Reflection of Kolcabas Comfort Theory By Michelle Heim

Reflection of Kolcaba’s Comfort Theory By: Michelle Heim

Objectives Importance of Comfort to Nursing Profession Kolcaba’s Theory of Comfort Empowerment of Patients and Families Health, Safety, and Transcendence at the End-of-Life (EOL) Planning, Implementation, and Evaluation of Comfort Care Reflection: Elaborate, Analyze, and Revise

Importance of Comfort for Nursing in EOL • American Nurses Association (ANA): comfort is a main goal in nursing care of dying patients • Richeson & Huch (1988): comfort is nursing’s unique contribution • Morse (1992): ultimate purpose of nursing is to promote comfort • Kolcaba (1994): nurses facilitate the outcome of comfort in relation to health-seeking behaviors or a peaceful death

Introduction to Kolcaba: A Theory of Comfort Defining comfort for nursing: -satisfaction of basic human needs in stressful health care situations Types of comfort: -relief -ease -transcendence Context in which comfort occurs: -Physical -Psychospiritual -environmental -sociocultural

Empowerment of Patients and Families • Peaceful Death/Good Death • Patient and Family involvement • Accepting mortality

Health, Safety, and Transcendence at the EOL • Health -Health-seeking Behaviors -Holistic Approach • Safety -Defining QSEN Competency for Patient-centered care -Health care, family, and patient as a team • Transcendence -Potential for extraordinary performance as an end -Comfort Peaceful/Good Death

Planning, Implementation, and Evaluation of Comfort Care Nursing Diagnoses • Death Anxiety r/t unresolved issues • Powerlessness r/t the effects of illness and impending death • Chronic pain r/t disease process at EOL Expected Outcomes Interventions • Death Anxiety -Assess client for fears r/t death -Assist client with life review and reminiscence -Provide social support (personal contact, phone call, therapeutic self) • Powerlessness -explore feelings of powerlessness -have the client assist in planning care whenever possible -help the client specify the health goals he/she would like to achieve • Chronic Pain -assess the client for pain using a valid and reliable self-report tool -Assess for pain routinely and at frequent intervals -Manage persistent or chronic pain using a multimodal approach (pharmacological and nonpharmacological) Death Anxiety Express feelings associate with dying - Seek help in dealing with feelings - State concerns about impact of death on others • Powerlessness -State feelings of powerlessness and other associated feelings -Differentiate between factors which are controllable and uncontrollable -Participate in planning and implementing care • Chronic Pain -Use a self-report pain tool to identify current pain level and establish a Comfort Functional Goal (CFG) -Perform necessary or desired activities with a pain level at or below CFG -Describe nonpharmacological means of relieving pain • -

Reflection L -Look back and reflect E -Elaborate and describe feelings A -Analyze the experience R -Revision N -New trial and improvement

References Cronenwett, L. , Sherwood, G. , Barnsteiner J. , Disch, J. , Johnson, J. , Mitchell, P. , Sullivan, D. , Warren, J. (2007). Quality and safety education for nurses. Nursing Outlook, 55(3)122 -131. Retrieved from http: //qsen. org/about-qsen/terms- and-conditions. Kolcaba, K. (1994). A theory of holistic comfort for nursing. Journal of Advanced Nursing 19, 1178 -1184. Retrieved from Pub. Med. Kolcaba, K. Y. , & Fisher, E. M. (1996). A holistic perspective on comfort care as an advanced directive. Critical Care Nursing Quarterly, 18(4), 66 -76. Retrieved from Pub. Med. Ladwig, G. B. , & Ackley, B. J. (2011). Guide to Nursing Diagnosis (3 rd Edition). Maryland Heights, MO: Mosby Inc. Vendlinski, S. , & Kolcaba, K. Y. (1997). Comfort care: a framework for hospice nursing. The American Journal of Hospice & Palliative Care, 14(6), 271 -276. Retrieved from Pub. Med.