Kolcaba's Comfort theory : Analysis and evaluation
Kolcaba’s Comfort Theory: Analysis and Evaluation
In my nursing practice I frequently care for long term elderly residents on ventilators and who suffer from stage 3 or 4 pressure ulcers, diabetic, venous ulcers etc. Instead of simply providing pain medications and wound treatment to ease their pain or giving medications to relax them, I wanted to learn ways to enhance the comfort of these residents. This led me to learn more about Katherine Kolcaba’s theory of comfort. I found her theory to be useful in understanding the theory of comfort. Hence as a nurse, it became important for me to analyze, evaluate and research more on its applicability in the world of nursing and also in other health care disciplines.
Level and Scope of the Comfort Theory
The middle range theory has more specific focus and is more concrete than nursing theory in its level of abstraction (Alligood, 2006b, 2006d; Chinn & Kramer, 2008; Fawcett, 2005). They specify such factors as the age group of the patient, and most important the action of the nurse (Alligood, 2006c). Given this information, the comfort theory can be referred to as a middle range theory. I believe that the theory of comfort is at the prescriptive level. Since there is a goal of “comfort” which is to be attained by prescribed actions which come under comfort management. Here the comfort management includes interventions focusing on comfort, actions providing comfort, goal of enhanced comfort, and the selection of appropriate HSBs by patients, families, and their nurses. Thus, “comfort management is proposed to be proactive, energized, intentional, and longed for by recipients of care in all settings” (Dowd, p713, 2010). When it comes to the scope of comfort theory, it is limited to comfort and is fairly simple to understand with lower level of abstraction.
Kolcaba’s Assumptions of Comfort Theory
Kolcaba believes that “comfort is a basic human need which persons strive to meet or have met. It is an active endeavor”
In my nursing practice I frequently care for long term elderly residents on ventilators and who suffer from stage 3 or 4 pressure ulcers, diabetic, venous ulcers etc. Instead of simply providing pain medications and wound treatment to ease their pain or giving medications to relax them, I wanted to learn ways to enhance the comfort of these residents. This led me to learn more about Katherine Kolcaba’s theory of comfort. I found her theory to be useful in understanding the theory of comfort. Hence as a nurse, it became important for me to analyze, evaluate and research more on its applicability in the world of nursing and also in other health care disciplines.
Level and Scope of the Comfort Theory
The middle range theory has more specific focus and is more concrete than nursing theory in its level of abstraction (Alligood, 2006b, 2006d; Chinn & Kramer, 2008; Fawcett, 2005). They specify such factors as the age group of the patient, and most important the action of the nurse (Alligood, 2006c). Given this information, the comfort theory can be referred to as a middle range theory. I believe that the theory of comfort is at the prescriptive level. Since there is a goal of “comfort” which is to be attained by prescribed actions which come under comfort management. Here the comfort management includes interventions focusing on comfort, actions providing comfort, goal of enhanced comfort, and the selection of appropriate HSBs by patients, families, and their nurses. Thus, “comfort management is proposed to be proactive, energized, intentional, and longed for by recipients of care in all settings” (Dowd, p713, 2010). When it comes to the scope of comfort theory, it is limited to comfort and is fairly simple to understand with lower level of abstraction.
Kolcaba’s Assumptions of Comfort Theory
Kolcaba believes that “comfort is a basic human need which persons strive to meet or have met. It is an active endeavor”
References: Alligood, M.R. (2006b). Models and theories in nursing practice. In M.R. Alligood & A.M. Tomey (Eds.) Nursing Theory: Utilization & Application (3rd ed., pp17-42) Alligood, M.R. (2006c). Models and theories: Critical thinking structures. In M.R. Alligood & A.M Apostolo, J., & Kolcaba K. (2009). The effects of guided imagery on comfort, depression, anxiety, and stress of psychiatric in patients with depressive disorders Chinn,P.L., Kramer, M.K. (2008). Integrated Knowledge development in nursing (7th ed.). St.Louis: Elsevier-Mosby. Dowd, T. (2010). Theory of Comfort. In M. Alligood & A. Tomey (Eds.), Nursing Theorists and Their Work (pp 705 – 721) Dowd,T., Kolcaba,K., & Steiner, R.(2000). Using cognitive strategies to enhance bladder control and comfort Dowd, T.,Kolcaba, K.,Steiner, R.,& Fashinpaur, D. (2007). Comparison of healing touch and coaching on stress and comfort in young college students.Holistic Nursing Practice, 21(4), 194-202. Fawcett, J. (2005). Contemporary nursing knowledge : Conceptual models of nursing and nursing theories (2nd ed.) Kolcaba,K.,& Kolcaba, R. (1991). An analysis of the concept of comfort. Journal of Advanced Nursing, 16, 1301-1310. Kolcaba, K. (2001). Evolution of the mid range theory of comfort for outcomes research. Nursing Outlook, 49 (2), 86-92. Kolcaba, K. (1997). The ComfortLine.com. Akron, OH: The University of Akron College of Nursing. Kolcaba, K. (1992b). The concept of comfort in an environment framework. Journal of Gerontological Nursing, 18 (6), 33-38. Kolcaba, K. (1994). A theory of holistic comfort for nursing. Journal of Advanced Nursing, 19, 1178-1184. Kolcaba, K., Dowd,T., Steiner, R., Mitzel, A. (2004). Hand massage to enhance comfort for hospice patients Kolcaba, K., & Fox,C. (1999). The effects of guided imagery on comfort of women with early stage breast cancer undergoing radiation therapy NANDA:Herdman, TH.,Heath,C., Meyer, G., Scroggins,L., & Vassallo,B., (2007-2008). Nursing Diagnoses: Definitions & Classification NIC: Johnson,M.,Bulechek, G.,Dochterman, J.,Maas, M.,& Moorhead,S. (2001). Nursing Diagnoses, Outcomes, & Interventions NOC: Moorhead, S., Johnson, M., & Mass,M.(2004). Nursing Outcomes Classification. St.Louis:Mosby, 228. March, A., & McCormack, D. (2009). Nursing theory-directed healthcare: modifying Kolcaba 's comfort theory as an institution-wide approach.