katherine kolcaba

8/18/2019 Katherine Kolcaba

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2/21

COMFORT THEORY

#C"m$"rt may be a blanket "r breeze%

s"me "intment ere t" s""te my knees&

a listening ear t" ear my w"es%

a pair "$ $""ties t" warm my t"es&

A PRN medicati"n t" ease my pain% s"me"ne t" reassure me "nce again&

A call $r"m my d"ct"r% "r e'en a $riend%

a rabbi "r priest as my li$e nears its end.

C"m$"rt is wate'er ( percei'e it t" be%a necessary ting de$ined "nly by me.)

*S.D. +awrence ,student nurse-

,K"lcaba% //0% p.1-


3/21

MOTIVATION AND HISTORICALBACKGROUND C"m$"rt 2e"ry "riginated $r"m a 3asters pr"gram

assignment 4 t" diagram er nursing practice

At tat time% se was a ead nurse "n an

Alzeimer unit

C"m$"rt was te state se wanted er Alzeimer

patient5s t" be in wen n"t participating in

acti'ities "r tasks. C"m$"rt became er $"cus in

nursing practice and researc

C"m$"rt te"ry was later applied t" "ter $ields "$nursing% suc as peri"perati'e care and pediatrics

ttp:66www.tec"m$"rtline.c"m6inde7.tml


4/21

ASSUMPTIONS & POINT OF VIEW

Nursing care is m"re e$$icient wen te"ry is

used because care can be deli'ered in an

"rganized manner

Science "$ nursing is ab"ut te c"m$"rt "$patients% $amilies% and nurses

8en nurses pr"'ide c"m$"rt measures% suc

as turning a patient e'ery "urs% te patient

is e7pected t" a'e a p"siti'e "utc"me Care is deli'ered and based "n a umanistic

and "listic appr"ac and patients5 needs

,K"lcaba% 1991-


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6/21

INFLUENCES ON KOLCABA’SPHILOSOPHY2ree 2ypes "$ C"m$"rt

Relie$* adapted $r"m (da =ean

>rland"5s w"rk: nurses relie'e

patient5s needs

Ease 4 adapted $r"m irginia;enders"n5s w"rk: uman

$uncti"ns necessary $"r

"me"stasis

2ranscendence 4 adapted $r"m

="sepine Paters"n and +"retta

?derad5s w"rk: patients impr"'ewit te elp "$ nurses

,K"lcaba% 1991-

@"ur C"nte7ts "$

C"m$"rt

Pysical Psyc"spiritual

En'ir"nmental

S"cial


7/21

CONCEPTS OF COMFORT THEORY K"lcaba rec"gnized tat disc"m$"rt is m"re tan ust a pain$ul

pysical sensati"n "r em"ti"nal pain tat is $elt. (nstead se

c"ncluded tat "ter aspects "$ c"m$"rt "r disc"m$"rt a$$ect "listicbeings.

K"lcaba de$ined te tree types "$ c"m$"rt: Relief * e7perience "$ a patient w" as ad a speci$ic c"m$"rt need met

Eae* a state "$ calm "r c"ntentment

T!a"#e"$e"#e* te state in wic "ne rises ab"'e pr"blems "$ pain

2ese types "$ c"m$"rt are addressed by means "$ te $"ur c"nte7ts: P%i#al* pertaining t" sensati"ns ,pain% c"ld% eat% tingling-% "me"static

mecanisms ,temperature c"ntr"l% bleeding% '"miting* can all disrupt tis area- "r

$uncti"n "$ te immune system.

P#%'(i!i)*al* pertaining t" internal awareness "$ sel$% including esteem%identity% se7uality% meaning in "nes li$e% and "ne5s $eelings "r belie$ in a iger

p"wer "r superi"r being.

