Components of the theory
Having worked in critical care and the long-term care setting as a nurse, I have notice the importance of providing comfort in many different situations. Nurses are constantly assessing patients, families, and other members of the healthcare team to provide comfort by using appropriate protocols and simple interventions that are in place. This can be extremely difficult because meeting a person’s expectations of comfort are all different and can only be defined by the patient. Therefore, I decided to explore the comfort theory developed by Katharine Kolcaba (March & McCormack, 2009). According to the comfort theory, comfort is defined by each person’s perspective of what comfort is to them (March & McCormack, 2009). The comfort theory is noted to be beneficial to the entire healthcare team, including patients and families (Boudiab & Kolcaba, 2015). This theory can be utilized in all areas of nursing practices. According to March and McCormack, (2009) the comfort theory was introduced by Katharine Kolcaba to help patients and families by providing comfort through a holistic approach. Through this approach, interventions are developed to meet the patients physical, psychospiritual, environmental, and sociocultural goals (Goodwin, Sener, & Steiner, 2007). These contexts are greatly related to the metaparadigms of nursing which are person, environment, health, and nursing (March & McCormack, 2009). The three forms of the comfort theory she
“If a patient is cold, if a patient is feverish, if a patient is faint, if he is sick after taking food, if he has a bed-sore, it is generally the fault of not of the disease, but of the nursing. I use the word nursing for want of a better” (Nightingale, 1860, p. 8). While Nightingale stressed the impact of one’s environment to promote healing, Virginia Henderson aimed to establish on the fundamental needs as a knowledge base to guide Professional nursing practice. Henderson emphasized on fourteen components required for effective nursing care which includes: breathing normally, eating and drinking adequately, elimination of body wastes, movement and posturing, sleep and rest, select suitable clothes-dress and undress, maintaining body temperature, keeping body clean and well groomed, avoiding dangers in the environment, communication, worship according to one’s faith, work accomplishments, play or participate in various forms of recreation, and learn, discover, or satisfy the curiosity (Fernandes et al., 2015). Her division of the fourteen components acknowledged patient needs with a holistic approach that is applied through the nursing process in a clinical setting.
Regrettably, the existence of nursing depends on the medical inadequacy of others. Unfortunately, nursing exists because people get hurt, cannot care for themselves, or need assistance with daily activities. Carol Taylor (2011), author of Fundamentals of Nursing: The Art and Science of Nursing Care, writes, “Nursing care involves any number of activities, from carrying out complicated technical procedures to something as seemingly as holding a hand” (p. 5). Taylor explains it is the duty of a nurse not only to learn the pertinent skills but also to bond with and comfort others. Nurses have to do and become many things: They must be stern when necessary, compassionate when needed, open minded
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.
The nursing process does not merely treat the patient as a physical body, but rather treats the patient holistically. The central philosophy of Dorothea Orem's self-care deficit nursing theory "is that all patients want to care for themselves, and they are able to recover more quickly and holistically by performing their own self-care as much as they're able" (Dorothea Orem, 2012, Nursing Theory). However, although self-care may be the core of Orem's theory, the decision to engage in self-care must be facilitated by the patient's social and physical environment, of which the family can play a critical role in shaping.
First of all, I recognized that I was dealing with humans, and not just dealing with a disease process and application of the nursing process in the aspect of restoring patient health. I was dealing with emotions, and families, and cultural beliefs that influenced individual’s aspects of care. I started to see that health did not just incorporate healing the disease, but also recognized the importance of making sure patient’s felt that their
Conceptual analysis is integral in understanding nursing theory. According to Walker and Avant (1995), concept analysis allows nursing scholars to examine the attributes or characteristics of a concept. It can be used to evaluate a nursing theory and allows for examination of concepts for relevance and fit within the theory. The phenomena of pain will be discussed in this paper and how it relates to the comfort theory.
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).
It is my personal belief that environment plays a considerable role in the patient’s short term and long-term wellbeing. When nurses acknowledge the environment that the patient is interacting in while receiving their care we know this greatly impacts the overall successfulness of the care plan. The patient’s feelings must be
Kristen M. Swanson’s Caring Theory is the solution in bridging the gap between nursing practice and theory. It offers an explanation of the links between patient well-being and the caring process (Tonges & Ray, 2011). Swanson explained that nurses should be able to demonstrate that they care about their patients, and that caring about their wellbeing is as important as their patients’ current medical problem (Tonges & Ray, 2011).
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.
Practicing as a nurse, I realize I follow my own metaparadigm of nursing. In this paper, I relate my own personal beliefs with that of a popular nursing theorist. Though my research on theory is just beginning, I feel my metaparadigm most relates to that of Katharine Kolcaba and her theory of comfort. I will seek to illustrate my philosophy with the knowledge and nursing experience I have.
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.
Comfort care is a care that is given to help a dying person. It is an important aspect of medical care at the end of a human’s life. The objective is to reduce or eliminate suffering as well as respecting the dying person’s wishes.