Introduction

Below are the definitions of the major concepts in the theory, which correlate with the diagram above.

Health Care Needs are those identified by the patient/family in a particular practice setting.

Intervening Variables are those factors that are not likely to change and over which providers have little control (such as prognosis, financial situation, extent of social support, etc).

Comfort is an immediate desirable outcome of nursing care, according to Comfort Theory. Additionally, when comfort interventions are delivered consistently over time, they are correlated with a trend toward increased comfort levels over time (the first part of Coomfort Theory), with desired health seeking behaviors (HSBs), and with improved institutional outcomes.

Health Seeking Behavior (HSBs): The concept of HSBs was first introduced by Scholtfeldt (1975). HSBs can be internal (healing, immune function, number of T cells, etc.), external (health related activities, functional outcomes, etc.), or a peaceful death. The relationships between comfort and health seeking behaviors are entailed in the second part of Kolcaba's comfort theory.

Institutional Integrity (InI) is defined by Kolcaba (2007) as the values, financial stability, and wholeness of health care organizations at local, regional, state, and national levels. In addition to hospital systems, the definition of “institutions” includes Public Health agencies, Medicare and Medicaid programs, Home Care agencies, Nursing Home consortiums, etc. Examples of variables related to this expanded definition of InI include patient satisfaction (HCHAPS scores!), cost savings, improved access, decreased morbidity rates, decreased hospitalizations and readmissions, improved health-related outcomes, efficiency of services and billing, and positive cost-benefit ratios. Relationships between Comfort, HSBs, and InI constitute the third part of the theory.

Tests of the theory can be on the first part, the second part, the third part, or the whole theory (article). In addtion, nurse comfort has been addressed by Comfort Theory (2003). Much excitement has been generated by linking nurse comfort (or nurse satisfaction) to increased patient comfort and to HCHAPS scores, after an institution adopts CT as its model of care.

Best Policies are protocols and procedures developed by an institution for overall use after collecting evidence.

Best Practices are those protocols and procedures developed by an institution for specific patient/family applications (or types of patients) after collecting evidence.