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1. MN 502 Nova Southeastern University Katherine Kolcaba Comfort Theory
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HERE FOR ORIGINAL, PLAGIARISM-FREE PAPERS ON MN 502 Nova Southeastern
University Katherine Kolcaba Comfort Theory EssayFor this assignment select a middle
range theory ( Kolcaba comfort theory). Using this theory, develop a paper that includes
scholarly the following criteria and format:Middle Range Theory: Name of the
Theory Introduction to the paper with purpose statement – Include an overview about
middle range theories in general, name theory this paper evaluates, and state the purpose of
the paperDefinition and Purpose of the Theory Define the middle range theory and the
purpose of the selected middle range theory.Theory definitionUsing the text as benchmark,
explain the major concepts and propositions of the theoryMN 502 Nova Southeastern
University Katherine Kolcaba Comfort Theory EssayTheory purposeUsing the text as
benchmark, explain the purpose of the middle range theoryNursing MetaparadigmDefine
and discuss the nursing metaparadigm within the context of the selected middle range
theory.PersonUsing the text as benchmark, explain if and how the theorist defines and
operationalizes the conceptHealthUsing the text as benchmark, explain if and how the
theorist defines and operationalizes the conceptEnvironmentUsing the text as benchmark,
explain if and how the theorist defines and operationalizes the conceptNurseUsing the text
as benchmark, explain if and how the theorist defines and operationalizes the
concept:Application of the Theory to practiceExplain the importance of the selected middle
range theory in nursing practice.Model case 1Demonstrate an example from the literature
or from practice experience where the theory is applicable and useful. Model case
2Demonstrate an example from the literature or from practice experience where the theory
is applicable and useful.Conclusion Summarize the meaning, usefulness, and applicability of
the theory to nursing The scholarly paper should be 4-5 pages excluding the title and
reference pages.Include level 1 and level 2 headings.The paper should begin with an
introductory paragraph that includes the purpose statement. The introductory paragraph
and purpose statement allow the reader to understand what the paper/assignment is going
to address.The paper should include a conclusion.Write the paper in third person, not first
person (meaning do not use ‘we’ or ‘I’).Include a minimum of three references from
professional peer-reviewed nursing journals (review in Ulrich Periodical Directory) to
support the paper. ***Historical references may be used as appropriate. (Definition of

2. historical reference: reference to a well-known person, place event or literary work that
adds meaning to the paper.) Use the references on the attachments.APA format is required
(attention to spelling/grammar, a title page, a reference page, and in-text citations).MN 502
Nova Southeastern University Katherine Kolcaba Comfort Theory
Essay attachment_1attachment_2attachment_3Unformatted Attachment PreviewA Novel
Theory for Nursing Education Holistic Comfort Journal of Holistic Nursing Volume 25
Number 4 December 2007 278-285 © 2007 American Holistic Nurses Association
10.1177/0898010107306199 http://jhn.sagepub.com hosted at http://online.sagepub.com
Miki Goodwin, MS, RN, PHN India Sener, MS, RN Susan H. Steiner, PhD, RNC, FNP Idaho State
University This article discusses how aspects of a holistic comfort theory were adapted to
create a taxonomic structure to apply its concepts to a fast-track nursing education
program. The principles of learner-centered education were combined with comfort theory
to develop strategies that appear to have produced positive influences on the attributes and
contexts of comfort within the learning community. With emphasis on balanced academic
exposure to the art of comfort as well as the rigorous science of nursing, students and
teachers developed a mutually rewarding learning partnership. The resulting grid, adapted
from Kolcaba’s taxonomic structure, exposes educators and students to the application of
holistic comfort theory. It is anticipated that this adaptation may assist students to
transform into professional nurses who are comfortable and comforting in their roles and
who are committed to the goal of lifelong learning. Keywords: holistic comfort theory;
learner-centered learning; taxonomic structure; curriculum Background and Literature
Review Nursing practice and research have long been influenced by theories related to
comfort and holism. However, there is a paucity of literature to suggest that a theory of
holistic comfort, exemplified by Kolcaba (2003), MN 502 Nova Southeastern University
Katherine Kolcaba Comfort Theory Essayhas been extended to nursing education. This
article examines how an adaptation of holistic comfort theory was designed and introduced
into a fast-track nursing education program in a western state university. Since Florence
Nightingale first opened a window in a sick room to admit air and light, nursing has been
described as both a science and an art. However, as nursing has continued to refine its
definition into the postmodern world, considerable emphasis has been placed in nursing
education on the science of nursing practice and research (Johnson, 1994). Such emphasis
has been necessary to establish nursing as a bona fide profession in its own right (McEwen
& Wills, 2002). Nurses have learned to memorize vast amounts of information, perform
complex skills, operate elaborate equipment, conduct intricate research studies, and
educate students to learn and master such information and skills at an ever-increasing
