Comfort Theory by Katharine Kolcaba in Practical Nursing
With the primary purpose to justify effectiveness and usability of Comfort Theory developed by Katharine Kolcaba in practical nursing, I have selected a clinical scenario that describes performance of nurses in an outpatient oncology unit. According to the main idea of the scenario, a nurse bears the responsibility for the old male patient who is diagnosed with cancer. Moreover, physicians claim that since cancer is terminal, further treatment is unlikely to contribute to his health and well-being. Despite the fact that physicians assure there is no need in continuing treatment because it neither increases the chances to recover, nor positively influences the current state and condition of patient, both adults and children insist that their father should continue chemotherapy because the chance to fight the disease always exists.
After having described the clinical scenario, I have selected and provided detailed information about a patient and his devastating diagnosis, I would like to claim that I have made a decision to use the Comfort Theory by Katharine Kolcaba to address this clinical scenario because the theory promotes the idea that comfort is the key to recovery. Despite the fact that comfort is an extremely complex, versatile, and multidimensional phenomenon, it leads to positive health outcomes (Kolcaba, 2003). Moreover, I am a proponent of the idea that this nursing theory is applicable in this scenario because the mission of all professionals in the field of health care is directly linked to the provision of comfort care.
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In other words, comfort of patients who suffer from different physical and psychological diseases should always remain the priority, as well as the first and last consideration for health care providers because comfort was, is, and always will be essential to physical health and psychological well-being of patients. Therefore, according to the estimations of researchers who investigate the changing role of nurses in health care, every professional and responsible nurse will be judged by her unique ability to make patients feel comfortable (Kolcaba, 2003). Thus, because one of the most universal and sacred missions of nurses is associated with the “general atmosphere of comfort”, I have decided to utilize Comfort Theory in this clinical scenario that is described above. Finally, despite the fact that physicians often see no signs of recovery and claim that there are no chances for survival of patients, nurses use comfort as one of the most effective cures that is usually not available to physicians.
Taking into consideration the main ideas promoted by the theory by Katharine Kolcaba, comfort is considered to be the main desirable state that all responsible and committed nurses wish for all their patients (Kolcaba, Tilton & Drouin, 2006). The American nursing theorist assures that it is essential for nurses to consider four main dimensions of comfort, including physical, psychospiritual, sociocultural, and, finally, environmental. Moreover, Comfort Theory encompasses several core assumptions that are associated with comfort of patients. First, human beings usually have holistic responses to diverse and complex stimuli. Second, comfort should be viewed as a desirable and positive holistic outcome. Finally, the author of the theory promotes the idea that all human beings always strive to meet numerous comfort needs that affect their physical and emotional health (Kolcaba, Tilton & Drouin, 2006).
This middle-range theory of comfort in nursing promotes the idea that there are three main forms of comfort, including relief, ease, and, finally, transcendence (Kolcaba, Tilton & Drouin, 2006). To begin with, according to the information provided by the author of this theory, comfort is the state of patients that meets their basic needs. On the contrary, the state of ease is the second integral type of comfort that is mainly associated with calmness and contentment. Finally, transcendence should be also viewed as one of the important comfort types that describes the unique state in which a patient can rise above challenges and complications caused by pain and disease (Kolcaba, Tilton & Drouin, 2006).
In addition, the researcher claims that there are four main contexts in which comfort of patients can occur, especially physical, psychospiritual, sociocultural, and, finally, environmental. The first context of comfort is called physical and includes a variety of bodily sensations, functioning of immune system, and many other interdependent elements. Psychospiritual context of comfort is no less significant and is primarily focused on internal awareness of self, especially on such dimensions of self as identity, self-esteem, meaning of life, and many other factors that have the power to affect and shape health (Kolcaba, Tilton & Drouin, 2006). The third context of comfort should be referred to as environmental because it provides the general idea that a variety of external factors, including temperature, odor, color, surrounding, and landscape can have positive, as well as negative impacts on health of patients. Finally, sociocultural context of comfort encompasses numerous relationships on interpersonal, family, community, and societal levels (Kolcaba, Tilton & Drouin, 2006).
