Introduction
According to CDC data for 2019-2021, roughly 20% of persons in the United States report chronic pain. Patients all around the globe are distressed by a wide variety of issues, including physical, psychological, emotional and spiritual pain (S. M. Oliveira et al., 2020). Palliative care patients and their caregivers’ grief and sorrow as they near the end of their lives. Many medical specialities are concerned with patient care, but nursing is the most prominent. The purpose of a nurse is to alleviate and decrease the suffering of patients in every way possible. Kathrine Kolcaba’s Comfort Theory provides a framework for addressing and minimizing human pain regardless of the situation (T. Vo, 2020). The Comfort Theory is the sole theory that focuses on recognizing and eliminating human suffering, making it a suitable choice for geriatric nursing and this paper. This paper explores how to integrate and implement the Comfort Theory in geriatric nursing patients with diverse acute and chronic medical issues and how to overcome the challenges and barriers to successful implementation.
Theory description
Overview of the Theory Purpose
The purpose of Kolcaba’s nursing comfort theory is both descriptive and explanatory. The theory seeks to define and explain fundamental concepts like comfort, relief, and holistic therapy. It underlines the significance of comfort in influencing favourable health outcomes (Lin et al., 2023). The theory aims to improve patient satisfaction with treatment by exploring the link between patients’ health-seeking behaviours and their degree of comfort in the medical setting (Marques & Alves, 2020). This theory is regarded to be in the middle range of theories since it concentrates on a central notion and a few related concepts. It does not explore more intricate and advanced theories (Yazdi & Ebrahimpour, 2021).
Concepts
Kolcaba’s theory stresses comfort as its central concept and considers health-seeking behaviour, comprehensive treatment, and institutional integrity essential in achieving it. It focuses on satisfying patients’ needs by considering their physical, psychological, spiritual, and social stress (Yazdi & Ebrahimpour, 2021).
Structure
The taxonomic structure of the comfort theory includes three types of comfort: relief, ease, and transcendence. In addition, the theory distinguishes four contexts for patient comfort: social, physical, psycho-spiritual, and environmental. A patient’s sociocultural environment comprises their social, family, and interpersonal relationships, contributing to their overall well-being (Al-Aaraj et al., 2023). The physiological senses and sensitivity to one’s environment are called the physical context. The environmental context of comfort addresses external conditions and influences, whereas the psycho-spiritual context addresses the individual’s interior self-awareness, encompassing religion, sexuality, and self-esteem (Yazdi & Ebrahimpour, 2021).
Unique Focus
Kolcaba’s comfort theory is distinguished by its exclusive commitment to promoting patients’ health and pleasure. This makes the theory applicable to various clinical settings and patient groups (Al-Aaraj et al., 2023). Proponents of the theory emphasize the importance of a pleasant therapeutic connection between healthcare personnel and patients in promoting rapid recovery. Notably, this theory applies to all stages of treatment, making it valuable in assisting patient recovery and providing high-quality care (Ashiq Ali, 2022).
Rationale for Selecting the Theory
Kolcaba’s Theory of Comfort is relevant in geriatric nursing due to its holistic approach to enhancing patient comfort (S. M. Oliveira et al., 2020). The theory emphasizes holistic care in geriatric settings by addressing patients’ physical, psychological, and spiritual needs. The emphasis on cultivating comfort for patients and nursing personnel distinguishes Kolcaba’s theory from others (Yazdi & Ebrahimpour, 2021).
With an ageing population, creating a healthcare system that actively works to improve the comfort of geriatric patients is vital. Adopting Kolcaba’s approach selectively can be tremendously beneficial in geriatric nursing. Using this theory, healthcare personnel can ensure that older patients are provided with proper comfort measures that satisfy their physical, spiritual, psychological, social, and environmental needs (Timothea Vo, 2020). Nurses, for example, can increase patient comfort and satisfaction by providing comfort measures such as massages, music therapy, and aromatherapy (Barreto Cardoso et al., 2020).
Furthermore, Kolcaba’s approach highlights the relevance of both patient and worker comfort. Nursing can be challenging, especially in geriatric settings where nurses may encounter complex and severe conditions. The theory acknowledges the reciprocal relationship between patient and staff comfort by including comfort measures for nursing staff, such as creating a healthy work environment, offering adequate breaks, and providing emotional support. Nurses who feel encouraged and at ease can deliver better patient care (Timothea Vo, 2020).
Moreover, applying Kolcaba’s theory to geriatric nursing may assist in building healthcare systems and policies that promote patient comfort. For example, this theory might encourage the establishment of policies that improve access to care for older patients by reducing wait times and improving communication between patients and healthcare providers (Yazdi & Ebrahimpour, 2021). The overall quality of care offered to geriatric patients can be considerably improved by adopting the concepts of Kolcaba’s theory into healthcare policies.
