The 4 Metaparadigm Concepts According to the Comfort Theory Ferris State University Ashley Cruz Kate Galloup Toni Leaf-Odette Jaime Stevenson

Concepts and Definitions Nurse Concepts and Definitions A nursing theory that was developed by Katharine Kolcaba in the early 90’s to help bring comfort back as a leader in care. Kolcaba stated comfort was decided as in 3 forms: relief, ease and transcendence It was achieved when the patient felt a physical, psychospiritual, environmental, and sociocultural state of mind Relief is achieved when analgesics are administered to those in pain Ease is achieved when a patient has a comfort state of mind Transcendence is achieved when a patient successfully achieves a set goal Comfort for nurses: Chitty & Black, 2011 Engagement Administrative support Compassionate mentoring Autonomy Continuing education Personal resources

DESCRIPTION OF THE THEORY ENVIRONMENT PERSON/PATIENT The patient or family member that can be influenced by a nurse or other health facilitator to help enhance comfort Religious beliefs and general attitude towards death and dying (Johnson, 2010). This includes the patient, their family members and any social group that helps define the patient (Kolcaba, 2011). A community in need of healthcare (Kolcaba, 2011). HEALTH “Health is considered to be optimal functioning, as defined by the patient, group, family or community” (Kolcaba). People need to feel comfortable in their own bodies. “An evaluation of one’s vulnerability to a condition and the seriousness of that condition” (Black, p. 253). An evaluation of how effective the healthy maintenance behavior might be” (Black, p. 253). The presence of a trigger event that precipitates the health maintenance behavior” (Black, p. 253). It is our responsibility to help people meet their goals. Society and social groups play a major role.

Improvement of the Health Care Environment LOCAL REGIONAL Deals directly with the patient, setting realistic goals that the patient and staff member agree upon to establish accurate health goals. Use what resources are available at that time to help decrease discomfort for the patient and family. Pain focused treatment → Decrease complications of pain → Decrease use of resources = Improved health (Kolcaba, 2003). When satisfying more and more patients at a local level increases response at a regional level. This is accomplished by spreading word through people and conferences. Return to former functioning → Faster healing = Decreased use of regional resources

GLOBAL GLOBAL When patients, families, and nurses are satisfied with health care in an institution, public acknowledgment about that institution’s contributions to health care will help the institution remain viable and flourish. Economical and effective nursing across all borders.

Comfort Care Just plain works!!! “What nursing has to do… is to put the patient in the best condition for nature to act upon him” (Florence Nightengale) Comfort Care Just plain works!!! Comfort Theory utilizes a variety of techniques and interventions to encourage Health Seeking Behaviors Comfort care encourages Health Seeking Behaviors both at internal and external levels. Comfort Care encourages institutional integrity which improves medical treatments locally, regionally and globally by making institutions more efficient, effective and financially sound.

Evidence based practice Can be based on 4 patterns of knowing that nurses use to determine the best practice for situations. These 4 levels of knowing were first developed by Carper in 1978. This concept of evidence based practice and decision making has been expanded upon since. (Fawcett)

Conclusion “Holistic comfort is defined as the immediate experience of being strengthened through having the needs for relief, ease, and transcendence met in four contexts of experience (physical, psychospiritual, social, and environmental)” (Kolcaba, 2010).

REFERENCES: Chitty, K. & Black, B. (2011). Professional Nursing: Concepts & Challenges, 6th ed. Maryland Heights, MO: Saunders Elsevier. Comfort Theory by Katharine Kolcaba. (2011). Comfort Theory by Katharine Kolcaba. Retrieved June 19, 2014, from http://currentnursing.com/nursing_theory/comfort Fawcett, J., Watson, J., Neuman, B., Walker, P.H., Fitzpatrick, J.J., (2001). On Nursing theories and evidence. Vol 33:2. P. 115-119. Retrieved from filr:///C”/Users/user/Downloads/http://digilib.bc.edu-reserves- nu417- dema- nu417119.pdf Gozalo, A., (2011) Theoretical foundations of nursing. Florence Nightingale. Retrieved from www.nursingtheories.weebly.com/Florence-nightinhal.html Johnson, W. (2010, March 19). Four Basic Metaparadigm Concepts in Nursing. eHow. Retrieved June 22, 2014, from http://www.ehow.com/list_6106429_four-basic- metaparadigm-concepts-nursing.html Kolcaba's Theory of Comfort. (2013). - Nursing Theory. Retrieved June 22, 2014, from http://nursing-theory.org/theories-and-models/kolcaba-theory-of- comfort.php Kolcaba, K. (2010, May 17th). The comfort line: Frequently asked questions. Retrieved from The Comfort Line website: http://www.thecomfortline.com/FAQ.html