Wensley Cynthia, Botti Mari, McKillop Ann, Merry Alan F
School of Nursing and Midwifery, Deakin University, 221 Burwood Highway, Burwood, VIC 3125, Australia.
School of Nursing and Midwifery, Deakin University, Epworth Deakin Centre for Clinical Nursing Research, 221 Burwood Highway, Burwood, VIC 3125, Australia.
Int J Qual Health Care. 2017 Apr 1;29(2):151-162. doi: 10.1093/intqhc/mzw158.
Comfort is central to patient experience but the concept of comfort is poorly defined. This review aims to develop a framework representing patients' complex perspective of comfort to inform practice and guide initiatives to improve the quality of healthcare.
CINAHL, MEDLINE Complete, PsycINFO and Google Scholar (November 2016); reference lists of included publications.
Qualitative and theoretical studies advancing knowledge about the concept of comfort in healthcare settings. Studies rated for methodological quality and relevance to patients' perspectives.
Data on design, methods, features of the concept of comfort, influences on patients' comfort. Data were systematically coded and categorized using Framework method.
Sixty-two studies (14 theoretical and 48 qualitative) were included. Qualitative studies explored patient and staff perspectives in varying healthcare settings including hospice, emergency departments, paediatric, medical and surgical wards and residential care for the elderly. From patients' perspective, comfort is multidimensional, characterized by relief from physical discomfort and feeling positive and strengthened in one's ability to cope with the challenges of illness, injury and disability. Different factors are important to different individuals. We identified 10 areas of influence within four interrelated levels: patients' use of self-comforting strategies; family presence; staff actions and behaviours; and environmental factors.
Our data provide new insights into the nature of comfort as a highly personal and contextual experience influenced in different individuals by different factors that we have classified into a framework to guide practice and quality improvement initiatives.
舒适是患者体验的核心，但舒适的概念定义模糊。本综述旨在构建一个框架，以呈现患者对舒适的复杂观点，为实践提供参考，并指导改善医疗质量的举措。
CINAHL、MEDLINE Complete、PsycINFO和谷歌学术（2016年11月）；纳入出版物的参考文献列表。
推进对医疗环境中舒适概念认识的定性和理论研究。根据方法学质量和与患者观点的相关性对研究进行评级。
关于设计、方法、舒适概念的特征、对患者舒适的影响的数据。使用框架法对数据进行系统编码和分类。
纳入62项研究（14项理论研究和48项定性研究）。定性研究探讨了不同医疗环境（包括临终关怀机构、急诊科、儿科、内科和外科病房以及老年护理机构）中患者和工作人员的观点。从患者的角度来看，舒适是多维度的，其特征是身体不适得到缓解，并且在应对疾病、损伤和残疾挑战的能力方面感到积极和增强。不同的因素对不同的个体很重要。我们在四个相互关联的层面上确定了10个影响领域：患者自我安慰策略的运用；家人陪伴；工作人员的行动和行为；以及环境因素。
我们的数据为舒适的本质提供了新的见解，即舒适是一种高度个性化和情境化的体验，在不同个体中受到不同因素的影响，我们已将这些因素分类到一个框架中，以指导实践和质量改进举措。