Implementation Plan
Implementing Kolcaba’s Theory in a geriatric department requires extensive planning and organization. Within the department, the first step would be to form a comfort care committee or team. This group should comprise diverse healthcare professionals, including staff nurses, nurse practitioners, clinical nurse specialists, and other key stakeholders. Their primary responsibility will be to analyze patients’ comfort levels and devise appropriate solutions (Auyezkhankyzy et al., 2022).
The comfort care staff will begin creating individualized comfort plans for each patient, considering their specific needs and preferences. These programs may involve several interventions, such as adding additional comfort measures such as massage therapy, heat therapy, or other holistic components (S. M. d. Oliveira et al., 2020). Furthermore, the team will identify and analyze patient comfort’s physical and emotional aspects to uncover further chances to improve their well-being.
The next crucial step in implementing Kolcaba’s Theory is to thoroughly educate and train all geriatric department staff nurses. This training should not only provide an overview of the theory and its fundamental concepts but also go into the more intricate aspects of comfort and how they may be studied and improved (Lafond et al., 2019). It is critical to provide nurses with the knowledge and skills to develop patient-centred comfort care programs. This education and training can be delivered through various channels, including continuing education seminars, lectures, and online resources, ensuring that all nurses are well-versed in theory and application (Lin et al., 2023).
Finally, as a final step in the implementation process, adopting Kolcaba’s Theory will demand regular monitoring and evaluation of the program. Regularly, the comfort care team should assess the effectiveness of the deployed treatments and collect data-driven insights to improve the comfort care process (Sharma & Kalia, 2021). This includes assessing the impact of the theory’s application on patient outcomes by tracking patient satisfaction levels, visit time, and other pertinent indicators. By meticulously analyzing the program, the team can identify areas of success and areas that require development and make appropriate adjustments to increase patient comfort (Lin et al., 2023).
Barriers to Implementation
The theory’s implementation plan may confront several potential impediments and challenges hindering its success. One such impediment could be the inadequacy of resources, which could include a variety of concerns, such as insufficient budget allocation or a staff shortfall (Kim & Yoo, 2023). Without adequate funding, investing in the essential tools, equipment, and training to implement the idea effectively may not be easy. Similarly, a staff deficit can delay the execution of comfort interventions because more workers may need to be available to complete the necessary activities (S. M. Oliveira et al., 2020).
Another potential challenge is the challenge in coordinating staff members’ schedules. It can be challenging to guarantee that all team members are available and on the same page, particularly in a busy hospital where staff members work different shifts and have different duties. Coordination of their schedules to allow for the implementation of comfort measures may thus be a major obstacle (S. M. Oliveira et al., 2020).
Involving older patients in comfort programs can be another barrier. Elderly persons may have unique needs, interests, and communication styles that demand special care. It may be challenging to communicate the objective and benefits of comfort measures to elderly patients, gain their trust, and encourage active participation (T. Vo, 2020).
Motivating staff to participate in the implementation process can also be challenging. Those unwilling to accept new tactics or sceptical about the benefits of putting theory into practice may resist change. Overcoming objections and establishing a sense of drive and enthusiasm in the team is essential for successful implementation (Lin et al., 2023).
Furthermore, adequately gauging comfort could provide an additional potential challenge. Measuring and evaluating the impact of comfort therapies and determining whether the implemented theory is providing the desired results can be difficult tasks (Lin et al., 2023). Creating trustworthy assessment tools and acceptance criteria for assessing comfort may require extensive consideration.
To overcome these barriers and challenges, several strategies can be employed. Strong leadership and clear communication are required from the outset of the implementation process. Leaders should communicate the vision and aims of putting Kolcaba’s theory into action, answer any issues or questions, and provide continued leadership and support to the team (Davis & Spoljoric, 2019).
Adequate resources are required for effective implementation. It is vital to allocate an appropriate project budget, ensuring sufficient funds are available to invest in the necessary resources, training, and equipment. Sufficient staffing is also essential, and efforts should be made to offer the necessary number of staff members while ensuring they have the necessary skills and knowledge to apply the theory efficiently (S. M. Oliveira et al., 2020).
It is also vital to have a structure for ongoing assessment, evaluation, and feedback. Regularly assessing patients’ comfort levels, gathering input from both staff and patients and examining the results can help identify areas for improvement and ensure that the implemented theory is aligned with the desired goals (Lin et al., 2023).
To overcome the challenge of engaging elderly patients, careful planning and strategizing are required. This may entail conducting extensive assessments of patients’ needs and preferences, tailoring comfort measures to their specific requirements, and utilizing effective communication strategies to express the benefits and purpose of the interventions (S. M. Oliveira et al., 2020). Involving family members or caregivers in the process might also help older patients engage successfully.
Finally, incentives and recognition can be provided to motivate employees. Recognizing and rewarding staff actively participating in the comfort care plan can instil pride and accomplishment (Yazdi & Ebrahimpour, 2021). Additional training opportunities, career growth chances, or awards can also motivate staff members to maintain their dedication to giving comfort to senior patients.
