Kolcabas Theory of Comfort NURS 451 Ferris State

Kolcaba’s Theory of Comfort NURS 451 Ferris State University Tracy Stark S

Description of Kolcaba’s Theory {Comfort Care Measures ~ No Extraordinary Measures} S Kolcaba’s Theory describes comfort existing in three forms: relief, ease, and transcendence. S When specific comfort needs of a patient are met, the patient experiences comfort in the sense of relief. S Ease addresses comfort in a state of contentment. S Transcendence is described as a state of comfort in which patients are able to rise above their challenges. S There are four aspects of life that can experience Kolcaba’s forms of comfort S Physical: SOB, fatigue, weakness, complaints r/t immobility S Psychospiritual: Fear of dying, anticipatory grief of spouse, belief in finality of death, i. e. no afterlife S Environmental: Homelike setting valued. S Sociocultural: Patient needs, family needs (Nursing Theory, 2013; Vendlinski, & Kolcaba, 1997)

Strategies of Kolcaba’s Theory End-of-Life/Palliative Care S Empowerment of patients or families at the end-of-life S Active involvement that is facilitated by the healthcare team, strengthened by having comfort needs meet. S Comfort needs are assessed subjectively (what patients and families say) and objectively (what the nurse observes). S Nursing must account for all intervening variables S Interdisciplinary Care Approach S Utilizes nursing, physician, respiratory care, social work, case worker, hospice, child life, & religious services. S Use therapeutic communication, promote autonomy, reposition as needed, medicine administration for palliative care as needed/requested. S Verbal and written communication, using the comfort grid as a framework for interdisciplinary discussion, can promote continuity, consistency and efficiency in the management of emerging comfort needs. S Comfort is reassessed to determine effectiveness (Kolcaba & Fisher, 1996; Vendlinski & Kolcaba,

QSEN Competency Objectives Patient-Centered Care: KSAs S Knowledge S Active involvement of interdisciplinary team, patient and family. S Evaluation and reevaluation accounting for all variables that affect comfort (i. e. physical, psychospiritual, environmental, and sociocultural. S Skill S As with the interdisciplinary team verbal and written communication can be utilized with patient and families, using the comfort grid as a framework for discussion. This can promote continuity, consistency and efficiency in the management of emerging comfort needs. S Attitude S Value opinion of all of those involved in care. Take time to explain and discuss aspects of care. S Family at bedside at time of death; peace of mind and less misapprehension. (Vendlinski & Kolcaba, 1997)

References Kolcaba, K. Y. , Fisher, E. M. (1996). A holistic perspective on comfort care as an advance directive. Aspen Publishers, Inc. 18(4) p. 66 -76 Nursing Theory. (2013). Kolcaba's theory of comfort. Nursing Theory. Retrieved from http: //www. nursingtheory. org/theories-and-models/kolcaba-theory-ofcomfort. php Vendlinski, S. , Kolcaba, K. Y. (1997). Comfort care: A framework for hospice nursing. American Journal of Hospice and Palliative Medicine. 14 (271). doi: 10. 1177/104990919701400602