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Analysis and Evaluation of the Theory of Comfort

Theory Analysis

Scope

The Theory of Comfort by Katherine Kolcaba is middle range theory. Middle range theories contain a limited amount of concepts and also have a more limited range. However, Kolcaba's Theory of Comfort is categorised as a high middle range theory so that it is a more general and abstract theory. Making it tightly related to a "Grande Theory" which is very abstract and general and can be employed to a number of experiences and replies (McEwen & Wills, 2011). This is very true for The Theory of Comfort as much articles have been written adapting the idea to multiple scopes of medical.

Middle range theories include something specific related to nursing practice like a situation or condition of an individual or patient inhabitants. Middle range ideas also look at the populations years and location when focusing on the development of a theory. A middle range theory also contains an intervention, suggested results, or an action of the nurse. Midsection range ideas are produced by interpreting and observing lived experiences with a regards to health and medical (Tomey & Alligood, 2002). In Katherine Kolcaba's Theory of Comfort she spent much time evaluating the relationships and final results of patients in relation to comfort.

Context

Katherine Kolcaba actually wrote the Theory of Comfort with Alzheimer's and dementia patients at heart. However, Katherine herself has co-written multiple articles about other scopes of medical related to her theory. Two recent articles were written making use of her theory to perianesthesia nursing and hospice nursing (Kolcaba & Wilson, 2002 and Vendlinski & Kolcaba, 1997). When Kolcaba was expanding her theory she employed rational reasoning. She utilized induction, deduction, reduction. Kolcaba applied a preexisting construction as her antecedent. The construction was compiled by Henry Murray (Tomey & Alligood, 2002), it was from a booklet entitled Explorations in Personality. Henry A. Murray was a professor of mindset at Harvard College or university; he received the Distinguished Scientific Contribution Award from the North american Psychological Association and the Platinum Medal Honor for lifetime achievement from the North american Psychological Basis. "When it first arrived in 1938, this reserve possessed a provocative and insightful result, urging psychologists to review personality holistically and in depth and emphasizing the complicated interactions between individual, social, and cultural characteristics. " --Salvatore R. Maddi, Teacher, Department of Psychology and Social Habit, School of Social Ecology, School of California, Irvine (Explorations in Personality, 2007). This was a good starting point for the theory as comfort is most beneficial achieved through holistic treatment. She also started out with a thought analysis of the term, "comfort". Katherine Kolcaba gathered the definition, of "comfort" from a variety of disciplines. Within The Theory of Comfort the metaparadigm proposition of medical actions is utilized (Kolcaba, 2001). That is noticeable in this theory since it is made around assessing for having less comfort and then reevaluating the patient to assess the success of any implementations made or actions taken.

Katherine Kolcaba utilizes the all four of the metaparadigm concepts: medical, patient, environment, and health. In medical there is an examination of comfort needs, actions to promote comfort, and then the reassessment of comfort levels. The analysis and reassessment can be either subjective or objective. The individual can be an specific or their family. The environment is any part of the patient's surroundings that can be manipulated by the nurse to enhance the patients comfort. Finally, health is the ideal functioning of the patient (Tomey & Alligood, 2002). The writer believes that Kolcaba does utilize all four of the metaparadigm because the individual is the center. The nurse is essential because the nurse provides the care to boost the comfort. The surroundings also plays an essential role in this theory as comfort or distress can be found in the patient's environment. Finally the writer believes that whenever many of these three are in cooperation to produce comfort the patient will have an increase in their health.

The philosophical declare that THE IDEA of Comfort is dependant on is individual needs. You can find two core the different parts of this school of thought. There first is the motivational drive that is behind individuals behavior. The second reason is the force influenced by public and ethnical politics that influences the patient's expectations. Patient's comfort needs are influenced by their expectations of experienced and holistic medical health care (Kolcaba, 2001).

The world view that meets The Theory of Comfort most concisely is the "reciprocal world view" this matches well because humans are productive and alternative. Humans connect to their environment and this interaction can lead to pain, displeasure, or comfort. Humans learn from their experiences and this leads them to the ability to make decisions that will keep them in a far more comfortable environment.

Content

The Theory of Comfort has six basic concepts: healthcare needs, medical interventions, intervening parameters, patient comfort, health seeking behaviors, and institutional integrity (Kolcaba, 2001). Health care needs are defined as the need for comfort that comes from stressful healthcare situations. The types of needs that can happen are: physical, psychospiritual, public, and environmental, these are the same terms that Kolcaba uses to judge the effectiveness. These needs are made clear through close monitoring (Tomey & Alligood, 2002). Medical interventions are thought as the commitment of nursing and health care institutions to market comfort treatment and meet the comfort needs of patients (Kolcaba, 2001). Intervening variables is anything that affects the outcome (Kolcaba, 2001). Some possible parameters include: earlier experience, age, attitude, emotional condition, support system, prognosis, and budget (Tomey & Alligood, 2002). Patient comfort is thought as, "immediate state to be strengthened insurance agencies needs met in 4 contexts of human experience, (physical, psychospiritual, public, and environmental)" (Kolcaba, 2001). Health seeking behaviors is thought as, "the pursuit of health as defined by the recipient, in assessment with the nurse, " (Tomey & Alligood, 2002). Instructional integrity can be an institution that have features of completeness, integrity, sincerity and is also also pleasing (Tomey & Alligood, 2002).

