Final Paper in Comfort Theory Ruben Perez NGR 5110 July 15th, 2013. Prof. Dr. Daniel Little Nursing Scenario I chose this scenario which is appropriate for the application of Kolcaba’s Comfort theory: You are a nurse on an inpatient oncology unit. Your patient is a 72-year-old competent male who has been told his cancer is terminal and that further treatment is unlikely to have any benefit. He accepts that and would like to explore hospice. However, his two adult children insist that he should continue chemotherapy and fight on and they tell you not to discuss with him or get a consult for hospice. Specific Concepts of the Theory In order to address this scenario I used the middle range theory of Comfort and its specific …show more content…
(Peterson and Bredow, 2009). Regarding the relevance to nursing practice, comfort is a positive outcome that is linked to an increase in health seeking behaviors and to positive institutional outcomes (Kolcaba & DiMarco, 2005). Nurses are constantly utilizing the comfort mechanisms and try to move patients towards the transcendence phase. Psychospiritual needs include teaching confidence and motivation through discomfort. Ways that nurses can implement comfort measures are through massage, allowing visitation, caring touch and continued encouragement (Kolcaba & DiMarco, 2005). Sociocultural comfort needs are the needs for cultural sensitive reassurance and positive body language. Nurses can provide these needs through coaching, encouragement, and explaining procedures. Nurses can help patients achieve the environmental comfort by lowering the lights, closing the doors, interrupting sleep minimally and limiting loud noise around the patients rooms (Kolcaba & DiMarco, 2005). Nurses document patient’s states before and after the use of comfort measures to verify if they are improving or worsening the client’s condition. Nurses knowing a patient’s condition can provide comfort measures to prevent negative outcomes. If a patient is requesting hospice care, a nurse may be aware of the possibility of achieve this goal. If the nurse notices an increase in pain, facial grimacing and anxiety, the nurse may realize that he
Florence Nightingale’s nursing theory is probably the most well known in the nursing profession. “Patients are to be put in the best condition for Nature to act on them. It is the responsibility of nurses to reduce noise, to relieve patients’ anxiety, and to help them sleep” (Theories of Florence Nightingale, 2012). This theory emphasizes that environmental factors and adaptation is the basis of holistic nursing care. This theory is important in my opinion because it ensures that the center of focus is on the patient. When patients are hospitalized making them comfortable in a new and strange environment is important to me. Eliminating noise at the nursing station and turning down the lighting in the hallways at night are just a few ways that nurses can improve the environmental factors surrounding patients. During hospitalizations I strive to eliminate any anxiety that my patient may be experiencing. Upcoming procedures and treatments can cause tremendous stress. Simply by providing sufficient information regarding treatments or procedures can be beneficial in reducing anxiety or
From a patients' point of view, comfort is multidimensional, characterized by relief from physical discomfort and feeling positive and supported in one's ability to cope with the trials of their illness, injury and/or disability. Nursing is a field driven by the act of providing care and comfort for patients and their families. Comfort is central to patient experience but the concept of comfort is poorly defined (Wensley, Botti, McKillop, & Merry 2017).
Hi Lisa, you have stated well, often, we (nurses) get in the way of our patients’ independence by thinking that we have to make all their decisions for them; it should never be like that. We are our patient’s helpers, we need to listen to their concerns, determine their weaknesses and figure out what we can do to enhance those weaknesses so that they can have the feeling of being “complete” instead of allowing them to fully depend on us. I agree with you that the nurse should work with Mr. R and his family to determine on how they want to deal with the “cancer” and we must respect whichever choices they make without interfering with them. I wouldn’t want any nurse to make all my decisions for me, I will always ask questions whenever things
Nursing Council New Zealand, Competency 1.5, Indicator 1 (NCNZ, 2007) - Applies the principles of cultural safety in own nursing practice was met by trying our best to ensure Max was always kept covered to give him privacy and comfort while we waited for paramedics to arrive in order to help keep him calm. Also by giving Max a pillow to rest his head and keep him comfortable helped to show how met this Nursing Council competency on cultural safety was met. Respecting the client’s privacy decreases the patient’s emotional discomfort during personal cares; this can be done by draping something over the client to ensure privacy and warmth (Brookside Associates, 2007).
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).
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
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
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.
In the professional setting, knowing the patient through his or her diagnosis, name, history of present illness, laboratory results or reason for staying in the hospital only contributes to the manner of physical care of the patient. However, recognizing the patient 's spiritual needs such as emotional support, mental positivity, and intellectual understanding of his or her situation gives a better assessment, as well as a trusting relationship between the nurse and the patient, as per personal experience. In the ward, it is evident that most of the staff nurses spend their time doing documentations, preparing medications, following-up laboratory requests, as well as reading through the patients ' charts to affirm the physician 's order. Throughout the duration of our shifts as student nurses, I see that the most that the staff nurses get to be conversant with the patient is when certain procedures (such as feeding through nasogastric tube, taking
Trossman (2006) states that at least 50% of patients are suffering from moderate to severe pain at their time of death, that 70 million Americans experience pain throughout their activities of daily living and that nurses hold the keys to pain management. According to Abdalrahim et al. (2010) there have been countless evidence-based studies regarding pain management; nevertheless, the inability to control the patients’ pain has increased due to nurses often devaluing the information they receive from the patients about their current pain level, these actions are directly related to a withholding of
In my nursing practice I frequently care for long term elderly residents on ventilators and who suffer from stage 3 or 4 pressure ulcers, diabetic, venous ulcers etc. Instead of simply providing pain medications and wound treatment to ease their pain or giving medications to relax them, I wanted to learn ways to enhance the comfort of these residents. This led me to learn more about Katherine Kolcaba’s theory of comfort. I found her theory to be useful in understanding the theory of comfort. Hence as a nurse, it became important for me to analyze, evaluate and research more on its applicability in the world of nursing and also in other health care disciplines.
Not all patients are capable of independently identifying and articulate their care needs, so the nurse also adapts the role as an advocate. Clarity and continuity in a trusting environment enables good communication. Progressive identification of needs takes place as nurse and patient communicate with one another in the interpersonal relationship (Peplau 1988, p. 84). Being considerate to the needs and vulnerability of patients is a moral attribute, as nurses are accountable for the care they deliver.
The developmental stages of the mid range theory of comfort are discussed in this article, which includes its philosophic orientation and its inductive, deductive, and retroductive reasoning. Other steps that are described are the concept analysis of comfort, the operationalization of the outcome of patient comfort, the application of the theory in previous nursing studies, and the evaluation of the current theory as it has been adapted for outcomes research. This article is a guide that shows how a concept grows, becomes embedded in theory, is tested, and is adapted for the rapidly changing health care environment. The theory of comfort
Hospice is a component of palliative care. A person does not necessarily have to be dying in order to see a palliative care specialist. This is where the service is often underutilized in the hospital. In the 18 months I have been a nurse, I have cared for many patients with chronic illnesses who have dealt with symptoms that have severely impacted their quality of life. Most of the time, it seems as though the patient’s care providers are interested in treating the patient’s acute problems. My experience has been that the symptoms are often overlooked or are being treated in a manner that is to the dissatisfaction and discomfort of the patient.
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.