Date post: | 24-Oct-2014 |
Category: |
Documents |
Upload: | kathy-kolcaba |
View: | 518 times |
Download: | 4 times |
The Comfort TheoryThe Comfort TheoryKatharine Kolcaba
By Erin Carline, RN, BSN, CCRN
Katharine Kolcaba
By Erin Carline, RN, BSN, CCRN
Who is Katharine Kolcaba?Who is Katharine Kolcaba?
Born Dec 28th, 1944 in Cleveland Ohio Diploma in nursing- St. Luke’s Hospital 1965 BSN- Frances Payne Bolton SON-1987 PhD and Clinical Nursing Specialist- 1997 Currently Associate Professor of Nursing
Emeritus at the University of Akron College of Nursing. Teaches on two online theory courses
(MSN and DNP levels)
Born Dec 28th, 1944 in Cleveland Ohio Diploma in nursing- St. Luke’s Hospital 1965 BSN- Frances Payne Bolton SON-1987 PhD and Clinical Nursing Specialist- 1997 Currently Associate Professor of Nursing
Emeritus at the University of Akron College of Nursing. Teaches on two online theory courses
(MSN and DNP levels)
What is the Comfort Theory?What is the Comfort Theory?
A mid-range theory A humanistic, holistic theory that is based
on patient needs Began in nursing
A mid-range theory A humanistic, holistic theory that is based
on patient needs Began in nursing
Why, might you ask is this considered a mid-range theory?
Why, might you ask is this considered a mid-range theory?
The comfort theory meets the following criteria for mid range…..
1. Its concepts and propositions are specific to health care disciplines
2. It is readily operationalized 3. It can be easily applied to many situations 4. Propositions can range from causal to
associative, depending on their applications 5. Assumptions fit the theory
The comfort theory meets the following criteria for mid range…..
1. Its concepts and propositions are specific to health care disciplines
2. It is readily operationalized 3. It can be easily applied to many situations 4. Propositions can range from causal to
associative, depending on their applications 5. Assumptions fit the theory
The Comfort TheoryThe Comfort Theory
The theory states that, in stressful healthcare situations, unmet needs for comfort are met by nurses and the health care team.
Interventions are successful if enhanced comfort is achieved by the patient compared with a previous baseline.
The immediate patient outcome of enhanced comfort is directly and positively related to patients engaging in health seeking behaviors
When patients engage in health seeking behaviors, they do better and report high satisfaction in their healthcare
High patient satisfaction leads to better institutional outcomes and higher institutional integrity
Institutional integrity is conceptualized as the quality or state of health care corporations being complete, sound, upright, honest and sincere.
The theory states that, in stressful healthcare situations, unmet needs for comfort are met by nurses and the health care team.
Interventions are successful if enhanced comfort is achieved by the patient compared with a previous baseline.
The immediate patient outcome of enhanced comfort is directly and positively related to patients engaging in health seeking behaviors
When patients engage in health seeking behaviors, they do better and report high satisfaction in their healthcare
High patient satisfaction leads to better institutional outcomes and higher institutional integrity
Institutional integrity is conceptualized as the quality or state of health care corporations being complete, sound, upright, honest and sincere.
Conceptual FrameworkPlease refer to handout for definitions
Conceptual FrameworkPlease refer to handout for definitions
How was the theory derived?How was the theory derived?
Late 1980s- “Diagram her practice” for dementia care
Presented at conference- feedback Found that the Framework was applicable
to many areas Began to study definition of comfort and
conceptual linkages
Late 1980s- “Diagram her practice” for dementia care
Presented at conference- feedback Found that the Framework was applicable
to many areas Began to study definition of comfort and
conceptual linkages
Conceptual AnalysisConceptual Analysis
Concept analysis began with extensive review of literature
Nursing Medicine Psychology Psychiatry Ergonomics English (Even Shakespeare!)
Found that comfort was frequently cited, not never clearly defined.
Concept analysis began with extensive review of literature
Nursing Medicine Psychology Psychiatry Ergonomics English (Even Shakespeare!)
Found that comfort was frequently cited, not never clearly defined.
Definition of ComfortDefinition of Comfort
The use of comfort was extremely varied. The use of comfort was extremely varied.