escalation. This highly complex and specialized profession may exact a sacrifice of the
holism and comfort 278 traditionally inherent to nursing practice in the process of nursing
education (Dossey, Keegan, & Guzzetta, 2005). Historically, nursing education has been
driven by the idea that information must be transmitted from expert to novice (Benner,
1984) whether in the formal classroom or in the clinical setting. Often this has created fear
and trembling in the novice and a reputation for the nurse expert as one who eats her
young! There can be no possibility of comfort in such an encounter, and where there is no
comfort, there is no real learning (Weimer, 2002). True learning implies an assimilation of

3. information and experience into one’s being; in the absence of real learning, information is
gathered only for the sake of reproduction, and experience is something that needs to be
acquired as quickly as possible. When a learner is comfortable, he or she is more likely to
linger in the learning experience. In such an encounter, the novice is transformed into a
learner and the nurse authority is transformed into an educator—a relationship that can
best be described as a learning partnership—an active and conscious awareness and
intention on the part of student and teacher (Applebaum, 2000). Like Nightingale, it takes a
certain courage and detachment from the norm (Hooks, 1994) to open the window and let
in the fresh air and light. After all, the Goodwin et al. / A Novel Theory for Nursing
Education wind might be blowing and the light might be strong, two frequent precursors to
change. The change in nursing education must include a shift from teachercentered to
learner-centered education (Weimer, 2002). This shift encourages students to acquire an
appreciation for the education they have embarked on and to assume responsibility and
accountability for that education, whereas the teacher assumes the role of guide, agent of
change, collaborator, and model of nursing excellence. This is the opposite of the more
familiar teacher-centered approach whereby the teacher maintains a lofty and authoritarian
stance, and the student receives the transmitted knowledge with fearful or diffident
passivity. How, then, can nursing education be delivered holistically to fuse its defining
science and art, while maintaining the comfort and intellectual inquiry of the process? This
question was the impetus for designing a project to introduce holistic comfort theory into
the nursing education program of a western state university. Holistic comfort was
addressed in the context of educating nursing students while maintaining highlearning
standards, the value of excellence, and the diminishment of fear (Hooks, 1994). The aim was
to integrate the Standards of Holistic Nursing Practice, established by the American Holistic
Nurses’ Association (1998), into nursing education (as cited in Dossey et al., 2005) while
ensuring the possibility that future nurses might acquire the necessary confidence and
competence to explore, inquire, and practice nursing for the benefit of society as a whole.
MN 502 Nova Southeastern University Katherine Kolcaba Comfort Theory EssayIn an
educational setting of air and light, learning may no longer be accomplished in the stale air
of darkness. Rather, learning may become a living thing, where teaching and learning are
reciprocal. Both educator and learner are relieved of traditional roles as both are eased into
a learning partnership that transcends the old relationship between student and teacher.
Relief, ease, and transcendence comprise the attributes of holistic comfort and may have
significant impact on physical, psychospiritual, social, and environmental contexts (Kolcaba,
2003). These attributes also have the potential to affect the learning experience of both
educator and learner. It was the premise of this project that meaningful nursing education
requires an opening of the window inviting new approaches that serve to promote holistic
comfort theory in education. Theoretical Perspectives Holism (from the Greek Holos, whole)
is the concept in which the existence of wholes is a fundamental 279 feature (Society for
General Systems Research, 2004). Chinn and Kramer (2004) describe a concept as “a
complex mental formulation of experience” explaining that “experience” refers to “the
totality of what is perceived.” This is precisely what the concept of holism purports to be
because it is based on the principle of looking at the whole, such as an individual or

4. community, which cannot be reduced to the sum of its parts (Dossey et al., 2005).
Nightingale is viewed as the “founder of modern nursing education” and was “the first to
mention ‘holism’ . . . in nursing and the first to clearly state that a unique body of knowledge
was required of those wishing to practice professional nursing” (Futch, 1993, p. 10). Today
holism in nursing is often conceptualized as caring for body, mind, and spirit interacting
within an environment. One theory that pertains specifically to holistic comfort is that of
Kolcaba (2003), on which this project in nursing education was largely based. Kolcaba can
be considered the pioneer in the field of holistic comfort. Over the past decade, she has been
developing her theory of holistic comfort in nursing practice and research. Kolcaba defines
holistic comfort as “the immediate experience of being strengthened by having [one’s]
needs for relief, ease, and transcendence met in four contexts (physical, psychospiritual,
sociocultural and environmental)” (Kolcaba, 2003, pp. 251252). Relief is defined by Kolcaba
(2003) as “the experience of a patient who has had a specific comfort need met” (p. 258).