The main concepts discussed in the Comfort Theory by K. Kolcaba are as follows: nursing, health, environment, comfort, and, finally, patient. The researcher emphasizes that the term “nursing” should be viewed as an ongoing and complex process that has a primary purpose to adequately assess and objectively comfort the needs of every patient (Kolcaba, Tilton & Drouin, 2006).
I am deeply convinced that the role of the Comfort Theory is of utmost importance in nursing because it promotes the value of comfort and motivates nurses to actively engage in health-seeking behaviors, promote positive health outcomes, clearly define and assess comfort needs of every patient, design a variety of effective and realistic interventions to meet comfort needs of their clients, and act in a caring manner. In simple words, Comfort Theory designed and developed by Katharine Kolcaba focuses on the fact that the main objective and mission of nursing concentrates on accurate assessment of numerous needs of patients that will enhance their comfort and lead to positive health outcomes (Kolcaba, 2003). Thus, this middle-range theory of comfort inspires health care providers to design and implement well-developed nursing care plans that will address numerous patients’ needs.
Comfort Theory is not only interesting and logical, but also incredibly effective because it has already been utilized, tested, and evaluated in numerous settings. For instance, Krinsky et al. (2014) who explore the practical application of this middle range theory to cardiac patients provide convincing evidence that this theory is very effective because it relieves symptoms associated with the feeling of discomfort caused by cardiac syndrome (Krinsky, Murillo & Johnson, 2014). Moreover, Ferrandiz & Martin-Baena (2015) who explore the application of this theory in different health settings present statistical data that proves the validity and reliability of this theory in practical environment (Ferrandiz & Martin-Baena, 2015).
In addition, Comfort Theory may be extensively used in the sphere of pediatric nursing to measure comfort of children and their families because researchers who investigate these aspects of nursing claim that utilization of this theory contributes to the development of more proactive and multifaceted approaches to pediatric care (Kolcaba & DiMarco, 2006). Because the use of this theory in pediatric practice is very easy, it provides substantial benefits to pediatric institutions which strive for the creation of a “culture of comfort” (Kolcaba & DiMarco, 2006). Finally, the usability and effectiveness of this theory was tested by the researchers in hospice nursing frameworks, peri-anesthesia settings, and, finally, orthopaedic nursing care for elders (Kolcaba, 2003). The researchers have come to conclusions that effective application of this theory drastically improves health outcomes of patients who belong to different age groups and suffer from numerous diseases (Kolcaba, 2003).
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After having provided convincing evidence that demonstrate the applicability of Comfort Theory in various nursing settings and justified its efficiency and positive impacts on health outcomes, it is possible to stress that this theory may be applied to the clinical scenario presented above that describes an adult competent male patient who is diagnosed with terminal cancer. Since the majority of cancer patients suffer from discomfort on physical, emotional, and psychological levels, Comfort Theory offers numerous effective solutions how to enable these patients to enhance his own comfort, as well as comfort of their families. For example, because chemotherapy is one of the most aggressive types of treatment that leads to numerous side-effects and puts at risk emotional health of patients, one of the most realistic and effective solutions for nurses is to listen attentively, meet patient’s desires and expectations, instill hope, and relieve the existing anxiety. This terminally ill patient can benefit from Comfort Theory because this nursing theory focuses not only on relief of physical pain that is almost impossible in this clinical case, but also helps to address and combat depression.
Thus, taking into account the main ideas promoted by the theory, it is possible to claim that one of the most achievable solutions is associated with eliminating depressive symptoms because anxiety, depression, and failure to cope with severe physical pain decrease the quality of treatment. Finally, nurses should establish trusting relationships not only with a patient, but also with his family to prepare him for peaceful death if there are no chances to continue living a normal life.
As a result, I would like to come to a conclusion that the role of Kolcaba’s Comfort Theory is fundamental in nursing practice because provision of “culture of comfort” is of paramount importance in different health care settings. This theory is logical and simple, its universal concepts and meaning may be extensively utilized by health care providers to increase the quality of health care services, develop effective comforting intervention, and promote comfort of patients and their families. Finally, this valid and reliable nursing theory that has been tested in numerous health care environments motivates and encourages nurses to be objective and consistent in addressing the needs of patients and assessing their comfort.