The four nursing metaparadigms of person, environment, health, and nursing are widely regarded as encompassing the four most relevant aspects of nursing. A case can be made for caring as a nursing metaparadigm, however, as it embodies one of the most important characteristics of effective nursing. Caring is regarded as "the essence of nursing...that...enhances patients' health and well-being and facilitates health promotion" (Khademian & Vizeshfar, 2008, p. 456). Caring is experienced by the patient as concern, nurturing, and a sense that the nurse recognizes and remembers things about the patient (Radwin & Fawcett, 2002, p. 359). As such, caring is a legitimate and often overlooked component of nursing care.
One manifestation of caring is that the patient feels comforted by nursing. Malinowski and Stamler (2002, p. 599) contend that "Comfort remains a substantive need throughout life and, as such, should be considered an indispensable constituent of holistic nursing care." Moreover, even "prestigious and influential leaders such as Florence Nightingale (1969)" have asserted the need for comfort "as a component of quality nursing care" (Malinowski & Stamler, 2002, p. 599). Caring and comfort are closely related in nursing, with the nurse's caring attitude being the motivation for her to provide the kind of care that results in the patient's comfort.
Nursing theorists also support the importance of caring and comfort in nursing. Gropper
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