Ease is defined as “a state of calm or contentment” (p. 253). Transcendence is defined as
“the state in which one rises above problems or pain” (p. 259). Kolcaba and DiMarco (2005)
later modified the definition of transcendence as the state in which one can rise above
perceived difficulties that cannot be “eradicated or avoided.” To clarify her theory, Kolcaba
developed a taxonomic structure of comfort in nursing practice as it applies to
patients/clients (Kolcaba, 1991). The components of the structure, which form a grid, are
the three attributes of comfort: relief, ease, and transcendence, and the four contexts in
which they occur: physical, psychospiritual, environmental, and sociocultural. The grid
provides a method to look objectively at the attributes and contexts of holistic comfort and
identifies areas that may need to be addressed. Building on Kolcaba and DiMarco’s (2005)
adaptation of Kolcaba’s grid, the four contexts of comfort can be expanded to explore the
comfort of students in the academic setting (see Table 1). The physical context relates to
bodily reactions to the requirements and demands of nursing education. The
psychospiritual 280 Journal of Holistic Nursing Table 1 Adaptation of Kolcaba and
DiMarco’s (2005) Taxonomic Structure to Learner Experiences Context Student Problem
Relief Physical Headache, nausea, upset stomach, sweaty palms, and shortness of breath
Psychospiritual Anxiety, fear, frustration, anger, and depression Faculty models and
encourages self-care such as adequate nutrition, sleep, fluids, and class preparation Faculty
encourages and exhibits positive attitude and calm approach Environmental Noisy, poor
lighting, temperature fluctuations, seating configuration, and visual and auditory
considerations Sense of diffidence and isolation related to background differences
Sociocultural Ease Transcendence Faculty provides clear expectations and advanced notice
for class preparation Learners able to attend and participate in learning even if
experiencing some physical discomfort Faculty awareness of importance of the setting in an
effective learning environment Faculty mitigates uncertainties about learners’ abilities to
meet learning expectations Faculty willingness to adapt the setting to promote an optimal
learning interaction Learners experience reassurance through faculty mentoring, coaching,
and a positive approach to learning Learners adapt to the setting and experience the
realization of learning under current conditions Faculty awareness of transcultural and
demographic influences in the learning environment Faculty models sensitivity through

5. tone of voice, attitude, body language, and nonjudgmental approach Learners feel a sense of
acceptance and are willing to risk exposure in learning encounters with faculty and peers
context may be the student’s self-awareness or insights in areas such as self-esteem,
outlook, personal meaning of the learning experience, and a relationship to something or
someone greater than oneself. Comfort in the environmental context refers to the setting in
which learning occurs and includes considerations such as space, seating, light, air,
furniture, landscape, and color. Finally, the sociocultural aspect of learning relates to
cultural, traditional, and spiritual or religious issues, as well as interpersonal relationships
between the student and faculty, support staff, peers, family members, and friends (Weimer,
2002). MN 502 Nova Southeastern University Katherine Kolcaba Comfort Theory
EssayKolcaba views comfort as a holistic outcome (Kolcaba, 1992) based on certain
assumptions that include the idea that human beings are holistic entities having holistic
responses and that they attempt to have their needs for comfort met. Although it is clear
from her work that the primary focus of holistic comfort has been related to nursing
practice and research, her theory can be readily extrapolated to nursing education. Kolcaba
herself has discussed the fact that nursing as a whole requires a theoretical framework “that
students and experienced nurses can integrate into their practices” (Kolcaba, 1995a, p.
117). It therefore became clear that using such a framework was an integral part of the
development of this project to make holistic comfort theory meaningful to students and
faculty. By expanding Kolcaba and DiMarco’s (2005) grid to nursing education, the authors
identified components of holistic comfort that may be implicit in learner-centered
education. The use of such a grid invites learners and educators to commit to exploring new
methods of teaching and learning from one another. Although it is clear that learner-
centered education is based on a learning partnership between student and educator, it
should be stressed that what results from this approach is a true learning community in
which the individual student learns in the context of the student–teacher collective. In this
sense, the comfort of the learning community as a whole contributes to the comfort of the
individual student. Assets derived from this learning community include a commitment to
learning, support, positive values, experiential competencies, resiliency, empowerment,
empathy, and positive relationships. The comfort of the individual student is thereby
strengthened by the comfort of the learning community; the student who experiences
comfort in the context of learning contributes to the strength of the community as a whole
(Magyary, 2002). The adaptation of Kolcaba’s holistic comfort theory (2003) naturally
supports a teaching philosophy that ensures holistic comfort. In many ways, physical and
environmental comfort go hand-in-hand in the academic setting; they encompass such
issues Goodwin et al. / A Novel Theory for Nursing Education as attention to the classroom
atmosphere and configuration, as well as making provision for students to have adequate
breaks for meals and attention to their own personal needs. To provide psychospiritual
comfort to students, teachers need to strive to instill confidence, motivation, and trust to
assist them to “rise above” the fears and anxieties experienced in nursing education.
