Origin of the comfort theory by Katherine Kolcaba

Origin of the comfort theory by Katherine Kolcaba

NRS 430V CLC – Nursing Theory and Conceptual Model Presentation

CLC – Nursing Theory and Conceptual Model Presentation

Origin of the comfort theory by Katherine Kolcaba

• Developed by Katherine Kolcaba
• Kolcaba serves as a registered nurse and had a Master’s degree in nursing
• Kolcaba initially analyzed the term comfort as a term that illustrates strength hence she discovered the theoretical importance of the term.
• She later developed the theory by creating a taxonomic structure.
• The theory was first published in 1994 with other modifications published in 2001 (Coelho, Parola, Escobar-Bravo & Apóstolo, 2016).

Kolcaba developed the comfort theory after conducting a conceptual analysis of the term in various disciplines such as medicine, nursing, psychology, and psychiatry. The theory is a middle-range theory that focuses on placing patient comfort as the main aspect of nursing care. To Kolcaba, nurses provide comfort to patient when they engage in holistic nursing (Coelho, Parola, Escobar-Bravo & Apóstolo, 2016).

ASSUMPTIONS OF THE COMFORT THEORY

• Humans respond to complex stimuli in a holistic way.
• Effective nursing care leads to holistic comfort which is a holistic outcome.
• Comfort is a human need hence humans are bound to seek it wherever possible.
• Nurses are caregivers who can easily identify comfort needs (Coelho, Parola, Escobar-Bravo & Apóstolo, 2016).

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Holistic comfort refers to the immediate strength that patients experience when their needs are met by nurses who are their caregivers. The comfort theory not only assumes that patients need comfort, but also that nurses have the ability to identify comfort needs and ensure that patients experience holistic comfort (Coelho, Parola, Escobar-Bravo & Apóstolo, 2016).

CONCEPTUAL MODEL

Comfort: this is a concept that strengthens patients and is achieved using comforting actions conducted by nurses during healthcare.

Intervening variables: Factors such as social support, finances, and prognosis that do not change during healthcare and healthcare providers have no control over them. They should be considered by nurses when determining interventions that lead to patient comfort.

Healthcare needs: the needs of patients in healthcare settings.

Enhanced comfort: A desirable outcome that occurs after nurses implement appropriate interventions to meet the comfort needs of a patient.

Institutional integrity: the wholeness, values, and financial stability of healthcare organizations at national, state, regional, and local levels. When nurses engage in comfort care, they promote institutional integrity.

Best practices: these are procedures and protocols developed by healthcare institutions for specific patients after assessments. Comfort needs are patient-specific hence best practices should focus on patient-centered care.

Best policies: Overall procedures and protocols developed by healthcare institutions for use in evidence collection. They should facilitate the identification of patients’ comfort needs (Coelho, Parola, Escobar-Bravo & Apóstolo, 2016).

The comfort theory proves the conceptual model because it encourages the determination of the healthcare needs of a patient and the use of comforting interventions to deal with these needs. In addition, the theory emphasizes on the need of considering intervening variables when providing comfort needs as a way of achieving enhanced comfort.

Propositions of the theory to nursing practice

• Nurses have the role of identifying the comfort needs required by their patients and their families.
• Nurses develop appropriate interventions to meet the comfort needs.
• When developing interventions, it is important to consider intervening variables.
• Effective interventions lead to enhanced comfort and are called ‘comfort measures’ (Coelho, Parola, Escobar-Bravo & Apóstolo, 2016).

The comfort theory describes nursing as a process that should involve the identification of the comfort needs of a patient, determining and implementing the most appropriate care plans, and conducting evaluations to determine if the plans meet the comfort needs of the patients. Intervening variables are those that are not controlled by healthcare providers but they affect the patient’s comfort such as availability of social support or finances. It is important to consider these variables before determining effective interventions (Coelho, Parola, Escobar-Bravo & Apóstolo, 2016).

Propositions of the theory to nursing practice

• Nurses and patients should agree on realistic and reliable health-seeking behavior.
• Comfort care leads to increased satisfaction with care and better care outcomes.
• Satisfaction with care ensures that healthcare institutions flourish (Coelho, Parola, Escobar-Bravo & Apóstolo, 2016).

When patients are comfortable, they become satisfied with the care they receive. Since patient comfort involves taking care of their physical, spiritual, social, and environmental needs, comfort leads to good patient outcomes which is a crucial healthcare outcome. Patient satisfaction with care also leads to good reputations for healthcare organizations (Coelho, Parola, Escobar-Bravo & Apóstolo, 2016).

TAXONOMIC STRUCTURE OF THE THEORY

Types of comfort

According to the diagram, there are three types of comfort: relief, ease, and transcendence.

Relief: The feeling experienced when an individual’s specific comfort needs are met.

Ease: the state of being contented or calm.

Transcendence: a state where an individual has the ability to rise above pain problems.

Comfort occurs in four contexts: physical, environmental, psychospiritual, and sociocultural.

Physical: Comfort that pertains to bodily functions such as immune function, bodily sensations, and homeostatic mechanisms.

Environmental: Comfort that pertains to the external surrounding of the patient such as sound, light, odor, temperature etc.

Psychospiritual: Comfort that pertains to a patient’s internal self-awareness such as their identity, self-esteem, sexuality, and religion.

Sociocultural: Comfort that pertains to the interpersonal relationships of a patient including relationships with family and friends (Coelho, Parola, Escobar-Bravo & Apóstolo, 2016).

The four metaparadigm concepts

• Nursing

ØAssessing comfort needs

ØDeveloping comfort measures that address the needs

ØConducting re-assessments to determine the effectiveness of comfort measures.

• Patients

ØIndividuals, families, or members of the community that need healthcare.

The four metaparadigm concepts include nursing, patient, environment, and health. in the comfort theory, nursing practice should involve the intentional assessment of patients’ comfort needs as a way of determining the needs and developing strategies to meet these needs. The term patients refers to people in need of healthcare such as families, individuals, and members of the community (Krinsky, Murillo & Johnson, 2014).