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Comfort Theory Tedra Estis, Laura Flowers, Lauren Underwood, Amanda Wright Southwest Baptist University Theories and Research NUR 4344 February 12, 2012:

Comfort Theory Tedra Estis , Laura Flowers, Lauren Underwood, Amanda Wright Southwest Baptist University Theories and Research NUR 4344 February 12, 2012

Overview:

Overview Introduction: Lauren Underwood Theorist Overview: Amanda Wright Nursing Theory Metaparadigms : Laura Flowers Implications to Nursing: Tedra Estis

Comfort Theory Introduction:

Comfort Theory Introduction Comfort theory was created in the 1990’s by Katharine Kolcaba , RN, MSN, PhD. Provides frame-work for patients enhanced sense of well being. Kolcaba believes that comfort is a positive concept with many aspects beyond just physical comfort ( Kolcaba , 2010).

Comfort Theory:

Comfort Theory Mid-range Theory Nursing practice Nursing education Nursing research

Principles of Comfort Theory:

Principles of Comfort Theory All interactions with patients and family members should be therapeutic. Nurses should assess for holistic comfort needs of patients and family members, then design interventions to meet them. ( Kolcaba , 2010)

Principles of Comfort Theory cont.:

Principles of Comfort Theory cont. Nursing staff should attempt to comfort patients and family members with a personal touch and sense of cultural awareness. Regularly reassess the comfort needs of patients and family members. ( Kolcaba , 2010)

Principles of Comfort Theory cont.:

Principles of Comfort Theory cont. Document patient and family members comfort levels frequently for efficient care and positive outcomes. ( Kolcaba , 2010)

Additions to Nursing Practice:

Additions to Nursing Practice Advanced directives Nursing care plan Hospice care Adult nursing care Peri -anesthesia nursing ( Kolcaba , 2010)

Comfort Theory Definition:

Comfort Theory Definition “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” ( Kolcaba , 2010, para 4).

Steps of Comfort Theory :

Steps of Comfort Theory Nurse identifies the patient’s comfort needs. Interventions are developed for patient. Patient develops enhanced comfort. Finally, either health seeking behaviors are begun or a peaceful death (depending on patient's condition).

Framework for Comfort Theory Development:

Framework for Comfort Theory Development ( Kolcaba , 2010)

Types of Comfort Needs:

Types of Comfort Needs Relief Ease Transcendence

Contexts of Experience:

Contexts of Experience Physical Psychospiritual Social Environmental

Comfort Theory’s Taxonomic Structure:

Comfort Theory’s Taxonomic Structure ( Kolcaba , 2010)

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Theory of Comfort The Basic Concepts Health Care Needs Intervening Variables Comfort Enhanced Comfort Institutional Integrity Best Policies Best Practice

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Health Care Needs According to the Theory of Comfort by Kolcaba , the Health Care needs are the needs that are determined through the patient in need. Intervening Variables The intervening variables are known as things that are not going to change. These variables include things such as the patients’ prognosis, their money situation, etc. Kolcaba , 2011

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Comfort This concept of comfort is the most important concept of the Theory by Kolcaba “The intentional comforting actions of nurses strengthen patients and their families. When patients are strengthened by actions of health care personnel, they can better engage in health seeking behaviors”( Kolcaba , 2011). Enhanced Comfort After the concept of comfort is established between the nurse and their patient, the next step in the Theory of Comfort is Enhanced Comfort. This concept is achieved immediately after comfort. Providing Enhanced Comfort can lead to the patient obtaining many health seeking behaviors.

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Institutional Integrity The concept of Institutional Integrity is a concept that is dependent on the nurse and the facility that the nurse is working at. It is our job as a health care professional to bring the best experience to all our patients throughout their stay in our facility. According to the Theory of Comfort, this concept is “defined as the values, financial stability, and wholeness of health care organizations at a local, state and national level”( Kolcaba , 2011).

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Best Polices & Best Practices The last two concepts of the theory by Kolcoba is the concepts of best polices and best practice. Best polices is the individual facilities procedures and guidelines that they have established as a whole. These are brought out by the nurses who work for the facility, and should be performed to the best of their ability. Best practices the procedures and protocols that are being performed throughout the institution, however what makes them different than polices is because they are determined on a individual basis for each individual patient throughout the hospital. Kolcaba , 2011

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PERSON HEALTH ENVIRONMENT NURSING Nursing Theory Metaparadigms Theory of Comfort

Comfort concept from the theory of PERSON:

Comfort concept from the theory of PERSON Persons can be considered as individuals, families, institutions or communities in need of health care.

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Comfort concept from the theory of Environment Any aspect of the patient, family or institutional surroundings that can be manipulated by a nurse(s ) or loved one(s ) to enhance comfort.

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Nursing is described as the process of assessing the patient's comfort needs, developing and implementing appropriate nursing interventions, and evaluating patient comfort following nursing interventions. Comfort concept from the theory of Nursing

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Comfort concept from the theory of Nursing con’t Intentional assessment of comfort needs, the design of comfort measures to address those needs, and the reassessment of comfort levels after implementation

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Comfort concept from the theory of Nursing con’t Assessment may be either objective, such as in the observation of wound healing, or subjective, such as by asking if the patient is comfortable.

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Comfort concept from the theory of Health Health is considered to be optimal functioning as defined by the person, group, family or community.

Comforts:

Comforts Providing comfort Relief-alleviating the pain or discomfort Ease-the absence of a specific pain Transcendence-being able to work through the pain when the pain cannot be alleviated

comforts:

comforts Relieving pain Single medication modality Massage Slow deep breathing Guided imagery

comforts:

comforts Easing pain Exercise Healthy diet Meditation Music therapy

comforts:

comforts Transcendence Support groups Prayer Friends and family support

Nursing implications:

Nursing implications Clinical areas where research has been done Pediatrics Hospice care Orthopaedic Adult care Peri -anesthesia www.thecomfortline.com

pediatric:

pediatric Measuring pain FACES FLACC Kolcaba Posies Avoid the word “pain” Use uncomfortable Or hurt Kolcaba, (1997)

Pediatrics:

Pediatrics Comforting the infant Cuddling and snuggling, swaddling Thumb sucking or pacifier Feeding Rocking (Kolcaba & DiMarco, 2005)

pediatrics:

pediatrics Comforting the toddler Parent presence Favorite toy from home Promote routine Allow appropriate choices such as snacks

pediatrics:

pediatrics Comforting the school age child Presence of friends Allowing autonomy as appropriate Verbal reassurance from the nurse Comforts from home: clothes, electronics Availability of the nurse To reassure parents To provide demonstrations of teaching To answer questions

pediatrics:

pediatrics Comforting the adolescent Providing privacy Reading body language Providing autonomic decision making where appropriate Time for friends

Hospice care:

Hospice care Define the dying patient’s physical , psychospiritual, environmental, and sociocultural needs. Involve the family in the decision making process. Develop patient’s end-of-life goals. Implement patient’s plan Evaluate and reassess

References:

References Kolcaba, K., & DiMarco, M. A. (2005). Comfort theory and its application to pediatric nursing. Pediatric Nursing, 31 (3), 187- 194. Kolcaba's Theory of Comfort (2011). Retrieved February 3, 2012 from http :// nursing-theory.org/theories-and-models/kolcaba-theory-of- comfort.php Kolcaba , K. (2010). Comfort Line. Retrieved from http:// www.thecomfortline.com/index.html Kolcaba , K. (2011, February 10). Comfort Theory. Retrieved February 5, 2012, from Nursing Theories: http://currentnursing.com/nursing_theory/comfort_theory_Kathy_Kolcaba.html