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The COMFORT Initiative: Palliative Nursing and the Centrality of Communication

Wittenberg-Lyles, Elaine PhD; Goldsmith, Joy PhD; Ragan, Sandra L. PhD

Journal of Hospice & Palliative Nursing: September-October 2010 - Volume 12 - Issue 5 - p 282-292
doi: 10.1097/NJH.0b013e3181ebb45e

Little attention has been paid to the specific communication training needs of nurses in palliative care. A narrative-based approach to communication, or narrative nursing, is proposed as a framework for developing holistic communication preparation for nurses. Building on clinical and nonclinical research in hospice, palliative care, and medical education settings, the authors present the COMFORT initiative as an outline of the tenets of narrative nursing. COMFORT is an acronym for communication, orientation and opportunity, mindfulness, family, oversight, reiterative and radically adaptive messages, and team. Explication of each concept is provided alongside a case study vignette that details communication properties at work. Integration of the COMFORT initiative into nursing education is proposed.

Author Affiliations: Elaine Wittenberg-Lyles, PhD, is Associate Professor, Department of Communication Studies, University of North Texas, Denton.

Joy Goldsmith, PhD, is Associate Professor, Department of Communication Studies, Young Harris College, Young Harris, GA.

Sandra L. Ragan, PhD, is Emerita Professor, Department of Communication, University of Oklahoma, Norman.

This article was compiled from information from a number of chapters in a book entitled, Dying With Comfort: Family Illness Narratives and Early Palliative Care (Wittenberg-Lyles, Goldsmith, Ragan, Sanchez-Reilly; in press).

Address correspondence to Elaine Wittenberg-Lyles, PhD, Department of Communication Studies, University of North Texas, 1155 Union Cir #305268, Denton, TX 76203-5268 (

The authors declare no conflict of interest.

© 2010 The Hospice and Palliative Nurses Association