Comfort Theory of Nursing – Katharine Kolcaba

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Katharine Kolcaba’s Comfort Theory of Nursing

By definition, a nursing theory refers to an organized, knowledge based concept that primarily defines the scope of nursing practice in terms of what constitutes nursing, the typical tasks of nurses and the reasons why these tasks are executed. With the roots of nursing theory dating back to the late 1800s, the contemporary emphasis on evidence- based practice in the 2020s and beyond underscores the significance of nursing in nursing education and practice. Over the years, several nursing theorists have conceptualized theories that are categorized as either grand nursing theories, middle range nursing theories or practice level nursing theories whose linking thread is that all these theories help to define what nurse do and why they do it. This essay therefore aims at examining the Comfort Theory of Nursing as advanced by Katharine Kolcaba by examining its theoretical foundations and application in the ED setting.

Theoretical Foundation/Framework of Comfort Theory of Nursing

Proposed Kolcaba (CTN) is a middle range theory (as it narrows down into specific areas of nursing instead of dealing with sweeping) was developed in 1990s as the gerontology specialist nurse operationalized comfort as a care outcome. According to Khan (2017) CTN comprises six propositional statements that focus on healthcare needs, nursing interventions, the intervening variables and enhanced comfort. Additionally, there is health seeking behavior and institutional integrity with each of the concepts playing a significant role determining, accounting attainment or enhancement of comfort of the patient, their family as well as the nurses themselves.

CTN Application in the Emergency Department Setting

Comfort is an outcome that is holistic since it designates an individual’s state that is both dynamic and multifaceted. Similarly, overcrowding in the ED is multifactorial problem by prolonged length of stay amongst other factors like staff shortages, and delayed response to consultations. As Krinsk et al(2014) note CTN can be utilized to enhance the environment of patients in need of care in the ED through a quiet time intervention to reduce the patient’s LOS which would then led to avoidance of overcrowding and subsequent decreased wait time to consultation. Application of CTN in the quiet time intervention would ensure comfort manifested in the form of ease, relief, and transcendence. At transcendence, the patient is able to rise above their difficulty and use health seeking behaviors to improve the care outcomes as comfort would occur in the physical, environmental, psycho-spiritual, and socio-cultural. The ED nurse would then use the 4Ps of comfort care needs namely pain, position, potty, and possession. During structured assessment, key phrases, scripted cues and specific questions would enable the nurse to create customized care plans and exhibit nursing caring, listening and respecting. This would help to decrease  the patient’s anxiety for example a cardiac patient, as they are aware they will see an nurse or nurse assistant on a continuous time to address the comfort needs. The use of CTN would also help to advance the science of nursing practice as the decreased anxiety levels would reduce the LOS even as the improved patient security would lower the nurse calls for assistance leading to a secondary outcome of decreased nurse workload as overcrowding in the ED.

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Comfort Theory of Nursing
Comfort Theory of Nursing

In conclusion, utilizing CTN as a theoretical framework to guide an intervention seeking to avoid overcrowding in the ED is bound to help put theory into practice. Successful implementation of a program like the quiet time intervention can enhance provision of high quality health care in the ED besides increasing the skills and knowledge of the healthcare staff stationed there.

References

Khan, A. A. (2017). Application of Katharine Kolkaba comfort theory to nursing care of patient. Int. J. Sci. Res. Publ7, 104-107.

Krinsky, R., Murillo, I., & Johnson, J. (2014). A practical application of Katharine Kolcaba’s comfort theory to cardiac patients. Applied Nursing Research27(2), 147-150.

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