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Middle range theory in nursing
Middle range theory in nursing
Middle range theory in nursing
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As an RN whose specialties have included Medical, Geriatric and Pediatrics, I am drawn to learn more about Katherine Kolcabas Theory of Comfort. It is also the theory from which my organization based its pain and comfort documentation requirements upon.
Katherine Kolcaba is a nursing theorist who developed the Theory of Comfort in 1990. It is a “middle range theory for health practice, education and research” (Kolcaba, 2011) with a focus on comfort. The three forms of comfort that Kolcaba describes are relief, ease and transcendence. It is these terms that my organization utilizes in documentation of pain and comfort in the electronic health record.
Comfort may be experienced with relief by administering medications to a patient experiencing
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The main tenants of Katherine Kolcaba’s theory can be summarized and defined in the four concepts in the metaparadigm of nursing. The first concept is Person. This can be defined as any individual or group in need of health care and is not restricted to the patient.
The second concept, the environment, is the setting that can be controlled by the nurse or an individual to augment comfort. (Masters, 2017). In a hospital setting this could include dimming the lights, providing a low stimulation environment, or limiting visitors. Another example may be removing an individual from a situation that is not conducive to healing. Health is the third concept and refers to the orchestration and collaboration of those involved in assisting the patient to a state of well-being. Lastly, the concept of nursing describes the utilization of the nursing process of assessment, planning, intervention to meet the comfort needs of the individual and evaluating the effectiveness of those
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Physical pain is more easily addressed by the administration of medication or a non-pharmaceutical intervention like repositioning, or the application of heat or cold. Nursing care on a general medical unit is about patient and family centered care which is in alignment with Kolcaba’s Theory of Comfort. A large portion of the patients seen on this type of unit have multiple comorbidities and challenging social situations that require assessment of their past health history, their support system, and their current living situation. All of this is taken into consideration in multidisciplinary rounds where data that is collected is communicated to all disciplines and a plan of care developed for each patient. The unit which I currently manage assembles our multidisciplinary unit daily. Needs are identified and assigned to the team members who include social work, care management and therapies in addition to the nurses and the providers. Since the team meets daily there is an opportunity to evaluate the effectiveness of the interventions prescribed. Nursing care management is integral in this work as part of the assessment, planning, and coordination of care in the hospital
WEEK 2 READING REVIEW 4
setting and as the patient returns to their home and community. The goal by all involved is to move the patient towards
Concept analysis is essential in nursing to produce a more in-depth understanding of the concept being analyzed; thus, improving nursing practice. The foundation for research and theory is built from concept analysis. The concept being analyzed in this paper is comfort. Comfort is the desired goal in nursing practice. All nursing care, including the nursing process (assessment, planning, implementation, and evaluation) is implemented to obtain the outcome of comfort ("Kolcaba's Theory of Comfort," n.d.). The purpose of this concept analysis is to define comfort, determine the defining attributes, create a conceptual definition, identify antecedents and consequences, identify a model, borderline, and contrary case,
Nosbusch, J. M., Weiss, M. E., & Bobay, K. L. (2011). An integrated review of the literature on challenges confronting the acute care staff nurse in discharge planning. Journal of clinical nursing, 20(56), 754-774. Reynolds, M. A. H. (2009). "The Species of the World Postoperative pain management teaching in a rural population.
Comfort theory by Katheryn Kolcaba is the experience of having Physical, Psychospiritual, Environmental and sociocultural needs met by the relief, ease, or transcendence of each problem. For example pain is the physical issue, Low self-esteem would be a psychospiritual, being in a noisy room can be environment, and not having sufficient finances for sociocultural problems. To relieve any of these problems is to meet each need and solve the problem. Ease is to calm the problem reducing or taking it away, and transcendence is rise above the needs or outgrow the needs (Flood, 2013). This theory addresses how one would identify and solve problems related to care, it also is used in nursing assessment. Identification of the problem is the first
Assessing and managing pain is an inevitable part of nursing and the care of patients. Incomplete relief of pain remains prevalent despite years of research due to barriers such as lack of kn...