Katherine Kolcaba has a complete of six propositions that outline her theory of comfort. The to begin the six is that a nurse recognizes the comfort needs that have not yet been identified by the patients other support systems. The second proposition is that the nurse is then accountable for designing interventions to handle those unmet needs of the individual. The third is taking into account the variables that may affect the involvement that has been suggested to help the patient. The forth proposition by Kolcaba is the fact after the comfort is achieved or achieved that patients are encouraged to take part in health seeking habits. The fifth proposition is the fact that once a patient has been strengthened and are taking part in health seeking behaviors they are simply then more content with their healthcare. The past proposition of The Theory of Comfort is when a patient is satisfied with their healthcare in a particular establishment that institution keeps its integrity (Kolcaba, 2001). All six of the propositions are relational in the streamline. All six of the propositions have to take result for the patient to be taken to an acceptable comfortableness with that level of comfort being maintained for a long period of your energy. All six of Katherine Kolcaba's propositions are relational as they are a streamlined reevaluating process that depends upon all parts for success and structurally necessary to have alternative health.

Katherine Kolcaba has outlined four major assumptions in her Evolution of the idea of Comfort. The first is "humans have holistic reactions to intricate stimuli" (Kolcaba, 2001). The second reason is that comfort is a desirable holistic final result that is relevant to the self-discipline of nursing. The 3rd is, it can be an active try to meet and keep maintaining comfort. The fourth and last assumption is that institutional integrity has a big component that is dependant on a "patient focused value system" (Kolcaba, 2001).

Katherine Kolcaba's diagramed conceptual model involves the basic concepts of THE IDEA of Comfort. The health care needs, medical interventions, and intervening factors all work in co-operation to become enhanced comfort. Enhanced comfort then leads to health seeking actions. The center or company that has used best policies and best practices will then be able to promote and connect health seeking behaviors utilizing those guidelines and tactics. Health seeking behaviors then have the ability to become inner and external manners which can result in greater health. The health seeking behaviors could also lead to a peaceful loss of life, (The Comfortliners, 2010) as this is actually the goal of hospice nursing and the idea of Comfort has been utilized in hospice nursing (Vendlinski & Kolcaba, 1997). This idea is much easier to visualize than read.

In order to evaluate the success of reaching comfort Katherine Kolcaba is rolling out a desk or taxonomic framework to report comfort. On the still left area of the chart are four rows labeled, "physical, psychospiritual, environmental, and communal, " (Tomey & Alligood, 2002) which will be the context that comfort occurs. The three columns at the top are the types of comfort, "relief, easiness, and transcendence, " (Tomey & Alligood, 2002). Kolcaba identifies alleviation as "the mentioned of having experienced a specific need found or mediated, " lessen is, "the condition of relaxed and contentment, " and transcendence is, "the state in which one increases above problems or pain, " (Kolcaba, 2001). When analyzing a patient's comfort the nurse fills in the twelve vacant squares with what action really helps to achieve that comfortableness.

Theory Evaluation

Significance

Comfort is a massively important concept of nursing and The Theory of Comfort is designed to bring comfort to patients. The diagrammed conceptual model supplies the simplest explanation for the theory. The metaparadigm concepts are not obviously described by Katherine Kolcaba; however she does indeed clearly says the philosophical state and its ideas. The conceptual framework and antecedent knowledge is minimally described within her work, nevertheless they are recognized and cited.

Internal consistence

The content and framework reflect each other nicely as they are both centered around alternative comfort, however the clarity throughout the idea is nominal. The six propositions of The Theory of Comfort are evidently mentioned by Katherine Kolcaba. The six propositions flow consistently to outline the idea well. The assumptions are plainly stated and are consistent with comfort and treating the individual holistically. The idea is reciprocal as all parts are dependent on others for success.

Parsimony

Throughout THE IDEA of Comfort there is certainly minimal clarity. The propositions and the conceptual diagram are the clearest components of the work. The theory would be more understandable if it were explained more simply.

Testability

The Theory of Comfort does not have a very specific evaluation techniques apart from the taxonomic structure that the nurse fills in by documenting what implementations help to achieve comfort, that was earlier mentioned. However with regular nursing assessments the nurse will know if comfort has been achieved, either objectively or subjectively. The best way to measure comfort somewhat a nurse is utilizing this theory or not is to frequently ask and objectively examine a patient and notice nonverbal indications of pain. As with any high middle range theory, The Theory of Comfort is very abstract and demonstrates difficult to evaluate leads to a definitive method.

Empirical adequacy

The Theory of Comfort has been designed to many different fields of nursing besides from its original target of dementia health care. Perianesthesia nursing has designed this theory to help patients especially by utilizing the stand to file different ways of obtaining comfort. It has also lead nurses in this scope of practice to realize the importance of education (Kolcaba & Wilson, 2002). The theory has also been utilized by hospice nurses, this is actually the ideal range of nursing to utilize this theory. It offers provided hospice nurses with a broader view on how to provide alternative comfort with their dying patients (Vendlinski & Kolcaba, 1997).

Pragmatic adequacy

The Theory of Comfort is an extremely practical notion as everyone feels better when they are comfortable. Patients and families are more able and happy to absorb information when they are comfortable and focused. This theory provides simple steps to ensure comfort has been delivered. THE IDEA of Comfort motivates nurses to think deeper about somewhat or not their patient is comfortable, along using what is causing distress and what's promoting comfort. In addition, it motivates nurses to file the deviation of methods in which a patient becomes comfortable in different settings. A simple medical knowledge such as an associate's degree is essential for utilizing this theory, yet, in order to comprehend the written theory in its entirety a more advanced knowledge level shows to be a necessity.

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