Positive Design

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.

Those two theories are Florence Nightingale’s theory of the important of the environment and Katharine Kolcaba’s theory of comfort. Both of these theories are lacking in the emergency room because of the lack a therapeutic environment for these patients. The goal for most emergency room physician is to keep the patient safe until the patient can be moved to an inpatient pscyharitic unit (Nicks & Manthey, 2012, p. 2). By the physicians having this mentality, it does not allow the patient to start his or her healing process in the emergency room while the patient is boarding waiting for an inpatient bed to become available. With the implementation of both of the nursing theories mentioned above this writer believes that it will change the environment that the patient is in and will teach the physicians to start to treat these patients and in turn, it will provide the patients with the quality care that he or she

Hospital social work is time limited and the focus could easily be more directed at problems rather than solutions. Patients enter the hospital with a physical problem and desire to leave with answers. In this type of environment the focus can be on the physical ailment rather than additional factors that may be contributing to physical distress. Environmental factors can promote well-being or become a barrier to wellness. An ecological perspective provides a lens to view patient systems in a broader context.

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

In contrast, a physical healing environment is carefully constructed and organized. Employees are trained caregivers who are knowledgeable in interacting with patients and families so as to help them cope with their concerns or grief. The environment, by its design, is a strong means of establishing a spiritual relationship through an engagement of all five senses. By choosing colors appropriately, for example, desired effects in human behavior are promoted and psychological systems established - the color green indicates healing, nurturing and conditional love, a symbol of growth (Stefanidakis, 2001). This is because color has the ability to induce emotional responses such as irritability, cheerfulness, or peacefulness. Further, by creating the interior of the hospital in a manner that resembles, even slightly, a church or a temple, providing religious artifacts, say rosary beads, spirituality can be promoted. A patient’s sense of control over their environment must be kindled (e.g., lighting and temperature) so that stress relief may occur.

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

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).

The nursing theory consists of four major concepts including person, health, environment, and nursing. According to the Fundamentals of Nursing, these four concepts “… give nurses a comprehensive perspective that allows you to identify and treat patient’s health care needs at all levels and in all health care settings.” (Potter & Perry, 2009, p. 40) Florence Nightingale’s theory was one of the first models for nursing. The focus of this theory was that nursing consists of caring through the environment and helping the patient overcome their symptoms and changes in function related to their prevailing illness. It also focuses on the manipulation on the environment for the potential benefit of the patient. Florence “… had always seen to the heart of things- that the real nurse must be a dedicated being- that

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.

* Watson divides environment into internal and external variables, which nurse could manipulate in favor of healing. Both variables are interdependent. Providing privacy, comfort and safety measures are part of this concept. Thus the provision of protective, supportive and corrective mental, physical, socio-cultural and spiritual environment leads to a holistic healing.

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

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

The physical environment and the arch technic design of a health facility has significant impact on comfort, safety, human performance and increased effectiveness of care (Reiling, Hughes, & Murphy, n.d.). Evidence based designs are called healing environment in other words they are smart investments since they promote patient satisfaction through less stressful environment ,reduce hospital stay as well save money, increase staff efficiency and moreover where interaction between staff and patient leads to positive health outcomes (Huisman, Morales, Van Hoof, & Kort, 2012).

Cancer patients spend a large amount of time in the hospital while receiving treatment for their illness. The hospital environment can have either positive or negative effects on a patient’s psychological status. A positive environment promotes healing, as it uplifts the patients’ morale as they receive treatment for this dangerous disease. Numerous hospitals tend toward loud, disturbing noises at night when patients and caregivers are trying to sleep. Also, an increase of artwork would improve the overall environment. The psychological effects of the hospital environment on cancer patients should be studied because of the implications that a positive morale has on the healing process.