble, pain, grief and worry. The third meaning of comfort is “relief from discomfort”. Cutcliffe and McKenna also pointed out that comfort denotes that which makes life pleasurable or easy. Comfort is also defined as sustenance or physical refreshment. Moreover, comfort denotes support incitement, encouragement, and strengthening.

Some scholars have argued that comfort is an instrumental principle in nursing and marks the desired aftermath of comforting. In this way, comfort is a goal of nursing. Numerous nursing associations such as the American Nurses Association, the Oncology Nursing Society and many others have conceptualized comfort as a “standard of care”. In nursing, comfort has also been linked to paying attention to the needs of the patient.

The concept of comfort has also been contrasted with the concept. In this way, comfort is perceived to exist on a continuum, with comfort on one end and discomfort on the other end. However, some authors have advanced this conceptualization to argue that the presence of comfort does not simply imply a complete absence of discomfort. Simply stated, a person can be comfortable while at the same time experience a certain level of discomfort.

From a phenomenological perspective, comfort denotes a state of embodiment that exceeds beyond awareness, and is realized after the patient moves from the state of discomfort. Comfort has also been referred to as stated of wellbeing regardless of the position of the patient in the health-illness continuum. In this way, comfort comes about as a result of therapeutic, purposeful nursing actions performed on behalf of the patient. 

Comfort is also perceived as a process. Also, the literature points out that the state of comfort is temporary; however, the duration of this temporary state is not yet clear. The concept of comfort has also been explored from a physiological perspective, which focuses the dimension of holism. Some sub-concepts associated with comfort include pain, vomiting, nausea and fatigue. 

Defining Attributes

Walker and Avant asserts that attributes play an instrumental role in differentiating a concept from other related concepts. From examining literature, a number of attributes were identified. The first attribute is cultural resonance. In this respect, comfort should be congruent with one cultural state, which means that a sense of belonging contributes to personal comfort. The second attribute is spiritual sourcing. This means that comfort can be achieved by connectedness to spiritual states such as peace of mind, meditation and prayer. The third attribute of comfort outlined in the literature is intra-personal resources, which implies that personal attributes contribute to comfort. Examples of such personal resources include independence, endurance, self-confidence, competency, sense of being useful, and being at pace with oneself. The fourth attribute is interpersonal communication. Thus, communication plays a crucial role in providing comfort. Other attributes of comfort outlined in the literature include family involvement and holistic intervention.

Case Studies

Case studies help to further explicate a concept. Case studies can be either conceived by the author or drawn from the literature. The author conceived the case studies presented in this paper.

Model Case

A model case illustrated all of the identified contributes associated with the concept. In the model case, Nanuk, a young Native American has succumbed to a head injury after a road accident. He has never been admitted in a hospital before. His head is hurting and the nurse has put him on some pain relievers. The nurse in charge of his care explains to his family everything he has done with respect to Nanuk’s climical care. Nanuk’s mother gently holds his hand in the hospital bed and assures him that the family is praying for his recovery. His mother also brought him food cooked from home. Nanuk feels warm and starts to sleep. His mother had invited a tribal religious leader to pray for his son’s recovery. In this case, it I evident that there are aspects associated with physical, spiritual, cultural, family, and emotional comfort in addition to clinical care.

Similar Case

A similar case denotes a scenario lacking some of the defining attributes. Based on the scenario above, assume that nurse administered treatment without inviting the family members. In such a case, family involvement and spiritual comfort will be lacking.

Otherwise Case

An otherwise case contradicts the model case and lacks all of the defining attributes. Assuming the scenario above, the nurse opts to administer treatment without any pain relievers and fails to involve the family members in the treatment plan.

Antecedents and Consequences

Antecedents denote prerequisite events for the occurrence of a concept. One antecedent of comfort include relinquishing some personal responsibility to caregivers and believing in their competence as well as ability to offer the needed comfort. Other antecedents include receiving the required treatment, support and intervention to ensure normal physical, emotional and mental functioning. Controlling symptoms and a sense of personal control are also antecedents of comfort.

Consequences denote the outcomes that follow the occurrence of a concept. Consequences are observed because of the changes in the state of comfort. The consequences identified in the literature include the absence of characteristics associated with discomfort. Other consequences include satisfied patient needs, a higher sense of personal control, relief from harmful stimuli, a heightened sense of cultural integrity, lower sense of suffering in the patient, and a higher sense of being cared about and for.

Empirical Methods

A number of measurement instruments used for measuring comfort empirically. They include end-of-life (EOL) comfort questionnaire, General Comfort Questionnaire, Comfortable Dying Measure, and Radiation Therapy Comfort Questionnaire. It is evident that there is no universal empirical method for measuring comfort; instead, the various subfields in nursing have developed their own instruments for measuring patient comfort.

Conclusion

The concept of comfort lacks a precise, universal definition and understanding in healthcare. A consensus is yet to be reached as to whether comfort is a process or an outcome (product). Moreover, the dichotomy between comfort and discomfort is an issue that requires further clarification. The concept of comfort has numerous defining attributes such as cultural resonance, spiritual sourcing, intra-personal resources, interpersonal communication, family involvement, and holistic intervention. Future efforts should focus on developing a universal tool for measuring comfort among patients.

 

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