Comfort as a need of the older adults in emergency departments: a scoping review.

backgroundPopulation ageing has changed the profile of emergency departments worldwide, making it essential to thoroughly understand the needs of geriatric patients who experience acute episodes.

objectiveThe present study aimed at mapping the older adults’s comfort needs in emergency departments, during acute episodes, to improve the provided care.

methodsWe conducted a scoping review following the Joanna Briggs Institute methodology. The main search was performed in the CINAHL Complete, PubMed, Scopus, and RCAAP databases. Articles were screened based on eligibility criteria and analysed by two independent reviewers, who selected titles, abstracts, and full texts with the support of automated tools. Only studies addressing the comfort needs of geriatric patients during acute episodes in emergency departments were included.

resultsSix studies published between 2009 and 2023 were included in this review, predominantly originating from Brazil, Australia, and the United States. The sample comprised four exploratory studies and two literature reviews, complemented by a prospective observational study, a qualitative focus group study, and a study employing a standardised methodological approach — all addressing the proposed theme. Findings show increasing concern with addressing older adults’ comfort needs in emergency care. Discomfort was mainly related to pain, anxiety, overstimulation, lack of privacy, and poor communication. Based on Kolcaba’s framework, comfort needs span physical, psychospiritual, sociocultural, and environmental dimensions, with two additional domains — decision-making and organizational comfort — emerging in emergency contexts. Effective communication and shared decision-making were central to promoting comfort. Nursing interventions focusing on communication strategies, empathetic care, and environmental adaptations enhanced safety, dignity, and overall well-being. These results highlight the need to integrate comfort-focused approaches into nursing education, clinical practice, and health policies.

conclusionsIn the context under study, the older adults’s comfort needs are directly related to the absence of relief, tranquillity, and transcendence, caused by acute illness and the environment’s specific characteristics. This has a considerable impact on the older adults’s comfort levels, significantly reducing them in the studied circumstances. REGISTRATION: This review’s protocol was published in the Open Science Framework Registries ( https://doi.org/10.17605/OSF.IO/8W2D5 ).