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Theory: Authors Name and Background
Registered Nurses (RNs) can use different mid-range and grand theories to design the best healthcare philosophies. Such theories present powerful ideas and concepts that can be used to improve the quality of patient care. The selected theory for this analysis is Dr. Katharine Kolcabas The Comfort Theory. This theory can make it easier for caregivers and RNs to support the changing health needs of patients from diverse backgrounds (Pappas, 2015).
Katharine Kolcaba was born in on 28th December 1944 in Cleveland (Pappas, 2015, p. 2). She obtained a diploma in nursing from the prestigious St. Luke Hospital School of Nursing in the year 1965 (Krinsky, Murillo, & Johnson, 2014, p. 148). The scholar later joined Frances Payne Bolton School of Nursing to pursue a bachelors degree in nursing. She later graduated with a nursing degree from the same institution in 1987.
He completed her doctorate degree from the same institution in 1997. During her schooling years, Kolcaba was fascinated by the concept of care. She also focused on the behaviors and expectations of many patients receiving long-term care. She also wanted to understand how the comfort of such individuals could be improved using scientifically-proven initiatives. These achievements and personals aspirations encouraged Katharine Kolcaba to come up with The Comfort Theory.
In order to come up with this theory, Katharine Kolcaba consulted numerous publications and documents in nursing. For instance, Kolcaba analyzed Hendersons Sleep and Rest Model (Alves-Apostolo, Kolcaba, Cruz-Mendes, & Antunes, 2007, p. 17). She believed significantly that rest and sleep were critical health needs for the elderly. She also consulted different works and theories such as the Orem (Pappas, 2015, p. 15).
As well, the theorist has managed to influence the works of modern nurses and practitioners. Future scholars will also continue to analyze this powerful theory and use it to develop new models that can improve the quality of patient care.
The theory is known to address a major concern in healthcare. Krinsky et al (2014) indicate that many patients experience unique comfort needs that are usually ignored by family members and caregivers (p. 149). As well, many patients are forced to stay in stressful conditions and situations. This issue explains why many clients do not achieve the most desirable health outcomes. The Comfort Theory therefore offers powerful insights and ideas that can be used to support the comfort needs of more patients (Alves-Apostolo et al., 2007). The theory guides caregivers and RNs to promote positive behaviors and conditions that can support the healing process. The theory also argues that patients with terminal conditions should be supported throughout their lives. By so doing, such patients will eventually die peacefully.
Theory Description
The Comfort Theory uses a deductive reasoning to present the best concepts to many people in the nursing practice. Throughout the developmental stages of the theory, Kolcaba analyzed different publications and concepts regarding the issue of comfort in healthcare. She observed that comfort was closely-linked to other concepts in nursing practice. She studied three theoretical models that focused on the issue of patient support and comfort. These include Relief, Ease, and Transcendence (Kolcaba, 2001, p. 87). She redefined these concepts and used them to come up with the conceptual framework for the targeted theory. By so doing, the theorist narrowed down from the existing evidences in order to produce the nursing model.
The author used several concepts to define the theory. The first concept is relief. This concept is defined as the alleviation of an existing discomfort (Alves-Apostolo et al., 2007). The concept of ease is defined by Kolcaba as the absence of various health discomforts or disorders. The third concept characterizing this model is transcendence. This term refers to a patients ability to overcome discomforts that might be hard to avoid, minimize, or eradicate (Kolcaba, 2001).
These concepts are therefore defined operationally in an attempt to develop the theory. As well, the author used several terms in order to make the theory more effective and applicable in different healthcare settings. Some of these definitions include environmental, socio-cultural, psychospiritual, and physical (Krinsky et al., 2014, p. 149). These terms focus on the major issues and experiences that affect an individual. The terms can be used to understand the major challenges and obstacles to effective patient care. The consistency in the use of these terms and concepts makes the theory meaningful.
The author also defines the concepts explicitly. This means that the terms and concepts are expressed in a clear manner (Krinsky et al., 2014). The author manages to present the concepts to the reader and caregiver in a clear manner. Medical practitioners and nurses have therefore been able to interpret such concepts effectively. As a result, the theory has played a positive role towards transforming the health outcomes of many underserved populations and communities.