Sociocultural comfort occurs when educators are culturally sensitive in voice and body
language when expressing reassurance, support, and understanding; caring is
demonstrated by respect for individual differences in culture and tradition. Educators can

6. provide comfort in these areas to students through modeling, coaching, mentoring,
listening, and reassuring (Kolcaba & DiMarco, 2005), which are all aspects of learner-
centered teaching. This project was designed to create a learning partnership that
addresses the three attributes in their contexts throughout the nursing curriculum.
Examples of how the holistic comfort theory (Kolcaba, 2003) may be introduced into
nursing education are many. For instance, by establishing a teaching–learning partnership,
a holistically comfortable learning environment may be established that is of benefit to both
educator and learner. Educators may be encouraged to explore new teaching strategies that
invite learners to take responsibility and be accountable for much of their own learning.
This supports the goal of fostering professional nurses who are empowered and committed
to lifelong learning (Weimer, 2002). MN 502 Nova Southeastern University Katherine
Kolcaba Comfort Theory EssayIn this environment, students may experience the relief of
knowing they share responsibility and accountability for many of their own learning
experiences. Fear, anxiety, and potential hostility may be eased in an atmosphere that
promotes collaboration and competency rather than competition and censure. Students
may have the opportunity to transcend traditional views of nursing education as they learn
what it is to feel comfortable, confident, and empowered in their education. It can be
predicted that these changes in the learning environment may have meaningful impact on
the physical, psychospiritual, and sociocultural well-being not only of students but also
educators as well. Implementation Population The specific population served in this project
comprised 40 learners in a fast-track nursing program. The learners and educators included
a wide array of 281 persons in terms of age, gender, marital status, race, culture, and
religious/spiritual affiliation. The groups possessed wide variation in experience as learners
in the context of nursing education. As required by the fast-track program, the students had
previous baccalaureate degrees in diverse areas such as computer science, psychology,
anthropology, veterinary medicine, and law. Some students had previous experience in the
health care field while many had not. Objectives for Learning Activities A wide variety of
learning objectives was identified, including introduction of the philosophy and theory of
holistic comfort in nursing education; exploration of the general concept of holistic comfort,
including identification of the attributes of comfort in their various contexts; elucidation of
the interpretations and the significance of holistic comfort in nursing education and
practice; identification of the methods necessary to incorporate holistic comfort in nursing
education to sustain the values and philosophy of the nursing program; and identification of
ways to incorporate holistic comfort in nursing practice. Learning Outcomes Learning
outcomes were developed to ensure that learners would develop an awareness and
appreciation of holistic comfort in nursing education and be able to discuss their
understanding of holistic comfort theory; learners would be able to identify the attributes of
relief, ease, and transcendence as they occur in the physical, psychospiritual, environmental,
and sociocultural contexts of nursing education; learners would be able to reflect on and
discuss how the elements of holistic comfort experienced in nursing education may inform
their practice, having the potential to affect patient care and outcomes, as well as benefit
“institutions where a culture of comfort is valued” (Kolcaba & DiMarco, 2005, p. 187).
Billings and Halstead (2004) recommend that learning experiences be emotionally

7. satisfying, yet challenging, and geared to promote cognitive and affective development as
students progress through the educational program. For nursing students, it is important to
facilitate cognitive development through acquisition and implementation of critical
thinking, technical competency skills, and intellectual inquiry. Of equal importance is
affective development that is fostered through such transformative activities as storytelling,
reflective journaling, and role modeling. MN 502 Nova Southeastern University Katherine
Kolcaba Comfort Theory EssayThis integrated approach promotes the essential balance 282
Journal of Holistic Nursing between the art and science of nursing education and practice.
Learning Activities Although much of the theory information and some of the activities were
generic, lesson plans were tailored to “fit” the specific learner level and circumstances of
first-year and senior students. Preclass assignments were specific to class level and
included reading assignments and online discussion in preparation for classroom
interaction. Generic activities included “icebreakers” and a brief overview of the principles
of learner-centered teaching and a PowerPoint presentation related to holistic comfort
theory in nursing education. One generic activity involved construction of comfort catchers
(an adaptation of the so-called “cootie catcher”) that allowed students to individually
“capture” the attributes and contexts of holistic comfort in personal meaning. Interaction
with the comfort catchers helped to create a comfort culture within the classroom. Another
generic class activity was creation of ..MN 502 Nova Southeastern University Katherine
Kolcaba Comfort Theory Essay