Comfort Care: Katharine Kolcaba Molina Allen Rebecca Beach Sara Schafer Heather Torre Ashley Yotkois
Comfort Care “When comfort care is the framework for nursing practice, each intervention is important if it enhances comfort” (Kolcaba, 1995). Developed by Katherine Kolcaba, comfort care exists in three forms: relief, ease, and transcendence with four contexts: physical, psychospiritual, environmental, and sociocultural. The following focuses on comfort interventions through the four metaparadigms and identifies the versatility in adapting comfort care universally for healthcare needs.
Applying Kolcaba’s theory to Evidence Based Practice Theory of Comfort has been utilized and evaluated in many areas of healthcare such as cardiac care, pediatric nursing, hospice, and perianesthesia nursing. Research of comfort theory implementation in these areas will help develop nursing education, increase morale and satisfaction, and support creation of institutional policies related to nursing. Relief- Occurs when patient comfort needs are met, such as when a patient is given prescribed pain medications after surgeries and procedures. Ease- Patients will experience comfort when they are in a comfortable state of contentment. This may occur when anxiety is resolved after being informed that a biopsy is not cancerous. Transcendence- When patients are able to rise above their challenges. For example, a patient who has accepted their cancer diagnosis but is positive about their personal outcomes. (Nursing Theory, 2013) “Therefore, to study the process of comfort without evaluating the quality of its product called comfort is an incomplete exercise” (Kolcaba, 1995).
Metaparadigm Concepts Environment : Patient’s surroundings that nurse alters maximizing external comfort Maintaining dignity and privacy Calming, quiet atmosphere Comfortable bedding Access to clean food and water Lighting & temperature Private room Nurse: Provider of individualized, goal oriented care to the patient to maximize their comfort in all related forms and contexts (March & McCormack, 2009) Nursing assessment and interventions promote comfort (Kolcaba, 2001) Patient experiences comfort in three forms: relief, ease, and transcendence “When comfort care is the framework for nursing practice, each intervention is important if it enhances comfort” (Kolcaba, 1995). “The nurse is engaged, interprets the needs of the patient, and envisions ways to enhance comfort” (Kolcaba, 1995).
Metaparadigm Concepts Person: Patient, family, or community requiring health care Basic needs for continuity of care Accommodations for family Cultural practices encouraged Religious service/prayer Assurance of life purpose Physical comfort Pain management Health: Optimal functioning of personal perception of comfort and well-being Holistic approach, taking into account each context of an individual Rehabilitation & comprehensive discharge planning Progression to previous baseline or improved level “Comfort is a holistic state that captures many of the simultaneous and interrelated aspects of positive human experience” (Kolcaba & Steiner, 2000). “. . . successful comfort care theoretically strengthens the patient” (Kolcaba, 1995).
Improving Healthcare with Kolcaba’s Comfort Theory Local Increases patient outcome and satisfaction in local healthcare settings by providing holistic, efficient, and individualized care (Kolcaba, 1995). Addresses needs of patient and family (Physical, Psychospiritual, Sociocultural, Environmental) Enhances work environment Saves time and money Regional Universal health care Decreased morbidity rates Financial stability of institutions (Nursing Theory, 2013) Global Policies are developed to maintain local and regional healthcare practice as well as peace promotion and refugee aid (Nursing Theory, 2013) Tailored comfort questionnaires
References Kolcaba, K. (1995). Comfort as a process and product, merged in holistic-nursing art. Journal of Holistic Nursing, 13(117), 117-131. doi: 10.1177/089801019501300203 Kolcaba, K. (2001). Evolution of the mid range theory of comfort for outcomes research. Nursing Outlook, 49(2). doi: 10.1067/mno.2001.110268 Kolcaba, K., & Steiner, R. (2000). Empirical evidence for the nature of holistic comfort. Journal of Holistic Nursing, 18(46), 46-62. doi: 10.1177/089801010001800106 March, A. & McCormack, D. (2009). Nursing theory–directed healthcare: modifying Kolcaba’s comfort theory as an institution-wide approach. Holistic Nursing Practice, 23(2), 75–80. Retrieved from http://0-ovidsp.tx.ovid.com.libcat.ferris.edu/sp-3.12.0b/ovidweb.cgi Nursing Theory. (2013). Kolcaba theory of comfort. Retrieved from http://www.nursing-theory.org/theories-and-models/kolcaba-theory-of-comfort.php