The major concepts defining the theory relate to each other in order to augment the practices of different practitioners. For instance, the three concepts follow one another in such a way that they deliver quality comfort to the client (Kolcaba, 2001, p. 89). The first stage is for caregivers to provide adequate relief to the comfort-needs of the targeted patient. This can be realized through the use of drugs and analgesia (Kolcaba, 2001).
The individuals sense and meaning of comfort should also be considered. The next stage is easing the pain or discomfort. The caregivers should use the best approaches to address every challenge that might cause anxiety. The final issue to consider is transcendence (Kolcaba, 2001). This is the final state realized by the patient after the above measures are completed in a professional manner.
Evaluation
The theorist has used a number of explicit and implicit assumptions in order to develop the model. To begin with, the theory is founded on explicit values. The theory assumes that caregivers can be able to address all the discomfits and pains faced by their patients. This fact explains why the concepts of relief and ease are defined in an explicit manner. In order to support these assumptions, the theory goes further to consider the four contexts in which patients discomforts or pains occur (Ferrandiz & Martin-Baena, 2015, p. 115).
These contexts might be socio-cultural, physical, psycho-spiritual, or environmental in nature (Ferrandiz & Martin-Baena, 2015). The theory guides medical practitioners to consider these contexts and propose the most desirable approaches that can deal with such discomforts. The theory also assumes that the four contexts can be used to explain the occurrence of discomfort in different patients.
The other noticeable fact about this theory is that it is founded on the four meta-paradigms of nursing. The use of the meta-paradigms in the theory makes it easier for nurses to use it to fulfill the goals of nursing practice. The theory describes nursing as the best process whereby the comfort needs of patients are assessed and addressed using the most effective interventions (Ferrandiz & Martin-Baena, 2015). According to the model, assessment of the patients needs can be examined in a subjective or objective manner.
An objective approach is characterized by observation. This is common when the targeted patient has a wound or injury (Apostolo, Mendes, Bath-Hextall, Rodrigues, & Cardoso, 2013). The nurse will then consider the best nursing practices that can address the discomfort arising from the injury. The subjective approach is embraced when nurses pose questions to their patients in order to understand whether they have discomforts or not (Ferrandiz & Martin-Baena, 2015, p. 117).
The theory therefore encourages nurses to engage in intentional assessment of the clients discomfort needs. The second approach will be to design desirable comfort strategies that can address the identified needs. The nurse should also re-assess the comfort level of the patient after implementing the designed comfort strategy (Ferrandiz & Martin-Baena, 2015, p. 118). The ultimate goal should be to alleviate the discomfort or pain affecting the patient (Apostolo et al., 2013). Nurses are therefore encouraged to use this knowledge to provide the best care to their clients.
As well, health is treated as the most favorable functioning whereby the needs of communities, patients, families, and groups are addressed. The theory goes further to consider patients as families, communities, institutions, and individuals that need quality medical support (Alves-Apostolo et al., 2007). The fourth meta-paradigm is also defined clearly in the theory. The environment is defined as the aspect of the targeted institutional surrounding, family, or patient that can be manipulated by caregivers in an attempt to deal with discomfort (Apostolo et al., 2013, p. 381).
Throughout the healthcare delivery process, nurses and physicians should collaborate in order to understand how the four meta-paradigms can be combined. The approach can produce the best results. Patients and their family members should be involved throughout the process. This approach will make it easier for the caregivers to identify the unique needs and challenges facing the patient (Ferrandiz & Martin-Baena, 2015). This knowledge will guide the practitioners to design the most appropriate healthcare delivery model.
One of the outstanding facts about The Comfort Theory by Katharine Kolcaba is that it is consistent and lucid. The author uses meaningful concepts that are supported by evidence-based ideas. The concepts are augmented using the four contexts that define a persons health. The caregiver can therefore use these concepts and terms to produce the best approaches. Such strategies can deal with the discomforts faced by the targeted patients. The next thing is to consider the four meta-paradigms of nursing in order to deliver quality care to the targeted communities or individuals. This clarity makes the theory applicable in a wide range of healthcare settings (Apostolo et al., 2013).
