lisa b. flatt, rn, msn, chpn. kolcaba’s comfort theory (2003) provides guidance for the nurse to...
TRANSCRIPT
![Page 1: Lisa B. Flatt, RN, MSN, CHPN. Kolcaba’s Comfort Theory (2003) provides guidance for the nurse to instruct and educate the patient and family in a holistic](https://reader030.vdocuments.site/reader030/viewer/2022013011/56649e0e5503460f94af7a8a/html5/thumbnails/1.jpg)
Lisa B. Flatt, RN, MSN, CHPN
![Page 2: Lisa B. Flatt, RN, MSN, CHPN. Kolcaba’s Comfort Theory (2003) provides guidance for the nurse to instruct and educate the patient and family in a holistic](https://reader030.vdocuments.site/reader030/viewer/2022013011/56649e0e5503460f94af7a8a/html5/thumbnails/2.jpg)
Kolcaba’s Comfort Theory (2003) provides guidance for the nurse to instruct and educate the patient and family in a holistic manner.
Holistic care: physical, psychospiritual, environmental and social needs
Types of comfort: relief, ease and transcendence
![Page 3: Lisa B. Flatt, RN, MSN, CHPN. Kolcaba’s Comfort Theory (2003) provides guidance for the nurse to instruct and educate the patient and family in a holistic](https://reader030.vdocuments.site/reader030/viewer/2022013011/56649e0e5503460f94af7a8a/html5/thumbnails/3.jpg)
Relief – state of recipient after need is metExample: patient states no pain, asleep
Ease – state of calm/contentmentExample: asleep, relaxed expression
Transcendence – state where patient rises above their pain or problemsExample: accepted facts and realistic of
condition
![Page 4: Lisa B. Flatt, RN, MSN, CHPN. Kolcaba’s Comfort Theory (2003) provides guidance for the nurse to instruct and educate the patient and family in a holistic](https://reader030.vdocuments.site/reader030/viewer/2022013011/56649e0e5503460f94af7a8a/html5/thumbnails/4.jpg)
Remove or alleviate painful symptom Meeting a specific need Not always complete Can be partial or temporary
![Page 5: Lisa B. Flatt, RN, MSN, CHPN. Kolcaba’s Comfort Theory (2003) provides guidance for the nurse to instruct and educate the patient and family in a holistic](https://reader030.vdocuments.site/reader030/viewer/2022013011/56649e0e5503460f94af7a8a/html5/thumbnails/5.jpg)
State of calm, peace, contentment Able to do ADL’s Total relief of pain Relief from situations that are long-term Does not have to follow pain or
discomfort
![Page 6: Lisa B. Flatt, RN, MSN, CHPN. Kolcaba’s Comfort Theory (2003) provides guidance for the nurse to instruct and educate the patient and family in a holistic](https://reader030.vdocuments.site/reader030/viewer/2022013011/56649e0e5503460f94af7a8a/html5/thumbnails/6.jpg)
ConqueringPainSufferingCertain circumstances
Motivated beyond the ordinary to reach an extraordinary goalPatient with spinal cord injury, walks again
after told they would not
![Page 7: Lisa B. Flatt, RN, MSN, CHPN. Kolcaba’s Comfort Theory (2003) provides guidance for the nurse to instruct and educate the patient and family in a holistic](https://reader030.vdocuments.site/reader030/viewer/2022013011/56649e0e5503460f94af7a8a/html5/thumbnails/7.jpg)
Physical – go along with the patients diagnosis, ie: pain relief, nausea, pruritis, constipation
Psychospiritual – self esteem, concept of self, relationship with higher being/belief (or having none), self concept, sexuality, meaning of life
Social – interaction with family, work and other relationships
Environmental – noise, temp, H2O, food, shelter, diet, rest, language
![Page 8: Lisa B. Flatt, RN, MSN, CHPN. Kolcaba’s Comfort Theory (2003) provides guidance for the nurse to instruct and educate the patient and family in a holistic](https://reader030.vdocuments.site/reader030/viewer/2022013011/56649e0e5503460f94af7a8a/html5/thumbnails/8.jpg)
Caring (goals to design interventions)
Comfort (interventions you take)
How nurses do work
Caring as an outcome
Design nursing interventions via nursing process to meet needs
Efficient & satisfying for caregivers and patients
Better use of existing resources
Nurses use daily Manage pain; O2;
elimination; hydration Distraction; deep
breathing Comfort measures
Back rub, music, bath, presence, therapeutic touch
![Page 9: Lisa B. Flatt, RN, MSN, CHPN. Kolcaba’s Comfort Theory (2003) provides guidance for the nurse to instruct and educate the patient and family in a holistic](https://reader030.vdocuments.site/reader030/viewer/2022013011/56649e0e5503460f94af7a8a/html5/thumbnails/9.jpg)
InductionBuilding general conclusions from specific
observed happenings Interventions nurse performs that define care-
constipated and give poop medicine
DeductionHow reach conclusions (assessment)- no
poop for 12 days Retroduction
Evaluations – results and reassessment
![Page 10: Lisa B. Flatt, RN, MSN, CHPN. Kolcaba’s Comfort Theory (2003) provides guidance for the nurse to instruct and educate the patient and family in a holistic](https://reader030.vdocuments.site/reader030/viewer/2022013011/56649e0e5503460f94af7a8a/html5/thumbnails/10.jpg)
