Kolcaba's Theory Of Holism

Nursing is as much science as it is a study in the human condition. Combining caring and the notion of human flourishing allows the nurse sharpen her understanding of patients’ needs by observing and understanding herself (Husted & Husted, 2008). A nurse is able to better anticipate the needs of her patients by noting similarities and differences between the two of them. With caring in the nursing corner, even under less-than-ideal conditions, one can still create havens of hope, nourishment, and the possibility for flourishing (MacCulloh, 2011).

The nurse also has to be aware of the nature of the nurse-patient relationship, the environment in which it takes place in, as well as an understanding of the context and the moment of the interactions in order to share a meaningful experience. Finally, nurses have to be passionate about his or her career. Nurse’s care and tend to the patients’ needs because nurses are passionate about the career. Even though the fundamental pattern of personal knowing, it provides a holistic nature of knowing. Many humanistic theories and models of nursing have been derived from personal knowing such as Peplau’s interpersonal relation theory, Kolcaba’s comfort theory, and Jean Watson’s theory of caring.

Barbara Dossey is truly a visionary in the holistic nursing movement and her theory is able to further the development of holistic nursing in its entirety as well as bolster patient outcomes. The context in which the theory was developed was in relation and connection to the products and ideas of Ken Wilbur, in an attempt to fortify the fundamental concept of healing (Dossey & Keegan, 2003). Dossey's four quadrant model in certain respects is a reaction to and influenced by the work of Wilbur, namely that his volumes stress that no particular or sole researcher, philosopher or theorist can describe, establish or clarify the constituents of reality (Dossey & Keegan, 2003). Dossey and Keegan emphasize that the obstacle and objectives in nursing is to bolster one's integral awareness while boosting one's overall strengths and abilities in nursing in general (2003). Ultimately, the theory developed in the context of the belief that healing occurs when the delicate balance and harmony of body and mind and spirit is successfully addressed and how ancient ideas can be effectively integrated in the realm of caring for patient in everyday living (Dosseydossey.com).

Nursing practice has revolutionized itself throughout the years. Today we realize the causes of current illnesses as complex and multifaceted (source). In past models, for instance the medical model, the approach was straightforward and neglected the patients active involvement in their care; the patient was viewed as the passive recipient and the doctor, an active agent that “fixed” their patients. ( source). New developed models since then, such as the biopsychosocial model, show us that care focuses on many factors. The model demonstrates understanding of how suffering, disease, and illness can be associated by many factors seen at the different levels in society and the medical sciences (source). Caring for each component is

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.

Holistic nursing to me is a practice of applying both subjective and objective patient assessment into the plan of care. Not only do we need to look at the physical condition of the patient, but also their social and environmental factors that influence their state of health. When this application process is incorporated into the patient plan of care, we are incorporating all aspects of the patient’s life that help define and create their ideal state of health. In review of several nursing theories discussed by Montgomery-Dossey and Keegan (2012), which incorporate the aspect of holistic nursing practice, I found that Jean Watson’s Theory of Transpersonal Caring was most closely linked to aspects of my current nursing practice.

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 the Comfort Theory, proposed by Catharine Kolcaba, the tradition of nursing discipline - deriving theory from former disciplines is examined, and the notion of former healthcare disciplines deriving nursing theory has been recommended. A short literature review of plagiarized theory sets the position to examine the modification of the theory. She describes convenience as one of the mechanisms for the full rehabilitation of the patient, and the personal desire of the patient to recovery across the permanency of the diseases. Holistic comfort has been described as the instant experience of being powered through having the requirements for relief, transcendence, and ease met in the four bases of experience (physical, environmental, psycho-spiritual, and social). Providing comfort is necessary for the care of a patient in the hospital background (March, 2009). Nowadays, comfort is being regarded as the last outcome for the terminally sick patient, and it is not seen as a standard hospital practice, when they prophylactically or for protocol, try to develop the patient’s health status. Theorist Katherine Kolcaba was among the first nurse researchers to advance a theory of comfort to develop patient’s outcomes and satisfaction, and to improve institutional integrity. This paper aims at describing the Comfort Theory, as well as its weaknesses and strengths as a middle-rank theory. It also defines its applications beyond the healthcare background, bases for further

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).

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.

The Neuman Systems Model (NSM) was formulated to assist in the coordination of patient care activities to be completely centered on the patient’s wholeness and well-being (Neuman and Reed, 2007). The NSM is a simple in-depth approach to explain the concepts of stressors and how they inspire well-being. Neuman (1972) states this model “extends beyond the illness model and includes the concepts of problem-finding, prevention, and the newer behavior science concepts and environmental approaches to wellness” (p. 265). The model is still used in current practice under the same context. This model currently is being used to guide the curricula of baccalaureate and master’s nursing programs in numerous schools of nursing worldwide (Neuman, 1996). This model is also being used as a guide for nursing homes and