Katherine Kolcaba’s Comfort Theory Essay

Katherine Kolcabas Comfort conjecture fits best with my philosophy of nursing and my period work environment. As a hospice nurse restableness is the top priority. The name and make forress of hospice make out is to provide ottoman and dignity at the end of life. The skilful term for shelter for health c be is the immediate state of be strengthened by having the necessitys for relief, ease, and transcendence addressed in the quartet context of holistic human experience fleshly, psychospiritual, sociocultural, and environment.The change goal would be to implement Kolcabas taxonomical structure of soothe as a way for the hospice whole staff to measure entertain. Katherine Kolcabas Comfort Theory Kolcaba was born as Katherine Arnold on December 8th, in Cleveland, Ohio. She legitimate her parchment in nursing from St. Lukes Hospital School of nurse in 1965. She graduated from the Frances Payne Bolton School of Nursing, Case Western Reserve University in 1987.She grad uated with a PhD in nursing and received a certificate of ascendency clinical nursing specialist in 1997. She specialized in Gerontology, ending of Life and Long Term Cargon Inter liberationions, Comfort Studies, Instrument Development, Nursing Theory, and Nursing Research. She is currently and associate professor of nursing at the University of Akron College of Nursing. She promulgated Comfort Theory and Practice a Vision for Holistic health C atomic number 18 and Research (Nursing Theories, 2011).DescriptionComfort Theory is a heart range surmise for health practice, education, and research. Comfort is viewed as an issue of conduct that lot promote or facilitate health-seeking behaviors. Increasing sympathizer can result in having negative tensions reduced and positive tensions look atd. Kolcaba (as cited in McEwin & Wills, 2011) be comfort within nursing practice as the satisfaction of the introductory human necessarily for relief, ease, or transcendence arising from health pull off situations that be stressful (p. 34). Purpose According to Kolcaba, (2010) the over completely purpose of Comfort Theory, was to cotton up the importance of comforting patients in this high tech world. It is what they want and have from us. Origin. To describe the origin or development of Comfort Theory, Kolcaba conducted a fantasy analysis of comfort that examined literature from several disciplines including nursing, medicine, psychology, psychia canvass, ergonomics, and English.First, terzetto types of comfort (relief, ease, transcendence) and iv contexts of holistic human experience in differing aspects of therapeutic contexts were introduced. A taxonomic structure was developed to guide for measurement, measurement, and evaluation of patient comfort (Nursing Theories, 2011). study concepts. Major concepts described in the Theory of Comfort include comfort, comfort portion out, comfort measures, comfort of necessity, health-seeking behaviors, origina tional integrity, and intervening variables (Kolcaba, 2010). Propositions.Kolcaba (as cited in McEwin & Wills, 2011) defines eight propositions that plug in the defined concepts * Nurses and members of the health care team identify comfort needs of patients and family members * Nurses design and coordinate interventions to address comfort needs * Intervening variables are considered when designing interventions * When interventions are delivered in a caring manner and are effective, the outcome of enhanced comfort is attained * Patients, nurses and opposite health care team members agree on wanted and realistic health-seeking behaviors * If enhanced comfort is achieved, patients, family members and/or nurses are more likely to engage in health-seeking behaviors these yet enhance comfort* When patients and family members are blow overn comfort care and engage in health-seeking behaviors, they are more satisfied with health care and contract better health-related outcomes * When patients, families, and nurses are satisfied with health care in an institution, globe acknowledgement about that institutions contributions to health care all(a) toldow for help the institution remain viable and flourish. Evidence-based practice or insurance policy improvements may be guided by these propositions and the theoretical framework (P. 234). universe of discourse According to the National Hospice and Palliative Care Organization, (NHPCO, 2012) in 2011, an estimated 1. 65 million patients received services from hospice and an estimated 44. 6% of all deaths in the United States were patients under(a) hospice care. In 2001, an estimated 36. 6% of cancer patients accessed three of more days of hospice care.The median length of service in 2011 was 19. 1 days. 56. 4% of hospice patients were female and 43. 6% were male. 83. % of hospice patients were 65 years of age or older, and more than ane-third of all hospice patients were 85 years of age or older. 82. 8% of hosp ice patients were white/Caucasian. Patients of nonage (non-Caucasian) race aimed for more than ane fifth of hospice patients. Today cancer diagnoses account for less than half of all hospice ad thrills (37. 7%). Currently less than 25% of U. S. deaths are now caused by cancer, with the majority of death due to some separate terminal sicknesss. The top four non-cancer primary diagnoses for patients admitted to hospice in 2011 were debility, dementia, heart disease, and lung disease (NHPCO, 2012).Level of carethither are four general levels of hospice care routine home care, continuous home care, general con care, and yard bird respite care. The facility where I currently work is a unit for general inpatient care. General inpatient care is care received in an inpatient facility for pain control or slap-up or complex symptom counsel which cannot be managed in other settings. In 2011, 2. 2% of hospice patients received general inpatient care. The percentage of hospice patients receiving care in a hospice inpatient facility increased from 21. 9% in 2010 to 26. 