Kolcaba’s Definition of ComfortKolcaba’s Definition of Comfort
“The state of having addressed basic needs for ease, relief, and transcendence met in 4 contexts of experience (physical, psychospiritual, sociocultural, and environmental)”
“The state of having addressed basic needs for ease, relief, and transcendence met in 4 contexts of experience (physical, psychospiritual, sociocultural, and environmental)”
Deductive Stage of Comfort TheoryDeductive Stage of Comfort Theory
Resulted in comfort being related to other nursing concepts to produce a theory
Murray’s Theory- framework 3 early nursing theorists were used to synthesize or derive
the types of comfort
Relief- Orlando Ease- Henderson Transcendence- Paterson and Zderad
Resulted in comfort being related to other nursing concepts to produce a theory
Murray’s Theory- framework 3 early nursing theorists were used to synthesize or derive
the types of comfort
Relief- Orlando Ease- Henderson Transcendence- Paterson and Zderad
Overview of the Theory:Definitions
Overview of the Theory:Definitions
Relief- The state of having a severe discomfort mitigated or alleviated
Ease- The absence of specific disorders Transcendence The ability to rise above
discomforts when they cannot be eradicated or avoided
Relief- The state of having a severe discomfort mitigated or alleviated
Ease- The absence of specific disorders Transcendence The ability to rise above
discomforts when they cannot be eradicated or avoided
Even more definitions….Even more definitions….
Physical- pertaining to bodily sensations and homeostatic mechanisms
Psychospiritual- pertaining to internal awareness of the self; including esteem, concept, sexuality, meaning in ones life and one’s relationship to a higher order or being
Environmental- pertaining to the external background of human experience (temp, light, sound, odor, color, furniture, landscape, etc.)
Sociocultural- pertaining to interpersonal, family, and societal relationships, traditions, rituals and religious practice.
Physical- pertaining to bodily sensations and homeostatic mechanisms
Psychospiritual- pertaining to internal awareness of the self; including esteem, concept, sexuality, meaning in ones life and one’s relationship to a higher order or being
Environmental- pertaining to the external background of human experience (temp, light, sound, odor, color, furniture, landscape, etc.)
Sociocultural- pertaining to interpersonal, family, and societal relationships, traditions, rituals and religious practice.
The aspects of comfort are interrelated and the whole is greater than the sum of its parts.
The aspects of comfort are interrelated and the whole is greater than the sum of its parts.
Taxonomic structureTaxonomic structure
The taxonomic structure enables us to identify comfort needs, design interventions targeted to those needs, and measure the effectiveness of those interventions.
The taxonomic structure enables us to identify comfort needs, design interventions targeted to those needs, and measure the effectiveness of those interventions.
Why is a framework important?Why is a framework important?
Caring attention to one cell that needs it, in the form of a comfort intervention can enhance total comfort more than could be expected by the nature of the specific comfort measures.
When comfort needs are met in one context, total comfort is enhanced in the remaining contexts
Placing comfort within a framework or theory provides nurses and team members with rationale for enhancing patient comfort.
Caring attention to one cell that needs it, in the form of a comfort intervention can enhance total comfort more than could be expected by the nature of the specific comfort measures.
When comfort needs are met in one context, total comfort is enhanced in the remaining contexts
Placing comfort within a framework or theory provides nurses and team members with rationale for enhancing patient comfort.
Take a peek at your taxonomic structure chart now
Take a peek at your taxonomic structure chart now
Physical comfort needs: physiologic mechanisms that are disrupted. Comfort measures are directed at regaining homeostasis.
Ex) fluid and electrolyte balance, oxygenation, pain, nausea, shivering
Physical comfort needs: physiologic mechanisms that are disrupted. Comfort measures are directed at regaining homeostasis.
Ex) fluid and electrolyte balance, oxygenation, pain, nausea, shivering
Psychospiritual needsPsychospiritual needs
The need for inspiration, motivation, and being able to “grow through” or “rise above” discomforts that cannot be immediately relieved.
Ex: massage, special visitors, caring touch, words of encouragement
The need for inspiration, motivation, and being able to “grow through” or “rise above” discomforts that cannot be immediately relieved.
Ex: massage, special visitors, caring touch, words of encouragement
Sociocultural needsSociocultural needs
Needs for socially sensitive reassurances, support, positive body language, and caring
Ex: honoring cultural traditions, assisting with paperwork
Needs for socially sensitive reassurances, support, positive body language, and caring
Ex: honoring cultural traditions, assisting with paperwork
Environmental Environmental
Include orderliness, quiet, comfortable furniture, minimal odors, safety
Ex: decrease noise and lights, allow for uninterrupted sleep.
Include orderliness, quiet, comfortable furniture, minimal odors, safety
Ex: decrease noise and lights, allow for uninterrupted sleep.
How does the comfort theory lead to institutional integrity?
How does the comfort theory lead to institutional integrity?
