A Critical Analysis of Comfort Theory - Report Example

Comfort theory was developed by Katherine Kolcaba in the 1990s with the aim of understanding the concept of comfort within the confines of the nursing profession. Comfort theory is a mid-range theory that was developed for nursing practice and education. Katherine Kolcaba spent time analyzing the concept of comfort from the perspective of English, ergonomics, psychiatry, psychology, nursing, and medicine. The analysis leads to the identification of three forms of comfort and the introduction of contexts of holistic human experience. The three kinds of comfort are transcendence, ease, and relief. A critical analysis of comfort theory is undertaken to facilitate a deeper understanding of comfort theory and its application in nursing practice and education.

Purpose of Comfort Theory

The primary purpose of comfort theory is to improve the nursing profession by contributing to nurse education and practice. The theory has been used as a background for studies that seek to analyzes the role of nurses in patient care. It helps improve the quality of care by identifying the key factors that nurses should consider to ensure the patient achieves comfort.

Scope

Comfort theory is a predictive middle range theory. It is predictive because all the concepts have been defined and the connection between them identified. The association between intervening variables, comfort and other concepts is clear. The theory focuses on nursing practice and cannot be applied on at institutional level. It explains why it is classified as a middle range theory.

Major Concepts and Propositions

The meaning and purpose of comfort theory is anchored on the meaning and description of fundamental concepts that make up the theory. The process starts with the identification of healthcare needs, which is done by a friend or family. Healthcare needs vary with individual and setting. After the identification of healthcare needs, the patient is at liberty to seek help from a medical professional. At this point, the concept of intervening variables gains relevance. Intervening variables include factors that are difficult to change and are beyond the control of healthcare providers. For example, the impact of social support, financial condition, and prognosis.

Kolcaba believed the concept of comfort has a very intimate association with nursing practice. Conventionally, nurses have always endeavored to provide comfort to their patients and their families through different interventions that are referred to as comfort measures. These interventions help strength patients and their families. Patients and family members who have been empowered by the comfort measures are motivated to engage health seeking behavior. The implication is that the actions of nurses have a significant impact on the health seeking behavior of patients and their families.

Comfort theory defines enhanced comfort is the covetable feeling that follows nursing care. The constant delivery of comfort interventions over a period leads to an increase in comfort levels and the desirable health seeking behaviors. It should be noted that health seeking behaviors include peaceful death, internal bodily functions, and the external factors. The external factors include functional outcomes and all the activities related to the provision of healthcare services and taking care of patients.

Institutional integrity refers to the financial stability, wholeness, and values of healthcare organizations at national, regional, state, and local levels. Institutional integrity is connected to best policies and best practices. Comfort theory defines best policies as the procedures and protocols that have been established by an institution after collecting and analyzing evidence. Best practices include the procedures and guidelines that have been developed by an institution for the sake of a particular patient after the collection of evidence.

Comfort theory has eight propositions that claim nurses identify the comfort needs of family members or the patient, nurses design intervention measures, and considers all intervening variables. The only way to achieve comfort is to ensure that the interventions are delivered as scheduled. Patients and nurses should work together to identify desirable outcomes. If nurses deliver good intervention strategies, patients are motivated to look for desirable health seeking behaviors.

Theoretical Assumptions

Comfort theory assumes that:

• Comfort is a holistic result of effective nursing care.
• People have a holistic response to complex stimuli.
• It is the nature of human beings to seek comfort, and they will take time to seek it whenever it is possible.
• Nurses have the capacity to identify the comfort needs of a patient, design comfort measures, and assess the outcome to determine ways to achieve enhanced comfort.

Functional Components of Theory Analysis

Theoretical and Operation Definitions

Comfort theory perceives nursing as the intended assessment of a patient's comfort needs, developed of comfort measures to handle the identified comfort needs, and the reassessment of the patient's family comfort after all the comfort measures have been implemented. Nursing comes out as a process of identifying needs and taking measures to address these needs, and the process starts again.

The patient describes a community, family or individual that requires health care. The environment includes all external influences (like policies, procedures and physical surrounding) that can be manipulated to enhance the level of comfort. Comfort theory views heath as the optimum function level for a family, individual or community after being subjected to comfort measures.