E"+i!'",e")al* pertaining t" te e7ternal backgr"und "$ uman e7perience,temperature% ligt% s"und% "d"r% c"l"r% $urniture% landscape-

S'#i'#*l)*!al* pertaining t" interpers"nal% $amily and s"cietal relati"nsips& als"

includes $amily traditi"ns% rituals and religi"us practices.,K"lcaba% //


8/21

TA-ONOMIC STRUCTURE 8en c"mbined% te tree types "$ c"m$"rt and c"nte7ts

create a 1 cell grid% re$erred t" as te ta7"n"mic structure%

wic was created by K"lcaba in 1991. 2is can be used as aguide wen assessing a patient5s le'el "$ c"m$"rt.

2ese aspects "$ c"m$"rt are interrelated wit "ne an"ter.

K"lcaba did n"t mean $"r tem t" be measured e7actly because

se $elt te pr"cess w"uld be time*c"nsuming and inaccurate

,K"lcaba% //0-. ;"we'er% a pattern "$ care can be establisedwereby patients c"m$"rt needs are intuiti'ely assessed in te

c"nte7ts.

Context of

Comfort

Type of Comfort

Relief Ease Transcendence

Physical

Psychospiritu

al

Environment

al

Social


9/21

NURSING METAPARADIGM

N"w lets l""k at te $"ur gl"bal c"ncepts "$

te nursing metaparadigm in relati"n t"

Katerine K"lcaba5s C"m$"rt 2e"ry.

;uman beings En'ir"nment ;ealt

Nursing


10/21

HUMAN BEINGS. 2is includes all in need "$ ealt care* indi'iduals% $amilies

and entire c"mmunities "r instituti"ns.

2e aspect "$ c"m$"rt is an imp"rtant and innate need t" be

attained. All umans deser'e t" be as c"m$"rtable as p"ssible.

Patient $"cused care is integral t" attaining c"m$"rt.

8en patients are m"re c"m$"rtable% tey are m"re likely t"

engage in ealt seeking bea'i"rs*including internal "r

e7ternal bea'i"rs "r e'en a peace$ul deat.

2e strengtening pr"perties "$ c"m$"rt pr"duce better

patient "utc"mes.

,K"lcaba% //0-


11/21

ENVIRONMENT. 3anipulati"n "$ te e7ternal surr"undings "$ te patient t"

$acilitate c"m$"rt. y means "$ t"uc% sigts% s"unds% ligting "r"d"rs t" pr"m"te a calming% c"m$"rting atm"spere. Any way tat

te senses can be altered t" enance c"m$"rt "$ te patient

applies.

;a'ing an understanding "$ te patient5s cultural% religi"us "rspiritual pre$erences and including tem in care pr"m"tes c"m$"rt.

8en te w"rds and acti"ns "$ te nurse are c"m$"rting% in

additi"n t" te intent "$ pr"'iding c"m$"rt% te inter'enti"ns are

"$ten percei'ed m"re as a c"m$"rt measure by te patients,K"lcaba% //0-.

Eliminate negati'ity in te en'ir"nment i$ p"ssible* pr"m"te

p"siti'e tinking and attitudes.


12/21

HEALTH. Acc"rding t" Katerine K"lcaba ,//0-% #;ealt is c"m$"rt) ,p.

0-

2e "ptimum le'el "$ $uncti"ning tat is appr"priate $"r and

de$ined by eac indi'idual patient.

2" be in g""d ealt a patient must attain wat 2;E! c"nsider

teir igest degree "$ c"m$"rt. C"m$"rt is a p"siti'e% dynamic

state and te ealt care team can d" m"re t" enance

c"m$"rt i$ tey g" bey"nd te treatment "$ disc"m$"rts and

pysical ealt ,K"lcaba% //0-.

8en "ne "$ te c"nte7ts "r 0 types "$ c"m$"rt is n"t

balanced "r being met% te patient may n"t be at teir igest

le'el "$ wellness "r ealt al"ng te ealt c"ntinuum.


13/21

NURSING. C"ntinual% acti'e use "$ te nursing pr"cess t" assess te c"m$"rt

"$ te patient and address teir needs t" attain c"m$"rt.

Assessing and reassessing weter te inter'enti"ns implemented

were success$ul in impr"'ing te c"m$"rt "$ te patient.

Pr"'iding c"mpetent empatetic% c"mpassi"nate% skilled and"listic nursing care t" eac patient% wit"ut in$licting udgment.