When patients have high levels of comfort, they engage in health seeking behaviors
When patients engage in HSB, they are more satisfied with their care
High patient satisfaction=better outcomes and institutional integrity
When patients have high levels of comfort, they engage in health seeking behaviors
When patients engage in HSB, they are more satisfied with their care
High patient satisfaction=better outcomes and institutional integrity
But why do nurses care about this?
But why do nurses care about this?
Rational for enhancing patient care Better pt satisfaction =better nursing care High patient satisfaction leads to
competitive edge in negotiations with employers and financial viability for the institution.
Rational for enhancing patient care Better pt satisfaction =better nursing care High patient satisfaction leads to
competitive edge in negotiations with employers and financial viability for the institution.
Can’t get that raise you deserve?Can’t get that raise you deserve?
Use the comfort theory! Give them some solid DATA why you deserve more money!
Use the comfort theory! Give them some solid DATA why you deserve more money!
StrengthsStrengths
Kolcaba is still actively teaching and constantly expanding her theory to new disciplines of nursing
The theory is applicable to the modern nursing profession.
It is easily searchable, understandable and applicable
It uses common, easily observable variables that are easily measured by the nurse and can be used for research and performance review
Kolcaba is still actively teaching and constantly expanding her theory to new disciplines of nursing
The theory is applicable to the modern nursing profession.
It is easily searchable, understandable and applicable
It uses common, easily observable variables that are easily measured by the nurse and can be used for research and performance review
Collaborative Technologies and Social Media Tools
Collaborative Technologies and Social Media Tools
Kolcaba knows what the modern nurse and nursing student needs to grasp and use a theory.
Facebook! Blog! Webpage! www. thecomfortline.com
YouTube Videos! This is not a theory that was developed hundreds of years
ago that you must strain to make applicable to modern healthcare.
Kolcaba knows what the modern nurse and nursing student needs to grasp and use a theory.
Facebook! Blog! Webpage! www. thecomfortline.com
YouTube Videos! This is not a theory that was developed hundreds of years
ago that you must strain to make applicable to modern healthcare.
Ironically….Ironically…. Kolcaba has stated that “The overall purpose of CT was to
highlight the importance of comforting our patients in this
high tech world. It is what they want and need from us.” Second goal: highlight the importance of nurses to
patients’ comfort
-make what nurses do visible in documentation
Thankfully, she enjoys spreading the message of the comfort theory; her goals help her “transcend” her own discomfort with technology!
Kolcaba has stated that “The overall purpose of CT was to highlight the importance of comforting our patients in this
high tech world. It is what they want and need from us.” Second goal: highlight the importance of nurses to
patients’ comfort
-make what nurses do visible in documentation
Thankfully, she enjoys spreading the message of the comfort theory; her goals help her “transcend” her own discomfort with technology!
Let’s “tweet” about the Comfort Theory!
Let’s “tweet” about the Comfort Theory!
Write a tweet about how the comfort theory can be applied to YOUR practice
OR A definition of the theory Address tweets to @KathyKolcaba Remember 140 characters or less! Include the hashtag #comfortline
Write a tweet about how the comfort theory can be applied to YOUR practice
OR A definition of the theory Address tweets to @KathyKolcaba Remember 140 characters or less! Include the hashtag #comfortline
BibliographyBibliography
Kolcaba, K.Y., & Kolcaba, R. J. (1991). An analysis of the concept of comfort. Journal of Advanced Nursing. 16 (2): 1301-1310
Kolcaba, K., (2001). Evolution of mid range theory of comfort for outcomes research. Nursing Outlook. 49(2): 86-92
Kolcaba, K., & Wilson, L. (2002). Comfort care: a framework for perianesthesia nursing. Journal of PeriAnesthesia Nursing. 17(2): 102-114
Kolcaba, K., Tilton, C., & Drouin, C. (2006). Comfort Theory: A unifying framework to enhance the practice environment. Journal of Nursing Administration, 36 (11), 538-544.
Comfort Care website: www.thecomfortline.com
Kolcaba, K.Y., & Kolcaba, R. J. (1991). An analysis of the concept of comfort. Journal of Advanced Nursing. 16 (2): 1301-1310
Kolcaba, K., (2001). Evolution of mid range theory of comfort for outcomes research. Nursing Outlook. 49(2): 86-92
Kolcaba, K., & Wilson, L. (2002). Comfort care: a framework for perianesthesia nursing. Journal of PeriAnesthesia Nursing. 17(2): 102-114
Kolcaba, K., Tilton, C., & Drouin, C. (2006). Comfort Theory: A unifying framework to enhance the practice environment. Journal of Nursing Administration, 36 (11), 538-544.
Comfort Care website: www.thecomfortline.com