Katharine Kolcabas Comfort Theory - Essay Example

Katharine Kolcabas Comfort Theory Auhtor [Pick the Background One the main goals of nursing care is to limit the discomfort of the patient to the maximum extent possible. Although this appears to be the central theme of the nursing practice as a whole, it was Katharine Kolcaba who for the first time introduced the notion of theorizing comfort and explaining it to allow nurses take appropriate measures in the daily practice to enhance comfort and minimize discomfort in patients. This is a novel idea, which has find widespread application in nursing practice on global scale. In Kolcaba’s understanding, human beings feel strengthened when their immediate needs for relief, ease and transcendence are addressed. This meeting of needs may be addressed physically, socioculturally, psychospiritually or environmentally. Whatever the means adopted, the ultimate aim is to reduce the discomfort of the patient which is perhaps the primary goal of any nursing care activity. Although it may be impossible to utilize all contexts (physical, psychospiritual, sociocultural or environmental) simultaneously; there is yet the possibility of utilizing the maximum modes possible, all aim at reducing discomfort while enhancing the feeling of comfort (Sitzman & Eichelberger, 2011). Chosen Problem in Practice In my opinion, one of the main problems that are encountered in the clinical setting on frequent basis is the care of patients having impaired integrity of skin, especially those patients who are unable to move on their own and are therefore immobilized to a variable extent. This group of patients comprises a special population who are destined towards a slow decline in their health status if appropriate measures are not taken during the early stages of their illness. As skin is the main barrier between the external and internal environment of the body, any defect in this barrier is likely to expose the individual to a variety of pathogens that can not only infect the dermatological tissue, but also invade the body, affect other organs and destroy the homeostasis of the body ultimately resulting in an unfavorable outcome (Freinkel & Woodley, 2001). A gravely uncomfortable consequence of impaired skin integrity is seen in the form of development of pressure-sores in patients are immobilized for extended periods of time. These lesions result due to the presence of persistent pressure on certain areas of the body and can ultimately contribute towards the fatality of the disease for which a patient is under treatment. Nursing Intervention The intervention designed for the chosen problem includes a number of measures that are collectively expected to result in a favorable prognosis of the condition and meet the goal of wound healing that is evident in the form of healthy tissue growth at the site of pressure sores. The intervention designed for the problem is explained below; Use of Analgesics Keeping in view Kolcoba’s theory, patients may gain substantial benefit from the use of appropriate analgesics, as they provide immediate and sustained relief from the discomfort of pain. Therefore, patients who are undergoing the discomfort of pain that result due to development of pressure-sores are ideal candidates for this intervention as it provides physical as well as psychological benefit by preventing the patient from draining emotionally due to sustained pain (Dolin, 2011). Pressure sore dressing Kolcoba’s assertion that comfort may result from ease lies behind the application of this intervention. The benefits of dressing are two fold; prevention of progression and reversal of the pathological process. In addition to this, the regular dressing of pressure sores is likely to help the patient emotionally, as it gives a feeling of being cared on regular basis. Dressing also provides a cushion that reduces the impact of pressure on the lesion; for this reason it enhances the ease of the patient (Timby, 2009). Frequently changing patient’s position Since pressure sores result due to sustained pressure; it is best to change the position of the patient on regular basis. When judged in the light of Kolcoba’s theory, this intervention is likely to provide benefit in physical terms. Since it is not possible for the nursing staff to change the position of the patient at regular intervals continuously, the attendants of the patient may be involved in the process. This is likely to benefit the patient in the sociocultural context. Back care Effective back care is likely to result in improved blood circulation in the area of the back, as this is the most commonly affected site. Doing this can have benefits that fall in the physical as well as the sociocultural contexts. The involvement of attendants/family is likely to bestow the sociocultural benefits in this setting. Protein-rich diet intake The role of a healthy diet in healing of wounds cannot be denied. Proteins play an essential role in the healing of wounds. For this reason, the diet of patients suffering from pressure sores should be modified to contain increased level of proteins, if not contraindicated otherwise (Arnold & Barbul, 2006). Doing this will provide then relief from the painful feeling in a short duration of time, as healthy eating is likely to enhance recovery thereby providing benefits in the physical and psychological contexts. Encouraging patient to ambulate The modern understanding is that patients should be allowed to live an active life as far as possible. This is important for the physical as well as psychological wellbeing. Supporting the patients emotionally to attempt an active lifestyle is likely to bring positive change in their behavior as it reduces their level of dependency and improves their image in the social context. The environment of the patient should be adjusted according to the ambulatory needs of the patient and any assistance in this regard should be provided. Tools like crutches or wheel chairs play a vital role in this regard. Facilitating the patients in this regard is likely to benefit them in the environmental as well as the psychological contexts. Evaluation of Effectiveness Evaluating the effectiveness will involve the following steps (Christensen & Kenney, 1995); Goal Identification, which in this case equates to a decrease in discomfort as well as an improvement in the status of lesions, which may be seen as healing of the wound. Data Collection which will involve collection of information from the patient as well as visible inspection (subjective and objective data) of the wound on daily basis as the intervention progresses. Interpretation of the findings will involve the analysis of the already obtained data and relating it to nursing actions Findings derived from analysis of data will be documented to subsequent use and reference. The findings will be compared to the desired outcome of the intervention. Revision of care plan will be based on the findings. If findings are suggestive of an improvement in the overall status (physical, psychospiritual, sociocultural and environmental) of the patient, the intervention will be continued. If the opposite is true, measures will be taken to improve the intervention plan to allow the patient benefit from improved care. Conclusion Kolcobas theory is an interesting way of explaining how the comfort level of a patient may be enhanced by simple measures that take away their worries. When patients are strengthened by increasing their comfort level, the outcome of nursing interventions is likely to yield more positive results than otherwise. Kolcobas theory can be used to provide the basis on which the comfort that results from nursing interventions can be judged. Since providing ‘comfort’ is one primary aim of nursing practice, the use of this theory or any further theories in this regard are likely to be helpful today and forever in the nursing practice. References Top of Form Arnold, M., & Barbul, A. (2006). Nutrition and wound healing. Plastic and reconstructive surgery, 117(7S), 42S-58S. Christensen, P. J., & Kenney, J. W. (1995). Nursing process: Application of conceptual models. St-Louis, Mo. ; Toronto: C. V. Mosby. Dolin, S. J. (2011). The Essence of Analgesia and Analgesics. British Journal of Anaesthesia, 106(6), 918-918. Freinkel, R. K., & Woodley, D. T. (Eds.). (2001). The biology of the skin. CRC Press. Sitzman, K., & Eichelberger, L. W. (2011). Understanding the work of nurse theorists: A creative beginning. Sudbury, Mass: Jones and Bartlett Publishers. Timby, B. K. (2009). Fundamental nursing skills and concepts. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins. Bottom of Form Read More