... middle of paper ... ... After the implementation of the stated interventions, the patient made physical and emotional progress towards the aforementioned goals. The above goals were not only met, but exceeded expectations of the patient and the nurses who provided care.
Findings. Pain has many different meanings to many people. What is important to know as a nurse or health care provider is that pain is what the patient says it is. It is not the nurse or provider’s place to determine what the patient’s pain is but rather take an in-depth history and assessment. Using this assessment and history can therefore help treat your patient’s pain accordingly. Also pain theories have been proposed and used the implications of nursing practice in regard to pain.
Katharine Kolcaba comfort theory is a middle range theory. Comfort theory developed to look at health practice, education and research. Kolcaba (1990) described comfort as existing in three forms relief, ease and transcendence. Holistic comfort is defined as the experience of being strengthened through having the needs for relief, ease and transcendence met in four context the physical, social, psycho-spiritual and environment (Kolcaba, 2010). The theoretical structure of Kolcaba’s comfort theory contributes to nursing by guiding the work and thinking of all health care providers (March & McCormack, 2009). The comprehensiveness of this theory will benefit nursing practice in theory development and
The general idea of, K, is that a nurse must have knowledge in the diversity of cultures, ethics, and education. The significance of this faction being that if the nurse is cognizant of the patient 's culture, beliefs, family values, support systems, and education level, a more thorough and comprehensive plan of care can be formulated. The premise of, S, is that a nurse must be skilled in the ability to communicate with and advocate for the patient, assess for and properly treat pain, and incorporate the needs and concerns of the patient and their family. The significance of this group and development of these skills include the achievement of pain control, increased rehabilitation periods, and an increase in patient/family satisfaction. The theme of, A, requires that a nurse maintains an open attitude toward the patient and to respect and validate the nurse-patient relationship, which will aid in a positive nurse-patient
Nursing encompasses the compassionate, holistic, and virtuous care that nurses deliver to patients, families, and communities in order to assist with achieving optimal health and wellness or attaining comfort and acceptance. Compassionate care encompasses the empathy and drive to help others that the nursing profession pos...
McCaffery, M. (1968). Nursing practice theories related to cognition, bodily pain, and man-environment interactions. Los Angeles: University of California Los Angeles Students’ Store.
Every person’s needs must be recognized, respected, and filled if he or she must attain wholeness. The environment must attuned to that wholeness for healing to occur. Healing must be total or holistic if health must be restored or maintained. And a nurse-patient relationship is the very foundation of nursing (Conway et al 2011; Johnson, 2011). The Theory recognizes a person’s needs above all. It sets up the conducive environment to healing. It addresses and works on the restoration and maintenance of total health rather than only specific parts or aspect of the patient’s body or personality. And these are possible only through a positive healing relationship between the patient and the nurse (Conway et al, Johnson).
The roots of comfort can be discovered back to the work of Nightingale who described comfort as a primary outcome for nursing (Kolcaba, 2015). Kolcaba spent many years executing research to create the Theory of Comfort which was developed from other nursing theories. Many nursing theories examine comfort. Watson’s Theory of Caring uses comfort to adjust the internal and external environments of a patient (Watson & Nelson, 2012). Roy’s Theory of Adaptation focus on the nurse heling patients by providing comfort for adaptation (Saleem Punjani, 2013). The overall goal is to provide comfort to the patient and their family.
Comfort status: Patient will report a positive perception of physical and psychological ease. There are three forms of comfort that exist. Relief would be attained if the antiemetic’s helped decrease the nausea and vomiting. Ease would be achieved if Laura has a reduction in her feelings of restlessness, depression and control over her treatment regime. Transcendence is the state
Attention Attention is defined as “notice taken of someone or something; the regarding of someone or something as interesting or important”. Attention is an important characteristic of caring in nursing because it helps the patient feel important and acknowledged. Comfort Comfort is defined as “a state of physical ease and freedom from pain or constraint” by the Oxford online dictionary (2016).
Watson, J. (1997). The theory of human caring. Retrospective and prospective. Nursing Science Quarterly. 10(1), 49-52.