Theory of Comfort Essay MSN5270

In nursing, comfort is a prized outcome desired by both the care team and the patients. As a result, nurses’ roles include assessing patients’ comfort needs, designing and implementing appropriate comfort measures, and evaluating whether or not the patient’s comfort needs have been met. Katharine Kolcaba, a middle-range nursing theorist, pioneered the theory of comfort, stating that comfort is a product of holistic nursing art (Mansfield et al., 2020; Oliveira et al., 2020). She defined the theory’s three concepts: relief, ease, and transcendence. Relief refers to the satisfaction of patients’ needs, such as measures to relieve post-surgical pain, whereas ease refers to the patient’s level of contentment, such as reduced anxiety (Mansfield et al., 2020; Oliveira et al., 2020).

Transcendence, on the other hand, refers to the patient’s ability to rise above all obstacles. The theory views patients as individuals, families, communities, or institutions and defines the environment as the immediate surroundings that the patient, their family, or the nurse can manipulate to maximize comfort. The following is an example of a comfort contract created by the patient, which specifies the expected level of post-surgical overall comfort, as well as a list of measures that can be taken at home to ensure the patient’s relief.

As a patient, I am aware that I have numerous options when it comes to selecting the best hospital for medical care. After consulting with my family and carefully considering the wide range of surgical procedures it offers, I chose this hospital as my most appropriate care facility. The specifications for my expected level of post-surgical comfort are listed below.

Pain alleviation
Appropriate wound care and accelerated wound healing
Ambulation as soon as possible
Resumption of normalcy and duties/ability to function independently
Excellent wound cosmesis
No or minimal complications

My family has taken the steps listed below to ensure my comfort following discharge

Designate a caregiver
Adequate rest
Providing food
Wound care
Pain medications
Psychosocial affection/support for mental health

References

Mansfield, N., Naddeo, A., Frohriep, S., & Vink, P. (2020). Integrating and applying models of comfort. Applied Ergonomics, 82(102917), 102917. https://doi.org/10.1016/j.apergo.2019.102917

Oliveira, S. M. de, Costa, K. N. de F. M., Santos, K. F. O. D., Oliveira, J. D. S., Pereira, M. A., & Fernandes, M. das G. M. (2020). Comfort needs as perceived by hospitalized elders: an analysis under the light of Kolcaba’s theory. Revista Brasileira de Enfermagem, 73(suppl 3), e20190501. https://doi.org/10.1590/0034-7167-2019-0501

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Theory of Comfort Essay Sample 2

Patient comfort spearheaded the sprouting of patient-centered care. The healthcare system is expected to provide healing as well as comfort. The theory of comfort is a middle-range theory developed by Katharine Kolcaba in 1994 (Vo, 2020). It is based upon a triad of concepts, including relief, ease, and transcendence, as well as a tetrad of domains, including physical, psychospiritual, sociocultural, and environmental (Vo, 2020). A relief means an experience of meeting a comfort need, while ease implies an experience that offers contentment. Meanwhile, transcendence refers to the experience in which care enables an individual to stretch beyond a problem or pain.

The physical domain defines bodily functions and sensations, while the psychospiritual domain focuses on life meaning, self-esteem, relationship to a supreme being, and sexuality. On the other hand, social-cultural domains encompass social relationships. Lastly, the environmental domain is rooted in the external environment (Vo, 2020). Patient comfort is attained when nursing care integrates all the domains and concepts. Similarly, patients tend to do better when their needs are explored and met. In the subsequent paragraphs, a patient comfort contract will be designed to highlight the expected level of post-surgical comfort, specific chronic discomforts, and relevant interventions for relief while at home.

A patient contract is more of an agreement between a patient and a healthcare provider. All patient contracts should be documented following a negotiation between the parties involved (Gallagher et al., 2022). The post-surgical period is associated with a couple of physical, psychospiritual, sociocultural, and environmental needs that necessitate intensive perioperative nursing care to attain patient comfort.

The following is an example of a contract between J. L., a 49-year-old African American male in his postoperative period following surgical evacuation of epidural hematoma, and an APRN. J. L had been involved in a road traffic accident because he was driving under the influence of alcohol. J. L understood comfort as being free from pain, feeling stronger, feeling cared for, valued, and connected to people (Fang et al., 2019). However, the APRN understood that patient comfort is multidimensional and holistic (Wensley et al., 2020). After an elaborate discussion, the following were J. Lâ€™s needs;

â€¢ Physical- monitoring of vital signs, GCS, fluids, analgesics, nutrition, bladder and bowel care, constant turning, seizure prophylaxis, and daily cleaning and dressing of his wounds.

â€¢ Psychospiritual- playing music, praying, and patient education.

â€¢ Sociocultural- accurate information and participation, family involvement, social and emotional support.

â€¢ Environmental- undisturbed rest, dim lights, and a safe healing environment.

Likewise, he was tasked with responsibilities including notifying healthcare providers in case of any concern, cooperating with healthcare providers, and taking medication as prescribed. Upon discharge, he was expected to continue with daily cleaning and dressing of his minor wounds, cease alcohol intake, engage in church activities, join a rehabilitative program and continue follow-up as an outpatient. Implementation of this comfort contract meant intensive perioperative nursing care.

