Comfort Care For Nursing As A Philosophy Of Health Care

Caring Hospice is a company that will provide nursing care to patients that are terminally ill. The ultimate goal is to insure the patient is kept as comfortable as possible while maintaining dignity during the dying process. This company will send registered nurses to the patient’s home for routine physical assessments, medication teaching and administration, education about terminal diseases and the dying process. The nursing staff will also create and maintain appropriate plans of care for the multi-disciplinary team to provide holistic care to the patient.

The concepts of the comfort theory are clearly defined and the relationships are easily understood. This theory is simple and basic to nursing care. The taxonomic structure of comfort facilitates researchers’ development of comfort instruments for new settings (Kolcaba,1991).The first assertion of the theory stating that effective comfort interventions leads to increased comfort for patients , has been tested and supported with women with breast cancer (Kolcaba & Fox, 1999), persons with UI (Dowd, Kolcaba, & Steiner, 2000), persons in hospice (Kolcaba, Dowd, Steiner, & Mitzel, 2004). And stressed college students (Dowd, Kolcaba, Steiner, & Fashinapaur, 2007). Also, the second assertion was supported in the UI study, when patients with enhanced comfort showed increased HSBs.

Death is inevitable. It is one of the only certainties in life. Regardless, people are often uncomfortable discussing death. Nyatanga (2016) posits that the idea of no longer existing increases anxiety and emotional distress in relation to one’s mortality. Because of the difficulty in level of care for end-of-life patients, the patient and the family often need professional assistance for physical and emotional care. Many family caregivers are not professionally trained in medicine, and this is where hospice comes into play. Hospice aims to meet the holistic needs of both the patient and the patient’s family through treatment plans, education, and advocacy. There is a duality of care to the treatment provided by hospice staff in that they do not attempt to separate the patient’s care from the family’s care. Leming and Dickinson (2011) support that hospice, unlike other clinical fields, focuses on the patient and the family together instead of seeing the patient independent of the family. Many times in hospitals, the medical team focuses solely on the goal of returning the patient back to health in order for them to return to their normal lives. They do not take into account the psychological and spiritual components of the patient’s journey and the journey that the family must take as well. For treatment of the patient, Leming and Dickinson agree that hospice does not attempt to cure patients, and instead concentrates solely

Hospice is a process to end-of-life care and a kind of support facility for terminally ill patients. It provides comforting care, patient-centered care and related services. Comforting care relieves discomfort without improving the patient’s condition or curing his illness. Hospice is extended in a healthcare facility or at home. Its objective is to provide compassionate, emotional, and spiritual care for the dying patient.

Caring for patients at the end of life is a challenging task that requires not only the consideration of the patient as a whole but also an understanding of the family, social, legal, economic, and institutional circumstances that surround patient care.

Many terminally-ill patients give up hope when treatments are no longer available to help them and hospice care is given to them as an option. However, hospice care has proven itself to provide the best quality care for the last six months of the dying. The purpose of hospice is to provide the best care for terminally-ill patients at the end stage of their lives. Hospice offer services to support too many aspects a patient’s life such as medical, legal, spiritual care. Hospice includes art therapists, music therapists, and certified chaplains on the palliative team.

Care designed to give supportive care to people in the final phase of a terminal illness and focus on comfort and quality of life, rather than cure. The goal is to enable patients to be comfortable and free of pain, so that they live each day as fully as possible. Aggressive methods of pain control may be used. Hospice programs generally are home-based, but they sometimes provide services away from home in freestanding facilities, in nursing homes, or within hospitals. The philosophy of hospice is to provide support for the patient's

The purpose of hospice is to effectively provide palliative care to terminally ill patients and their families, it is available to any age, religion or race. According to the National Hospice and Palliative Care Organization, “hospice provides expert medical care, pain management, and emotional and spiritual support expressly tailored to the patient’s needs and wishes Support is provided to the patient’s loved ones as well” (NHPCO, 2015). In

The comfort theory is a nursing theory that was first developed in the 1990s by Katharine Kolcaba. The Theory of Comfort considers patients to be individuals, families, institutions, or communities in need of health care (Petiprin, 2015). The environment in which this theory can be applied is in any aspect of the patient, family, or institutional surroundings that can be controlled by a nurse or a patient’s loved one by means to enhance their comfort. Health is considered to be optimal functioning in the patient, as defined by the patient, group, family, or community (Kolcaba, 2005).