Medical practitioners and RNS can therefore use this theory to support the health needs of patients with terminal conditions. The health model has also been found useful whenever working in family care settings. The elderly and persons with long-term diseases can be supported using this model. The practice can address the discomforts affecting different patients (Apostolo et al., 2013). The applicability of the theory explains why it is clear, consistent, and lucid.
Application
As mentioned earlier, Katharine Kolcabas theory has the potential to guide a wide range of nursing practices and actions. The first important thing to consider is that the theory focuses on the four meta-paradigms of nursing. A proper knowledge of these meta-paradigms as defined by the model can make it easier for nurses to support the health needs of more individuals, communities, and institutions (Apostolo et al., 2013).
Since discomfort is a major nursing challenge, such caregivers will use the theory to present powerful initiatives that can minimize the pains affecting their clients. Nurses who plan to use this theory will address a wide range of health challenges and ensure their patients to have peaceful healing processes.
Conditions such as cancer, diabetes, and cardiovascular disease are characterized by discomforts. This is the case because terminal conditions are associated with endless pain (Apostolo et al., 2013). This theory therefore has the potential to transform the experiences of the affected patients. The most important thing is for caregivers to use the model to create multidisciplinary teams. Such teams should include the right individuals and family members in order to produce the most desirable outcomes.
The theory also guides practitioners to consider the four contexts that can produce discomfort. The practitioners will therefore use this knowledge to outline the most desirable practices that can minimize the targeted pain. This approach will support the needs of every targeted patient. Ferrandiz and Martin-Baena (2015) believe that future nurses will come up with better nursing actions that can improve the level of discomfort management.
This theory will also help me as a registered nurse (RN). It is agreeable that I always encounter a wide range of health problems and challenges. I have always observed that discomfort is a major problem affecting many patients. Discomfort makes it hard for many patients to have quality lifestyles. That being the case, I will always embrace the concepts and ideas presented in this theory to support the health needs of such patients (Apostolo et al., 2013).
I will be able to address the major sources of discomfort using evidence-based ideas. I will also embrace the concept of teamwork. The strategy will ensure more persons are involved throughout the treatment process. The ultimate goal will be to ensure more patients lead quality lives.
I will also educate more caregivers and practitioners about the strengths of Katharine Kolcabas theory. These practitioners will be encouraged to embrace the concepts and skills presented by the theory. Since discomfort is a common denominator in every health condition, more nurses will be ready to use the theory and deliver quality support to the affected patients. This practice will play a significant role towards supporting the health needs of many patients in our organization.
As well, members of the public and families will be sensitized about the importance of this theory (Krinsky et al., 2014). They will be encouraged to use the theory whenever managing various terminal conditions such as cancer. These practices will make it easier for more people to lead quality lives. In conclusion, Katharine Kolcabas Comfort Theory has been applied in different healthcare situations to produce quality health results. Practitioners who want to address the discomfort needs of their patients should embrace the concepts described in this theory.
Reference List
Alves-Apostolo, J., Kolcaba, K., Cruz-Mendes, A., & Antunes, M. (2007). Development and Psychometric Evaluation of the Psychiatric In-patients Comfort Scale (PICS). Enfermeria Clinica, 17(1), 17-23.
Apostolo, J., Mendes, A., Bath-Hextall, F., Rodrigues, R., & Cardoso, D. (2013). The Use of Non-Pharmacological Nursing Interventions on the Comfort of Cancer Patients: A Comprehensive Systematic Review Protocol. JBI Database of Systematic Reviews & Implementation Reports, 11(2), 372-388.
Ferrandiz, E., & Martin-Baena, D. (2015). Translation and Validation of a Spanish version of the Kolcabas General Comfort Questionnaire in Hospital Nurses. International Journal of Nursing, 2(1), 113-119.
Kolcaba, K. (2001). Evolution of the Mid Range Theory of Comfort for Outcomes Research. Nursing Outlook, 49(1), 86-92.
Krinsky, R., Murillo, I., & Johnson, J. (2014). A Practical Application of Katharine Kolcabas Comfort Theory to Cardiac Patients. Applied Nursing Research, 27(2), 147-150.
Pappas, C. (2015). Is There a Difference in Pain Management of Patients with Upper Extremity Injuries in Relation to Age? Digital Commons, 1(1), 1-34.
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