Essay Kolcaba

Applying The Theory Of Comfort In Nursing Practice

Nursing practice can be complex due to the fact that people in general can be vastly different in their wants, needs, and expectations. However, one thing that has been found to be true amongst people is their desire for comfort. One middle-range theory that is essential in nursing practice today is the theory of comfort. This theory emphasizes the importance of comfort within the health care setting. Comfort increases the overall experience of the patient and their family, it increases their ability to heal and cooperate, and it also positively impacts health care and medical facilities. This research shows how the theory of comfort needs to be implemented across all medical fields, especially nursing, if professionals want to provide the highest quality of care for their patients.
Kolcaba (2001) states that nursing is the process of observing and determining the comfort needs of patients. Assessment may be objective based solely on observation or subjective based on asking the patient whether or not they are comfortable. The nurse is expected to create and execute appropriate nursing interventions as well as evaluate the patient’s comfort after the interventions. The research believes this is crucial in health care settings when first coming in contact with a patient. People are constantly looking for comfort both within and outside of health care. Being in a situation that can be confusing, overwhelming, painful, or scary only increases the necessity for comfort. Drouin, Kolcaba, and Tilton (2006) further support this notion when doing research on examples of poor quality of care of a group of patients. Such examples included patient and family complaints, skin breakdown, medication errors, injuries, and secondary complications to what they originally entered the medical facility for. From these issues the researchers developed goals to increase the experience people had within health care. The goals were as follows; expand comfort to increase the satisfaction of patients, include comfort in education material given to patient and their family, develop unit-based research within the framework of comfort by distributing questionnaires, improve patient and family access to health care informational material, revise criteria to focus on enhancing comfort, introduce pet therapy and therapy garden, implement a patient-focused model for decision making, help patient and their family navigate the health care system, and discharge by appointment. All of the goals listed strive to bring comfort to patients. The research believes this is necessary for positive patient outcomes.
Wright (2011) expresses how knowledge can also provide comfort to people in medical settings by explaining that people had increased levels of comfort when they were in well-known areas and participating in procedures they were familiar with. One of the issues within the medical field is people are not familiar with what they are experiencing. Confusion and lack of control can...

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Kolcaba's Theory of Comfort

Kolcaba's Theory of Comfort was first developed in the 1990s. It is a middle-range theory for health practice, education, and research. This theory has the potential to place comfort in the forefront of healthcare. According to the model, comfort is an immediate desirable outcome of nursing care.

The Theory of Comfort was developed when Katharine Kolcaba conducted a concept analysis of comfort that examined literature from several disciplines, including nursing, medicine, psychology, psychiatry, ergonomics, and English. After the three forms of comfort and four contexts of holistic human experience were introduced, a taxonomic structure was created to guide for the assessment, measurement, and evaluation of patient comfort. According to Kolcaba, comfort is the product of holistic nursing art.

Kolcaba described comfort existing in three forms: relief, ease, and transcendence. If specific comfort needs of a patient are met, the patient experiences comfort in the sense of relief. For example, a patient who receives pain medication in post-operative care is receiving relief comfort. Ease addresses comfort in a state of contentment. For example, the patient's anxieties are calmed. Transcendence is described as a state of comfort in which patients are able to rise above their challenges. The four contexts in which patient comfort can occur are: physical, psychospiritual, environmental, and sociocultural.

The Theory of Comfort considers patients to be individuals, families, institutions, or communities in need of health care. The environment is any aspect of the patient, family, or institutional surroundings that can be manipulated by a nurse or loved one in order to enhance comfort. Health is considered to be optimal functioning in the patient, as defined by the patient, group, family, or community.

In the model, nursing is described as the process of assessing the patient's comfort needs, developing and implementing appropriate nursing care plans, and evaluating the patient's comfort after the care plans have been carried out. Nursing includes the intentional assessment of comfort needs, the design of comfort measures to address those needs, and the reassessment of comfort levels after implementation. Assessment can be objective, such as the observation of wound healing, or subjective, such as asking the patient if he or she is comfortable.

Kolcaba includes definitions of key elements of her nursing theory, as well. Health care needs are defined as those needs identified by the patient and/or family in a particular nursing practice setting. Intervening variables are factors that are not likely to change, and over which health care providers have little control. These variables include prognosis, financial situation, social support, and others. Health-seeking behaviors are the behaviors of a patient in an effort to find health. Institutional integrity is the value, financial stability, and wholeness of health care organizations at the local, regional, state, and national levels. Finally, best policies are protocols and procedures developed by an institution for overall use after the collection of evidence.

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