In my nursing practice, I frequently care for dying patients. Instead of simply providing medication to ease pain during the dying process, I wanted to learn about ways to enhance the comfort of the dying patients and possibly assist their family during a difficult time. This desire led me to examine the conceptual model of comfort. Through my research of the concept of comfort care at end of life, I discovered Katherine Kolcaba’s theory of comfort. I found her theory to be useful in describing the concept of comfort care and decided to further analyze it for a more thorough understanding of its usefulness and applicability to nursing practice. Nurses are the ones in direct contact with their patients, providing relief from certain discomforts, continuously assessing, monitoring and providing care that will ensure the patient is at ease. According to Kolcaba, “Comfort is the desirable state that nurses would want for their patients.” (Kolcaba, 2003). With its fundamental emphasis on physical, psychospiritual, sociocultural, and environmental aspects of comfort, the Theory of Comfort care will contribute to a proactive and multifaceted approach to care. This paper aims to describe the origin of Comfort Theory, its primary concepts and relational statements, review of the literature, critique describing its strength and limitation as a middle range theory

In the physical realm of patient-centered care pain, comfort, sleep, and rest are important aspects of the fourth dimension of patient-centered care. Patient-centered care is the complete focus of the medical team on providing respectful care to meet patient needs, preferences and values guide decisions on each individual patient care. To understand the subjective view of the patient, these four aspects are at the forefront of their needs within the hospital setting to provide the best patient outcome. Nurses provide good patient-centered care by actively partnering with patients to determine care priorities and plans to tailor their level of involvement, according to their preferences, and being flexible by changing the care plan as the situation changes including providing smooth transitions between care goals. By doing this, nurses can assist patients with all pain by providing comfort and assuring the patient that there will be no deficiency of their quality of sleep.

The concept of comfort is one that nurses provide every shift; however, it is not always easy to define. Katherine Kolcaba’s Comfort Theory will be used. Walker and Avant’s method for concept analysis will be used. The first step is to select a concept, which is comfort. The next step is determining the purpose of the analysis. The purpose is to define what comfort means and what comfort measures are and how they are used in nursing. The third step is to identify the uses of the concept of comfort. This includes definitions of term comfort and a literature search. The fourth step is to determine the defining attributes of comfort. This allows for insight into the

Patients and family members in medical intensive care units experience pain and anxiety while overcoming illness and disease. Nightingale was one of the first nurses to recognize that the relationship between health and comfort is strong and direct (Peterson & Bredow, 2013, p. 194). Kolcaba’s theory of comfort addresses the need for nurses to provide patients and families with relief, ease, and transcendence to facilitate health-seeking behavior (McEwen & Wills, 2011, p. 234). The purpose of this paper is to evaluate Kolcaba’s theory of comfort (CT) using the Synthesized Method described by McEwen and Wills (2011) and to describe how this theory can be applied in practice.

Comfort is defined by Merriam-Webster’s dictionary (2014) as “a state or situation in which you are relaxed and do not have any physically unpleasant feelings caused by pain, heat, cold, etc.” or as “a state or feeling of being less worried, upset, frightened, etc., during a time of trouble or emotional pain.” Dictionary.com (2014) defines comfort as “a feeling of relief or consolationm” or “a person or thing that gives consolation,”or “ a state of ease and satisfaction of bodily wants, with freedom from pain and anxiety.” Dictionary.com (2014) lists the origin of the word comfort as coming from the 13th century Old French term confort, meaning “source of alleviation or relief.” One can see there are multiple meanings and interpretations of the word comfort. This paper will set forth to discuss the word comfort as a concept and its interpretation and use in many disciplines, including its significance in nursing.

The case study based on the palliative patient Mrs. Mavis looks at issues both the family and the patient are dealing with in regards to the end of life treatment Mrs. Mavis is receiving. Mrs. Mavis is a palliative patient, currently unconscious, who is dying and only wants comfort measures within her nursing care. This was made clear through her advanced care directive, which was made weeks before beginning to receive her end of life care. Mrs. Mavis’ comfort measures include pain relief, hygiene and keeping her comfortable. Mrs. Mavis’ family want her to have fluids and medications to help improve her health. They also want oxygen and pain relief to help with her breathing. Issues such as educating and supporting the family, pain management, the effectiveness of having an advanced care directive and pain assessment will be evaluated to determine the best effective interventions for Mrs. Mavis and her families care. Interventions that will be discussed through-out this essay include the use of analgesia medication, the use of subcutaneous injections and syringe drivers, emotional support for the family, effective communication, educating the family on Mrs. Mavis’ wishes and the importance of having an advanced care directive. These interventions will be evaluated to ensure they are the best practice for Mrs. Mavis’ care.