Conclusion
In conclusion, this paper explored the incorporation of Kolcaba’s Comfort Theory into nursing care for geriatric patients with acute and chronic medical conditions and techniques for overcoming obstacles and challenges to successful implementation. The theory provides a solid framework for dealing with human suffering and improving comfort in nursing care, particularly in geriatric settings. Focusing on the fundamental concept of comfort and considering patients’ physical, psychological, spiritual, and social needs can improve patient satisfaction and overall well-being (Yazdi & Ebrahimpour, 2021). The theory’s taxonomic structure, which incorporates several types of comfort and contextual aspects, provides a comprehensive approach to patient care. Implementing Comfort Theory in geriatric nursing requires careful planning, education, and ongoing evaluation. While there may be shortcomings and challenges, strong leadership, efficient communication, and adequate resources can help overcome them (S. M. Oliveira et al., 2020). By incorporating the Comfort Theory into their geriatric nursing practice, healthcare practitioners can promote patient comfort, contentment, and enhanced quality of care.
References
Al-Aaraj, H., Alnawafleh, K. A., Al-Jabri, M. M., Almuhtadi, L. M., Mohammed, A. T., & Ghatasheh, A. A. (2023). Using Kolcaba’s Comfort Theory in Nursing Research: A Critical Analysis. HIV Nursing, 23(3), 1342–1346-1342–1346.
Ashiq Ali, A. (2022). Comparison of Two Nursing Theories Orem’s Theory of Self-Care Deficit & Kolcaba’s Comfort Theory. Journal on Nursing, 12(2).
Auyezkhankyzy, D., Gulbiniene, J., & Riklikiene, O. (2022). Application of Kolcaba’s Theory of Comfort in Nursing Practice. Астана медициналық журналы, 112(2), 27-34.
Barreto Cardoso, R., Alfradique de Souza, P., Pereira Caldas, C., & Ribeiro Bitencourt, G. (2020). Nursing Diagnoses in Hospitalized Elderly Patients Based on Kolcaba’s Comfort Theory. Revista de Enfermagem Referência(4).
Davis, J. H., & Spoljoric, D. (2019). Comfort: Context for the Study Abroad Faculty Role. Nursing Science Quarterly, 32(4), 314-319. https://doi.org/10.1177/0894318419864327
Kim, M. S., & Yoo, S. (2023). Correlations among Perceived Symptoms and Interferences, Barriers to Symptom Management, and Comfort Care in Nurses Caring for Chemotherapy and Transarterial Chemoembolization Patients. Cancer Nursing, 10.1097.
Lafond, D. A., Bowling, S., Fortkiewicz, J. M., Reggio, C., & Hinds, P. S. (2019). Integrating the Comfort Theory™ into Pediatric Primary Palliative Care to Improve Access to Care. Journal of Hospice & Palliative Nursing, 21(5). https://journals.lww.com/jhpn/Fulltext/2019/10000/Integrating_the_Comfort_Theory__Into_Pediatric.7.aspx
Lin, Y., Zhou, Y., & Chen, C. (2023). Interventions and Practices Using Comfort Theory of Kolcaba to Promote Adults’ Comfort: An Evidence and Gap Map Protocol of International Effectiveness Studies. Syst Rev, 12(1), 33. https://doi.org/10.1186/s13643-023-02202-8
Marques, K., & Alves, C. (2020). Nursing Diagnoses Clusters: Survival and Comfort in Oncology End-of-Life Care. Int J Palliat Nurs, 26(8), 444-450. https://doi.org/10.12968/ijpn.2020.26.8.444
Oliveira, S. M., Costa, K., Santos, K., Oliveira, J. D. S., Pereira, M. A., & Fernandes, M. (2020). Comfort Needs as Perceived by Hospitalized Elders: An Analysis under the Light of Kolcaba’s Theory. Rev Bras Enferm, 73(suppl 3), e20190501. https://doi.org/10.1590/0034-7167-2019-0501
Sharma, M. C., & Kalia, R. (2021). Testing Katharine Kolcaba Theory of Comfort: Effectiveness of Integrative Comfort Care Interventions on Discomfort Experienced by Children (Aged 5–10 Years) During Postoperative Period. Journal of Pediatric Surgical Nursing, 10(4). https://journals.lww.com/journalofpediatricsurgicalnursing/Fulltext/2021/10000/Testing_Katharine_Kolcaba_Theory_of_Comfort_.11.aspx
Vo, T. (2020). A Practical Guide for Frontline Workers During Covid-19: Kolcaba’s Comfort Theory. J Patient Exp, 7(5), 635-639. https://doi.org/10.1177/2374373520968392
Vo, T. (2020). A Practical Guide for Frontline Workers During Covid-19: Kolcaba’s Comfort Theory. Journal of Patient Experience, 7(5), 635-639.
Yazdi, K., & Ebrahimpour, Z. (2021). A Review of Kolcaba Comfort Theory of Nursing.
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