The taxonomic structure of comfort is based on the three types of comfort, which are relief, transcendence, and ease. Relief is the feeling that comes when a comfort need has been met, ease describes a state of being content and calm, and transcendence is a state where an individual has gone beyond pain. These three types of comfort can be manifested in physical, sociocultural, environmental and psychospiritual contexts. The physical context refers to the immune system, bodily functions. The psychospiritual context deals with the intimate understanding of one's mind, sexuality, self-esteem and the meaning of life. The environmental context includes all external factors, and sociocultural context refers to interpersonal relations with friends, family, and colleagues.

Figure 1 Kolcaba's Taxonomic Structure

Linkages

All the concepts are connected in comfort theory. Kolcaba included diagnosis, assessment, , plans, intervention and evaluation. Each step leads to the next making it inappropriate to jump one step. The ideas are linked in a linear pattern making it easy to understand how comfort theory operates.

Logical Organization

The logical organization of comfort theory is good as evidenced by the development of theory as time passes. Kolcaba did an impressive concept analysis to mark the beginning of her theory. She studied comfort from different perspectives to confirm the meaning of comfort. All the arguments in comfort theory are supported by adequate research. The logical development of the theory has been good. The need to integrate comfort in healthcare emphasizes the importance of comfort theory in the 21st century.

Summarized Diagram

Figure 2 Conceptual Framework (Kolcaba K. , 2017)

Stated Outcomes and Consequences

The stated outcomes included institutional integrity that is characterized by best policies and best practices. The other consequences include peaceful death, internal behavior, and external behaviors.

Functional Components of Theory Evaluation

Validity, Relevance and Significance

Comfort theory is a valid theory that meets all the standards required to be classified as a middle range theory. The ideas flow in a linear pattern and the application of the theory in nursing practice and nursing education emphasizes its significance. Comfort theory is relevant to nursing practice where professionals learn to maximize comfort by following a set procedure. The significance of comfort theory is demonstrated by the wide number of studies that focuses on the theory and its application in some cases.

Strengths and Weaknesses

The clarity of comfort theory is high because of the use of simple terms that nurses and other medical professionals can understand. The conceptual elements of the theory are directed with the exception of the confusion between enhanced comfort and comfort. The use of simple terms makes the theory friendly to a wide range of people. The consistency of theory cannot be disputed because Kolcaba does not alter meanings as she describes the comfort theory. All her works refer to the same meanings and descriptions. The addition of social comfort as the fourth context has been reflected in all the works of the author. The theory has been organized very well starting from the purpose and inspiration of the theory to the factors that influence comfort and enhanced comfort. The close association between the concept comfort and nursing makes it easy for nurses to relate to comfort theory.

The weakness of comfort theory lies in its adequacy. The proponents of comfort theory believed it could be applied in any situation, but Kolcaba provides descriptions based on hospital setting. Queries have been raised about the application of comfort theory in an entire institution. There is no evidence to show comfort theory can work in any healthcare setting. There is no explanation of how comfort measures can be applied outside the hospital setting. The focus on one setting lowers the adequacy levels of comfort theory.

It is time for Kolcaba to consider widening the theory to consider institution wide application. Currently, the theory is limited to the nursing domain with the key focuses on nursing practice and education. The description of comfort is limited to what nurses can do. The scope and application of comfort theory can widen if other researchers find ways to go beyond the nursing domain and apply comfort theory. On the same note, Kolcaba fails to mention the importance of the nurses’ comfort. The theory talks about the comfort of the family and the patient but not that of the nurses. Logically, comfortable nurses are likely to give their best and ensure high quality service is available. Focusing on the comfort of nurses can help expand the application of comfort nurses to an institution. Increasing the comfort of nurses pushes them to work hard, which leads to high quality services that reflect positively on the organization.

Conclusion

Comfort theory is a mid-range nursing theory that focuses on nursing practice and education. The core concepts of the theory include comfort, intervening variables, health care needs, enhanced comfort, best policies and best practices. The theory has been influential in the field of nursing education where different people have studied its application in different areas. Comfort theory has been identified as the contemporary theory that could help bring back the concept of comfort in nursing practice. The theory can be applied in pediatrics and other areas that emphasize comfort.