comfort theory: a framework for healthy bladders and planning for

20
Comfort Theory 101 Katharine Kolcaba The University of Akron College of Nursing

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Page 1: Comfort Theory: A Framework for Healthy Bladders and Planning for

Comfort Theory 101

Katharine KolcabaThe University of Akron

College of Nursing

Page 2: Comfort Theory: A Framework for Healthy Bladders and Planning for

What do we mean by comfort?

• Complex term• Common use• Technical definition

(Kolcaba, 1992)• Strengthening

component (rationale for comforting interventions in both populations)

Page 3: Comfort Theory: A Framework for Healthy Bladders and Planning for

Dictionary Definitions: Comfort (Webster) • 1. To soothe in distress or sorrow.• 2. Relief from distress (absence of previous

discomfort) (negative sense)• 3. A person or thing that comforts• 4. A state of ease and quiet enjoyment, free from

worry (neutral sense)• 5. Anything that makes life easy • 6. Suggests the lessening of misery or grief by

cheering, calming, or inspiring with hope (positive sense)

• verb, noun, adjective, adverb

Page 4: Comfort Theory: A Framework for Healthy Bladders and Planning for

ReliefRelief

I need help because I’m lonley.

Page 5: Comfort Theory: A Framework for Healthy Bladders and Planning for

Ease

I feel totally peaceful.

Page 6: Comfort Theory: A Framework for Healthy Bladders and Planning for

Transcendence

I did it! (with the help of my coach…)

Page 7: Comfort Theory: A Framework for Healthy Bladders and Planning for

Research Study: Comfort in LTC setting (Hamilton, 1989)

• Research questions:• What is the residents’ definition of comfort?• What contributes to the residents’ comfort?• What detracts from the residents’ comfort?• How can residents become more comfortable?• (Qualitative study)

Page 8: Comfort Theory: A Framework for Healthy Bladders and Planning for

Five recurring themes:

Physical Comforthomeostasis, pain relief,

symptom management

Page 9: Comfort Theory: A Framework for Healthy Bladders and Planning for

• 2001: Data from more than 2.2 million nursing home staff who usually underestimate true pain burden of residents.

• Woefully inadequate pain management among frail and old population of Americans.

Page 10: Comfort Theory: A Framework for Healthy Bladders and Planning for

• Positioning– Returning to bed when

requested– Better seating

arrangements

Page 11: Comfort Theory: A Framework for Healthy Bladders and Planning for

But physical comfort and positioning isn’t the only important type of comfort

• There are three more comfort themes that the participants in this study cited…

Page 12: Comfort Theory: A Framework for Healthy Bladders and Planning for

Comfort theme of self-esteem (psychospiritual)

Page 13: Comfort Theory: A Framework for Healthy Bladders and Planning for

Comfort theme of approach and attitudes of staff (sociocultural)

Page 14: Comfort Theory: A Framework for Healthy Bladders and Planning for

Comfort theme of hospital life (environment).

Page 15: Comfort Theory: A Framework for Healthy Bladders and Planning for

Definition of Holistic Comfort

Relief Ease Transcendence

Physical

Psycho- Spiritual

Socio-Cultural

Environ-mental

(Kolcaba, 2003)

Page 16: Comfort Theory: A Framework for Healthy Bladders and Planning for

Technical definition of Comfort (cont)

• The state of being strengthened when needs for relief, ease, and transcendence are met in four contexts of experience: physical, psychospiritual, sociocultural, and environmental

• Nice fit with nursing practice and research!

Page 17: Comfort Theory: A Framework for Healthy Bladders and Planning for

Comfort Theory (3 parts)

• Comforting interventions enhance patients’ comfort.

• Enhanced patient comfort is positively related to engagement in HSBs – Comfort is strengthening

• When patients (and families) engage in HSBs, institutions have better outcomes– Patient satisfaction, nurse retention, costs down

Page 18: Comfort Theory: A Framework for Healthy Bladders and Planning for

Practical Application• Holistic assessment of patients’ comfort needs

– Use grid as a guide• Holistic interventions to meet those needs.

– Use grid as a guide• Relationship of comfort (holistic outcome) to

health seeking behaviors (HSBs) – External HSBs: e.g. functional status, rehab progress– Internal HSBs: e.g. healing, t-cell counts, etc.– Peaceful death: perfect for hospice and palliative care

• Holistic instruments to determine outcomes

Page 19: Comfort Theory: A Framework for Healthy Bladders and Planning for

• Institutional outcomes: increased patient satisfaction, decreased cost, decreased readmissions, etc.

• Don’t forget about comfort of nurses!

Page 20: Comfort Theory: A Framework for Healthy Bladders and Planning for

• Kolcaba, K. (2003). Comfort Theory and Practice. Springer.

• Available at: – www.uakron.edu/comfort– www.SpringerPub.com– www.Amazon.com