3aintaining a str"ng% trusting nurse*patient relati"nsip and

in'"l'ing te patient in meeting teir c"m$"rt needs and g"als

will make te pr"cess m"re success$ul.

,K"lcaba% //


14/21

INTERPRETATION & INFERENCE (nter'enti"ns $"r te patient are based "n

needs "$ te patient as well as $amily needs

C"m$"rt needs are intermi7ed. 3eeting "neneed may% in turn% $ill an"ter need

8en c"m$"rt needs are $ul$illed% te

patient $eels sa$e and well cared $"r.

,K"lcaba% 199-


15/21

IMPLICATIONS &CONSE/UENCES

8en c"m$"rt tasks suc as cleaning up r""m

"r straigting seets are pre$"rmed% patients

$eel cared $"r.

Patients w" a'e less stress a'e better"utc"mes

Nurses $eel m"re "b satis$acti"n because

e'en te smallest tasks bring c"m$"rt t"

teir patients.


16/21

EVALUATIONCla!ifi#a)i'" 'f

O!i0i"

Katerine5s pil"s"py e'"l'ed $r"m "lism% uman

needs and 3urray5s 2e"ry "$ ;uman Press ,190F-and was designed "nly $"r nursing ,K"lcaba% //0

pp.


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18/21

PRACTICE

2eC"m$"rt2e"ry

A$+a"#e$Di!e#)i+e1 guide t"

make decisi"nsab"ut care and pain

management,endlinski G

K"lcaba% 199H-

;ealty ladderPr"gram $"r Irinary

(nc"ntinence in"lder adults ,Scirm

et al.% //-

Pe$ia)!i#*assistingte cild wit sel$c"m$"rting acti"nssuc as #r"cking)

,K"lcaba G Di3arc"%

//-

P#%ia)!i# N*!i"010*i$e$ i,a0e! )'!elie+e $e(!ei'"

a"$ i"#!eae #',f'!)2A(')'l' & K'l#a3a4

56678

Pe!ia"e)%eia*Clinical Practice

Juidelines,retrie'ed $r"mttp:66www.aspan."rg6

-

http://www.aspan.org/Portals/6/docs/ClinicalPractice/Guidelines/http://www.aspan.org/Portals/6/docs/ClinicalPractice/Guidelines/http://www.aspan.org/Portals/6/docs/ClinicalPractice/Guidelines/http://www.aspan.org/Portals/6/docs/ClinicalPractice/Guidelines/


19/21

CASE STUDY

C'")e9) 'f

C',f'!)

T(e 'f C',f'!)

Relie$ Ease 2ranscendence

P%i#al

P#%'(i!i)*al

E"+i!'",e")al

S'#i'#*l)*!al

15 year old female, diabetic patient as admitted to the hospital for asecond time in one month ith hyper!lycemia" She as found to be cryin!and ithdran, curled up in the fetal position in the dar#" Sta$ is

concerned because she does not ant to participate in administerin!insulin, chec#in! her blood su!ars, and meal plannin!" She indicates thatshe feels di$erent than everyone else and ants to be able to eathatever she ants"


20/21

REFERENCES:

Ap"st"l"% =.+.A.% G K"lcaba% K.% ,//9-. 2e e$$ects "$ guided

imagery "n c"m$"rt% depressi"n% an7iety% and stress "$ psyciatric

inpatients wit depressi'e dis"rders. Archives of PsychiatricNursing, 23,


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REFERENCES:3arc% A.% 3cC"rmick% D. ,//9-. Nursing te"ry*directed

ealtcare m"di$ying k"lcaba5s c"m$"rt te"ry as an

instituti"n*wide appr"ac. "olistic Nursing Practice 23,-% pp.

H*F/. Retrie'ed $r"m Pub3ed

Scirm% .% aumgardner% =.% D"wd% 2.% Jreg"r% S.% G K"lcaba% K.%

,//-. NJNA. De'el"pment "$ a ealty bladder educati"npr"gram $"r "lder adults. eriatric Nursing, 2,-% pp 0/1* 0/

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