Direct what you do Indirect you or others do
Hot or cold fluids Heat/cold application Massage Medications Meditation/prayer Distraction Mouth care Linen change Things from home Positioning
Peaceful environment
Active listening Support patient and
family: identify concerns/fears
May include: MSW, Pastoral care
![Page 11: Lisa B. Flatt, RN, MSN, CHPN. Kolcaba’s Comfort Theory (2003) provides guidance for the nurse to instruct and educate the patient and family in a holistic](https://reader030.vdocuments.site/reader030/viewer/2022013011/56649e0e5503460f94af7a8a/html5/thumbnails/11.jpg)
Physical Therapeutic touch, skin care, comfort through
warmth, mouth care, ROM Psychospiritual
Soothing presence Support during decision-making times
Social interactions Family interactions Social interventions Respect boundaries Structure and organization in healthcare setting-
same page r/t care/communication/disciplines – noise – late night VS- no rest
![Page 12: Lisa B. Flatt, RN, MSN, CHPN. Kolcaba’s Comfort Theory (2003) provides guidance for the nurse to instruct and educate the patient and family in a holistic](https://reader030.vdocuments.site/reader030/viewer/2022013011/56649e0e5503460f94af7a8a/html5/thumbnails/12.jpg)
Sender – has message that is meaningful to them in a respectful manner
Receiver – gets message the decoder Encoding – body language, tone of
voice, facial expression Hidden messages – don’t use ‘medical
jargon’, education on care Clarify and restate message ‘answers’ Sender must acknowledge acceptance
of ‘answer’
![Page 13: Lisa B. Flatt, RN, MSN, CHPN. Kolcaba’s Comfort Theory (2003) provides guidance for the nurse to instruct and educate the patient and family in a holistic](https://reader030.vdocuments.site/reader030/viewer/2022013011/56649e0e5503460f94af7a8a/html5/thumbnails/13.jpg)
Intensity of presence Actions
Open posture, approachableFacing the personBend forwardEye contactCultural appreciationCalmness and ease
![Page 14: Lisa B. Flatt, RN, MSN, CHPN. Kolcaba’s Comfort Theory (2003) provides guidance for the nurse to instruct and educate the patient and family in a holistic](https://reader030.vdocuments.site/reader030/viewer/2022013011/56649e0e5503460f94af7a8a/html5/thumbnails/14.jpg)
Develop trust and convey acceptance Need to be genuine with desire to assist Influences: age, gender, education,
value system, ethical and cultural belief, expectations, preferences
![Page 15: Lisa B. Flatt, RN, MSN, CHPN. Kolcaba’s Comfort Theory (2003) provides guidance for the nurse to instruct and educate the patient and family in a holistic](https://reader030.vdocuments.site/reader030/viewer/2022013011/56649e0e5503460f94af7a8a/html5/thumbnails/15.jpg)
Concentration Verbal and non-verbal interactions Clarify – pt says I want chocolate milk –
“Let me understand, you would prefer chocolate milk?”
Reflection – “You sound as if you really like chocolate milk, can you tell me why?”
Restate – “Do you want chocolate milk” Focus on content – chocolate milk Open ended questions – “How are you
feeling today?”
![Page 16: Lisa B. Flatt, RN, MSN, CHPN. Kolcaba’s Comfort Theory (2003) provides guidance for the nurse to instruct and educate the patient and family in a holistic](https://reader030.vdocuments.site/reader030/viewer/2022013011/56649e0e5503460f94af7a8a/html5/thumbnails/16.jpg)
Sensitivity to culture, beliefs Misunderstandings Lecturing Stereotyping Distractions Lack commitment Emotions Interrupting Poor listening skills
![Page 17: Lisa B. Flatt, RN, MSN, CHPN. Kolcaba’s Comfort Theory (2003) provides guidance for the nurse to instruct and educate the patient and family in a holistic](https://reader030.vdocuments.site/reader030/viewer/2022013011/56649e0e5503460f94af7a8a/html5/thumbnails/17.jpg)
Gender, age, etc…… Men and women, communicate differently
Women – intimacy, self esteem, decrease differences
Males – independence, establish rank Stage of growth and development
Infants, teens, adults, aged Cultures and values
Language and translationViews
Preferences
![Page 18: Lisa B. Flatt, RN, MSN, CHPN. Kolcaba’s Comfort Theory (2003) provides guidance for the nurse to instruct and educate the patient and family in a holistic](https://reader030.vdocuments.site/reader030/viewer/2022013011/56649e0e5503460f94af7a8a/html5/thumbnails/18.jpg)
Holistic intervention Promotes comfort, control, well-being,
patient and family participate Complementary therapy
Accupuncture, massage, accupressure, yoga
![Page 19: Lisa B. Flatt, RN, MSN, CHPN. Kolcaba’s Comfort Theory (2003) provides guidance for the nurse to instruct and educate the patient and family in a holistic](https://reader030.vdocuments.site/reader030/viewer/2022013011/56649e0e5503460f94af7a8a/html5/thumbnails/19.jpg)
Assessment Analysis Planning
Interventions – consider ethical and legal implications
Implementation Evaluation