Empirical Evidence for the Nature of Holistic Comfort

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Journal of Holistic Nursing
http://jhn.sagepub.com/ Empirical Evidence for the Nature of Holistic Comfort Katharine Kolcaba and Richard Steiner J Holist Nurs 2000 18: 46 DOI: 10.1177/089801010001800106 The online version of this article can be found at: http://jhn.sagepub.com/content/18/1/46

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Empirical Evidence for the Nature of Holistic Comfort
Katharine Kolcaba, Ph.D., R.N.C. Richard Steiner, Ph.D., M.P.H. University of Akron
The nursing outcome of holistic comfort encompasses physical, psychospiritual, social, and environmental aspects of human nature. The primary purpose of this study was to test four propositions about the nature of comfort: (a) Comfort has equal proportions of state and trait characteristics; (b) comfort is sensitive to changes over time; (c) when subjects are exposed to an effective intervention, they demonstrate differences in comfort that increase in a linear way compared to a control group; and (d) the whole (total comfort) is greater than the sum of its parts (relief plus ease plus transcendence). A secondary purpose of this study was to present preliminary concurrent validity between two types of comfort instruments, a traditional questionnaire with a Likert-type format and visual analog scales. Findings were positive for all theoretical propositions and moderate concurrent validity between the Radiation Therapy Comfort Questionnaire and the visual analog scale for total comfort was demonstrated.

Valid measures of the effectiveness of holistic interventions are needed to improve nursing practice. With the increased interest in holistic interventions that target responses in the context of human experience (i.e., physical, psychospiritual, social, and environmental), holistic measures that are multidimensional and entail many interrelated parts are essential for understanding effects on an indivisible whole (Johnson, 1990; K. Kolcaba, 1992). For example, the goal AUTHORS’ NOTE: This research was supported in part by funding from the Alumni Association of the Frances Payne Bolton School of Nursing, the American Nurses Association Nurses’ Education Fund, and Sigma Theta Tau (Alpha Mu and Delta Omega Chapters). JOURNAL OF HOLISTIC NURSING, Vol. 18 No. 1, March 2000 46-62 © 2000 American Holistic Nurses’ Association


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of holistic interventions (e.g., guided imagery, massage therapy, and therapeutic touch) is that many desirable changes will be experienced simultaneously by recipients. These changes might include increased relaxation, positive thinking, well-being, and contentment. Such integrated changes may be temporary but are consistent with the complexity of human experience. To measure such complex outcomes with separate instruments is time and energy consuming and creates artificial partitioning of whole person responses. Comfort is a holistic state that captures many of the simultaneous and interrelated aspects of positive human experience (K. Kolcaba, 1992). In numerous clinical research settings, enhanced comfort is a desirable and meaningful outcome. In the examples of infertility, immobilization after cardiac catheterization, chronic obstructive pulmonary disease, and radiation therapy...
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