New Hampshire Medical Center : A Vision For Holistic Healthcare And Research

Kolcaba (1994) expanded the concept of patient needs using Murray’s (1938) theory of human press, hanging nursing concepts on his abstract framework and developing relationships between needs, interventions, outcomes, and comfort. Kolcaba (2003) created a diagram of the CT, substructed from the theory of human press. Researchers individualize the diagram, starting with line four. Each researcher then develops unique versions of lines five and six. Each item on line five should have a conceptual definition and each item on line six should have operational definitions.

This theory has been a guiding frame for a lot of studies and researches. Some of the areas are nurse midwifery, perioperative nursing, urinary bladder control, orthopedic nursing, etc. For clinical practice, the perianesthesia nurses incorporated comfort theory in managing their patients’ comfort. The comfort theory was also used as a teaching philosophy in a fast- track nursing education program for students. Kolcaba developed the General Comfort Questionnaire to measure holistic comfort in a sample of hospital and community participants. She also asserts that emphasizing and

“A healing hospital is a place characterized by thousands of small and wonderful things and a few big ones. At the center is love. More than anything else, supports a strong culture of caring. It expresses the deep passion of both patients and caregivers” (Chapman, 2003). Healing hospitals focus on patient-centered care.

Patient-Centered Medical Homes (PCMH) are growing in popularity as the right thing to do improve patient care. PCMH are growing in popularity, as there is early evidence of their effectiveness (Egge, M. 2012). The PCMH concept has been widely promoted as a way to enhance primary care and deliver better care to patients with chronic conditions. This model of care has stimulated the attention of payers, Medicaid policy makers, physicians, and patient advocates, as it has the potential to address several of the limitations of the current healthcare system (Wang, J. et al 2014). Currently, primary care in the United States is focused on acute and episodic illness, it inadvertently limits comprehensive, coordinated, preventive and chronic care (Bleser, W. et al 2014). The PCMH address these limitations through organizing patient care, emphasizing team work, and coordinating data tracking (Bleser, W. et al 2014). A PCMH and HMO have some similarities but are markedly different.

Communication is key to effective healthcare practices. According to American Journal Of Critical Care (2014), Patient-centered care starts with “effective communication, being empathetic and available, avoiding personal prejudges, and listening therapeutically are integral parts of patient-centered care” (Riley, White, Graham, Alexandrov, 2014, p. 320). This will improve communication; promote patient involvement in care, which creates a positive relationship with the healthcare provider and medical team. This results in improved adherence to treatment plan. Clinical practice guidelines need to be implemented for the patient and family members to be able to be involved in informed decision-making regarding healthcare needs. The fundamental core of nursing is to have a partnership with the patient and their family regarding the patient’s outcome.

Hederson, S., Princell, C. O., and Martin, S. (2012, December). The patient-centered medical home. American Journal of Nursing, 112(12), 54 59. doi: 10.1097/

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 first article about the Theory of Comfort was published in 1994 by Kolcaba. In 2001,

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 primary purpose of the organization is to uphold improvements in the quality and value of healthcare grants through government aided research, assessment, and sharing of data. Through Office of Grants Giveaway (OGG) the company allocates medical donations to hospitals. The Health Body Wellness Center’s (HBWC) through OGG takes an initiative of tracking the grants distributed to small hospitals, to achieve this, the company has contracted We Automate Anything (WAA) and given them the responsibility of implementing the small hospital grant tracking system. This system enables them to allocate and track the gifts within a specified period. OGG assigns awards to one hospital and follows how they have been utilized within a period of one month. The unused portion of the subsidy is recalled and issued to another hospital. This is done in a continuous and rotational manner.

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

According to Kolcaba, (1994) the purpose of CT is to describe how negative tensions (discomfort) can be reduced by increasing comfort (positive tensions) through nursing intervention that eventually leads to an outcome of enhanced health-seeking behavior (HSB). Kolcaba provides an in-depth description of her theory that allows the reader to understand concepts and relationships.

In the data analysis, SPSS version 15.0 was used. The descriptive statistics were evaluated as either part of individual scales or as dichotomous variables. Comfort offering EOL care were explored. The testing of the hypothesis by the use of a multivariable linear regression model. Adjustments in the model for age, education and experience with older adults, EOL education, and EOL care experience as potential confounders were done. Consideration of the significance of statistical test was made if the population was less than

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

Ellis, A. (2003). Discomfort anxiety: A new cognitive-behavioral construct (part I). Journal of Rational - Emotive & Cognitive - Behavior Therapy, 21(3-4), 183. Retrieved from http://search.proquest.com/docview/220282433?accountid=458