1% in 2011 (NHPCO, 2012). The main reason for a general inpatient admission is for comfort care that cannot be achieved at home or in another setting.Nursing RoleMy current role at the hospice unit is one of a staff nurse. I work three, twelve hour shifts on the dayshift. My responsibilities include the day to day care of the patients that I am assigned. I provide the patients with comfort care and symptom management based on the physicians orders. I do pick out certain standing(a) orders that can be put in place without making a call to the physician and using my nursing judgment alone. I level directly to the unit manager on my unit. Power I tint that I exact informal power at my facility. I have been in that respect the longest of all the nurses, including the manager. I am the person that all the nurses turn to when there is a question regarding policy and procedure.I am the person that othe rs seek out for advice and unfortunately the person that most nurses vent to. I am always willing to pick up bare(a) shifts without complaining. I continually hear from the other nurses, you never complain. I get it on what I do I love providing comfort care for patients in need. Are there days when things get crazy? Are there things I wish I could change? Absolutely, but complaining doesnt change anything and I feel that being around someone that complains all the time bring others down as well up. I always try to stay positive and encourage others. The management team comes to me as well to ask me my opinion about certain changes.I feel that I could be a positive influence for change, but ultimately the ratiocination would not be mine to make. Any decision has to go with my unit manager and then up the chain of command to the clinical director, and executive director. Comfort Theory Best Fit for Hospice According to Kolcaba, (2010) health is considered to be optimal function ing, as defined by the patient, group, family, or community. There are several major assumptions in Comfort Theory. Human beings have holistic responses to complex stimuli. Comfort is a desirable holistic outcome that is germaine to the discipline of nursing, human beings strive to meet, or to have met, their basic comfort needs. It is an active endeavor.When comfort needs are met, patients are strengthened (Kolcaba, 2010). The mission statement of the company that I work for includes * Recognize that individuals and families are the accepted expert in their own care * Support each other so we can put our patients and families first * Find creative solutions which add quality to life * Strive for excellence beyond accepted standards, and * outgrowth the communitys awareness of hospice as a part of the continuum of care. I feel that the mission of my company falls in line with the assumptions of Kolcabas Comfort Theory. The main goal of hospice care is comfort care. Currently we as sess pain using a number outgo or a face/FLACC cale depending on if the patient is able to verbally respond.The majority of our patients are unable to communicate. Pain using a face or FLACC scale can vary from nurse to nurse. The FLACC scale measures pain using face, legs, activity, cry, and consolability. Kolcabas taxonomic structure would be an excellent way to measure comfort on a hospice unit such as the one where I work. Development. Katherine Kolcaba developed an interest in the concept of comfort during her practice as the head nurse of a dementia care unit. Her understanding that comfort lead to optimal functioning of the dementia patients, was the beginnings of her comfort opening.Kolcaba realized the kinship between behaviors such as aggression, fighting with others, refusal to cooperate, or tearing up the environment and a patients comfort level. Interventions to reduce these behaviors were called comfort measures (Kolcaba, 2003). Since that time, the system has been utilise in the fields of hospice (Kolcaba, Dowd, Steiner, & Mitzel, 2004 Vendlinski & Kolcaba, 1997), orthopaedic care of giving patients (Panno, Kolcaba, & Holder, 2000), pediatrics (Kolcaba & DiMarco, 2005), and perianasthesia nursing (Kolcaba & Wilson, 2002). Kolcaba (1994) stated, the first dimension of the theory of comfort consists of three states of comfort called relief, ease, and transcendence (p. 1179). Relief is having a specific comfort need meet.An example would be relief from pain. relief is the state of calm or comfort (Kolcaba, 1994). Individuals who feel ease are in a relaxed state. Ease can add to an individuals health seeking behavior. transcendency is each individuals ability to rise above ones pain or trouble (Kolcaba & Kolcaba, 1991). The second dimension of the theory consists of the contexts in which comfort occurs. This is a holistic concept. It can be examined in the physical, psychospiritual, sociocultural, and environmental perspectives. Physical com fort pertains to the body. Musculoskeletal pain, urinary discomfort, gastrointestinal unbalance would fall into this category.Psychospiritual comfort pertains to self-esteem, the meaning of ones life, and ones connection with a higher power. Sociocultural comfort pertains to family, personal races, and ones cultural background. Environmental comfort pertains to the external surrounding (Kolcaba, 1994). The theory consists of three parts. Part one describes how comfort needs are assessed, purloin nursing interventions are implemented, and the patient experiences increased comfort. The second part of the theory describes the relationship between comfort and health seeking behaviors. Kolcaba reports that patients whose comfort needs are meet are better able to participate in positive behaviors, which promote health and welfare.The third part of the theory describes the relationship between clients health seeking behaviors and the integrity of the institution (Kolcaba, Tilton, & Dro uin, 2006). Outcome measures for institutions can be improved when staff utilizes comfort measures. It is desirable that nurses caring for hospice patients are skilled in the art of comfort. Providing physical comfort such as managing pain, positioning an individual with advanced musculoskeletal problems, care bowel patterns regular, assisting residents in a toileting program to avoid incontinence, and protection breakable skin are skills used on a daily basis. Nurses in hospice care must address psychospiritual concerns such as depression, the loss of physical functioning, as well as the loss of loved ones and friends.Most patients in hospice care have been forced by illness and debility to give up their homes and independence. Sociocultural comfort is provided when nurses understand a persons cultural background. Encouraging family support and understanding a residents background and accomplishments assist nurses in developing interventions to support comfort. The environment to a fault plays a part in an individuals comfort and well-being in the long-term care environment. Providing a home-like, active, and joyful environment fill up with children, animals, and treasured items from home are very important. Comfort theory has been utilized as a framework for hospice nursing (Vendlinski & Kolcaba, 1997).