Kolcabas Theory of Comfort Sandra Kolk Ferris State

Kolcaba’s Theory of Comfort Sandra Kolk Ferris State University Nurs 451

Knowledge Comfort Theory • “Holistic, positive outcome of nursing care” • Patient Centered Care • 2 dimensional- type of comfort & context in which comfort occurs • Type: Relief, ease, transcendence • Context: physical, psycho spiritual, environmental, social Analogies/Example • Plans of comfort care based on Kolcaba’s theory are created to meet the needs of every individual • Example: Mr. L on Hospice has trouble sleeping • Determine the needs of Mr. L to facilitate comfort care • Staff discovered music helps Mr. L to relax and sleep • Music incorporated in the plan of care to promote comfort

Skills How to Implement Analogies/Example • Promoting health, safety, and transcendence. • Implementing comfort care by incorporating knowledge and individual needs • Understanding the needs of every individual and “building patterned, individualized methods for the practice of comforting. ” • Analyzing all aspects of an individuals situation to determine variables of the comfort grid • Physical, Psycho-spiritual, Environmental, Social • Understanding and respecting religious beliefs, culture, family dynamics, values, etc. • Addressing physical needs to maintain comfort.

Attitude Value of Comfort Care Characteristics • Importance of trusting relationship between the nurse and patient/caregivers to provide optimal care • Planning- respectful consideration of physical, psycho-spiritual, environmental, and social aspects of an individual when developing POC. • Implementing- considering how a patient responds to measures of comfort and adjust accordingly to promote comfort care • Separating holistic comfort as seen in Hospice from out-come oriented comfort • Evaluation- assure optimal comfort for a patient and determine necessary adjustments to POC when comfort needs are not met

Elaborate • L- Kolcabas Theory of Comfort Care • E- The basis of this theory is to provide a framework of care for hospice nursing. Hospice care provides more holistic comfort centered measures of care, and less out-comes oriented measures of care. Kolbaca uses a comfort grid to demonstrate her theory by describing the correlation between the type of comfort care and the context in which comfort occurs. • A- It is important to determine the needs of patients as individuals and developing trusting relationships with patients and their families. This theory of comfort care can be used to improve the quality of end of life care. • R- Patient centered care is important to nursing practice in any setting, however, based on Kolcaba’s theory I believe it is especially important to implement in end of life care to provide comfort. This theory approach acknowledges the importance of individualizing plans of care based on a holistic patient centered care approach to provide maximal comfort to a patient. • N- This theory can be used outside of Hospice and End of Life care as well. Any patient that is being treated for needs to be comfortable. It is important to determine what makes a patient comfortable and the necessary measures that need to be taken to promote comfort.

Analyze Personal thoughts • Promoting maximal comfort is very important during End of Life care. • Incorporating family members and respecting individual factors within Plan of Care. • Kolcabas Theory is very useful in End of Life care to promote individualized comfort measures. Potential problems • Holistic approach versus medical approach may create problems when collaborating with Interdisciplinary teams • Separating comfort care from goal oriented care as a nurse.

Revise-Final thoughts • No single theory would work better to provide comfort measures. • Combination with other theories such as the Human needs theory would enhance the effect on patient care. • Considering all aspects of an individual to promote comfort and meet their needs is essential to nursing care. Utilizing Kolcabas theory to analyze physical, psycho spiritual, environmental, and social aspects of a patient is important when providing comfort care with a holistic, patient-centered care approach.

References Kolcaba, K. Y. & Fisher, E. M. (1996). A holistic perspective on comfort care as an advance directive. Critical Care Nursing Quarterly, 18(4), 66 -76. Vendlinski, S. & Kolcaba, K. Y. (1997). Comfort care: A framework for hospice nursing. American Journal of Hospice and Palliative Medicine, 14(6), 271 -276