J. L understood the risk of being bedridden as well as the importance of family and social support systems throughout the care process. The APRN demonstrated the hallmarks of a humane society and caring, including empathy, dignity, compassion, and kindness (Wensley et al., 2020). Consequently, J. L experienced ease, relief, and transcendence following the fulfillment of his physical, psychospiritual, sociocultural, and environmental needs. These led to high levels of satisfaction. A study by Tian et al. (2021) demonstrated that patient satisfaction in the comfort care group was significantly higher compared to the experimental group during care of oral and maxillofacial surgery patients (87.76% vs. 63.27%, P<0.05). Finally, patient comfort requires a collaborative care model and a low nurse-to-patient ratio to prevent burnout (Sun et al., 2021).

Conclusion

Patient comfort is multidimensional and holistic. It requires a collaboration between the healthcare providers and the patient, particularly during the formation and implementation of a comfort contract. Patient comfort is associated with high levels of patient satisfaction and indicates quality and safe patient-centered care.

References

Fang, J., Liu, L., & Fang, P. (2019). What is the most important factor affecting patient satisfaction – a study based on gamma coefficient? Patient Preference and Adherence, 13, 515â€“525. https://doi.org/10.2147/PPA.S197015

Gallagher, E., Alvarez, E., Jin, L., Guenter, D., Hatcher, L., & Furlan, A. (2022). Patient contracts for chronic medical conditions: Scoping review: Scoping review. Canadian Family Physician Medecin de Famille Canadien, 68(5), e169â€“e177. https://doi.org/10.46747/cfp.6805e169

Sun, C., Jia, M., Wu, H., Yang, Q., Wang, Q., Wang, L., & Xu, H. (2021). The effect of comfort care based on the collaborative care model on the compliance and self-care ability of patients with coronary heart disease. Annals of Palliative Medicine, 10(1), 501â€“508. https://doi.org/10.21037/apm-20-2520

Tian, Y., Lin, J., & Gao, F. (2021). The effects of comfort care on the recovery quality of oral and maxillofacial surgery patients undergoing general anesthesia. American Journal of Translational Research, 13(5), 5003â€“5010. https://www.ncbi.nlm.nih.gov/pubmed/34150085

Vo, T. (2020). A practical guide for frontline workers during COVID-19: Kolcabaâ€™s comfort theory. Journal of Patient Experience, 7(5), 635â€“639. https://doi.org/10.1177/2374373520968392

Wensley, C., Botti, M., McKillop, A., & Merry, A. F. (2020). Maximising comfort: how do patients describe the care that matters? A two-stage qualitative descriptive study to develop a quality improvement framework for comfort-related care in inpatient settings. BMJ Open, 10(5), e033336. https://doi.org/10.1136/bmjopen-2019-033336

Theory of Comfort Essay Sample 3

Comfort Contract

Comfort contract has been more critical for effective quality care delivery to the patients. People feel less anxious when they participate in a plan of care to reduce discomfort post-surgery. Nurses have played a significant role to provide comfort to their patients in whatever environment they practice. A key approach to providing physical and emotional comfort is to create an environment conducive to healing. My goal for this week’s discussion is to present the historical background of the theory of comfort and describe the major components and Their relationships. I will also demonstrate a design comfort contract whereby patients or their surrogates designate an expected level of postsurgical overall comfort, and where they can specify chronic discomforts and interventions that they use at home for relief.

The comfort nursing theory is derived from the Middle-range theory and developed for the first time in nursing in the 1990s by Katharine Kolcaba. It provides a framework that describes the holistic approach to nursing interventions (Krinsky, 2014). A comfort contract is extremely crucial to cut bridge the gap between post-surgical pain management and pain education because of its focus and integration of both experiences. According to Kolcaba, individuals have mental, spiritual, and emotional lives, which are intimately connected with their physical bodies.

Comfort is the immediate state of well-being strengthened by having the human needs for relief, ease, and transcendence (types of comfort) addressed physically, psycho-spiritual, socio-culturally, and environmentally (contexts in which comfort is experienced). This definition emphasizes that although nurses may not be able to fully meet all their patient\’s needs for comfort, they can continue to address them proactively throughout the continuum of patient care (Wilson, 2004). The theory of comfort encompasses four major components physical, psycho-spiritual, environment, and socio-cultural. Therefore, nurses should consider the holistic approach, and interrelated, and individualized nature of comfort needs to meet the patient’s needs.

During a surgical procedure, the patient does not only need physical comfort but also the anxiety related to surgery and the aftermath of care constitutes a major detractor from psycho-spiritual comfort. Therefore, a comfort contract that emphasizes the overall aspect of care is extremely essential to support the patient\’s post-surgical needs. The first is standard comfort interventions that are designed to maintain homeostasis.

It also includes attention to pain, hypothermia, administration of appropriate medications, and repositioning. These comfort measures are designed to help the patient maintain or regain physical function and prevent complications. The second type of comfort intervention is to help to relieve anxiety, ensure reassurance, and promote hope. It involves listening and offering an optimistic plan for recovery in a culturally sensitive way. The effectiveness of these interventions depends on their implementation at a time when the patient is ready to accept new or more positive thoughts (Wilson, 2004).

Conclusion

Everyone needs comfort mainly after having surgical procedures patients always look for physical, psychosocial, and environmental comfort. The comfort contract comes up with some good insights that support the patient\’s needs. People feel more comfortable when they establish and contribute to their plan of care. Nurses\’ role is to make sure that the patient\’s goals have been met by providing physical and emotional comfort and creating an environment conducive to healing.

References

Krinsky, R., (2014). A practical application of Katharine Kolcaba’s Comfort Theory to a cardiac patient.

Linda Wilson (2004). Comfort management is a priority for patients in all settings. Comfort theory provides a foundational and holistic approach to comfort management. This article reviews comfort theory and presents the application of comfort theory in the perianesthesia setting.