Evolution of the Mid Range Theory of Comfort for Outcomes Research
Katharine Kolcaba, PhD, RN, C

The developmental stages of the mid range theory of comfort are discussed in this article, which includes its philosophic orientation and its inductive, deductive, and retroductive reasoning. Other steps that are described are the concept analysis of comfort, the operationalization of the outcome of patient comfort, the application of the theory in previous nursing studies, and the evaluation of the current theory as it has been adapted for outcomes research. This article is a guide that shows how a concept grows, becomes embedded in theory, is tested, and is adapted for the rapidly changing health care environment. The theory of comfort
This premise was recently added to the theory of comfort through retroduction, after induction and deduction.

Nurses can and should manipulate surrounding environmental features such as noise, furniture, and ambiance to enhance patient comfort.
Whole person holism5 is at the core of the theory of comfort. This perspective holds that persons are in and surrounded by their environment. Nurses can and should manipulate surrounding environmental features such as noise, furniture, and ambiance to enhance patient comfort. This view is congruent with Nightingale’s6 view of the environment as an element that can aid healing and the restoration of health. Persons possess their own energy fields as do nurses. Comfort theory can accommodate the blending of these energy fields during therapeutic interactions.
AN ENVIRONMENTAL FRAMEWORK: THE INDUCTIVE STAGE Induction is a form of logical reasoning in which generalization is induced from a number of specific observed instances.7 When nurses are earnest about their practice and are earnest about nursing as a discipline, they become familiar with implicit or explicit concepts, terms, propositions, and assumptions that underpin their practice. When nurses are in graduate school, they may be asked to diagram