Theories in the nursing profession, like in any other profession are gradually developed to facilitate understanding of the major facts associated with that profession. In the context where theories are either grand or mid-range, all categories facilitate and influence a concise and disciplined thinking, as well as, research. The intensive relationship that exists between the theories, research and practices show that it is feasible that the theory is gathered from research, non-empirical sources, experience, and moral knowledge. In a bid to compare the middle range theories or research with other related grand theories, it is imperative to understand that they contain several properties (Lasiuk & Ferguson, 2005). First, they stand the position to adapt a vast range of practices, as well as, experience. The sources can also be developed or built from an array of sources. Finally, they are stable enough to get tested. It is because of this empirical finding that the theories are expected to be elementary enough to facilitate the process of addressing the challenges that are emerging in the contemporary century as far as nursing is concerned. There are numerous mid-range theories. In this context, the theory of analysis is the theory of comfort.
The introduction of the theory first occurred in the year 1994. The theorist, Kolcaba was working on her program as a graduate student who focused on the concept of comfort (Kolcaba, 2003). Notably, the theory belongs to the middle range category of nursing theories. It oscillates around the concept of comfort. In this context, the concept refers to the instantaneous status of acquiring strength. The strength is acquired by having the needs of relief, transcendence, and ease. Usually, these aspects are more of psychological than physical when health is concerned. Particularly, the above needs can be assessed from a holistic human experience approach. There are different ways of doing so considering that there is a variety of human experiences. They include the sociocultural, the psych-spiritual and the environmental experiences. The theorists focused on these experiences in the development of the theory. Arguably, the theorist introduced her theory after conducting a series of research and applying some assumptions and drawings from experience.
It is imperative to denote that achieving the comfort will always allow individuals to participate in health-seeking demeanor. These behaviors may include the internal or physiologic healing, the peaceful death or the external or health related engagements. The theorists’ shows immense understanding of the necessary factors that foster elevated healing of patients who may be suffering from diseases that can easily lead to demise. The aspects established in the theory depict that the level of comfort of a patient is essential in the context of enhancing the health seeking behavior amongst individuals. Such a theory, therefore, must have undergone a series of adjustments for it to be termed as a reliable approach in any health-related scenario.
Health practitioners, especially the nurses, find the theory as a reliable concept in their line of work. First, the nurses assess the level of a patient’s comfort and the needs that the patient could have for him or her to be comfortable. The key issue here is that of assessment. Nurses intend to assess the need and design the comfortable environment after which it can be implemented. From a professional point of understanding, the assessment may occur in an objective or subjective manner. First, it could be objective in a scenario such as that which it would result in healing. Alternatively, it could be subjective in the context that an inquiry is stipulated to seek the status of a patient’s comfort. As such, the structure of the theory by Kolcaba possesses an absolute potential to channel the work, as well as, the argument of the health care givers within the institutions of health care (Kolcaba, 2003).
From a professional perception, it is usually a general conception for any sector or field of inquiry to finally determine the nature of knowledge and the aims of the field. Further, it also ought to elaborate the manner through which the knowledge is tested, organized and applied in the field (Nursing Theories, 2011). The entire body of knowledge which serves as the rationale for professional practices such as that of nursing also has the patterns the structure and even the forms which are expected to serve as the edges of expectations. It also exemplified the extent and the features of thinking about the field. It is, therefore, imperative to fathom these patterns since they are essential to understanding the nature of the field. In this context, the subject field is nursing. However, it is essential to denote that the understanding of these patterns does not mean that the scope of knowledge is understood. However, it instills utmost attention to the query of the right meaning regarding the kinds of knowledge held within the discipline of nursing.
The case study focuses on the theory of comfort. In a bid to comprehend the process through which the theory was developed. An essential tool for this task is that of the patterns of knowing. There are four fundamental patterns of knowing. They include empirics, aesthetics, personal knowledge, and ethics (Young & Paterson, 2007). They assist in the professional assessment, as well as, analysis of the conceptual and syntactical structure of nursing information.
For the theory to be certified as an influence source of information for practitioners in the health care industry, it is proper to conduct sufficient empirical research regarding the proof of being rational. In this case, the test for empirics postulates affirmative results in the context of the theory of comfort. In consideration to Merton (1968), a socialist and proponent of the middle range theory, the middle range theory are described as the reference for empirical research. Further, it offers particle testable axioms. The theory of comfort, from an empirical perspective, is a middle range theory (Lasiuk & Ferguson, 2005). The theorist responsible for it focused on the concept of comfort as the central idea. A set of tools has been established to assess the comfort levels of patients. These tools include the general comfort questionnaire, the comfort behaviors check and the visual analog scale amongst others. These tools provide reliable findings relating to the demeanor associated with the patients who are subject to health issues such as pain or distress.
Most importantly, the process of utilizing these instruments has facilitated the conducting of numerous research conducted by the theorist in question, Kolcaba (Nursing Theories, 2011). The theory applies to the field of nursing and practicing education. Hence, it provides a direction that the future research can be conducted based on theory. Examples of research gaps that have been established for further research include nursing care for victims with mental or hearing disabilities. Also, another avenue of research is that of labor and delivery. Other areas of research are that of the per-and-intra-operative care, gynecological practice, critical care, the burning unit and the emergency air transport amongst others.
Accordingly, the theory has undergone essential testing. The findings have been supported by a set of patient populations. They include the experimental studies, the psychometric studies which were all gathered from small samples of women who were suffering the early stages of cancer (Kolcaba, 1992). These patients were undergoing the painful cancer therapy. Other people with painful experiences that were used to ascertain the rationale for this research include those who experience urinary frequency and inconsistency and those that are close to experiencing death were also used. Different researchers established their findings regarding the topic of comfort. Examples of these findings include the research conducted on stress reduction, holistic comfort care, and other nursing care practices. The research focuses on of these and other researchers conducted from the year 1992 to the year 2007.
Aesthetics, from a nursing perception, is that perception that is garnered from mere observation of an event in a particular time. Usually, when these elements are at its most developed stage, exemplifies the capacity to understand a scenario, as well as, the act without much consideration. The theorist uses a personal approach to interact with victims of postoperative pain (Kolcaba & Kolcaba, 1991). According to the apprentice skills acquired, it is easy to determine when a student is suffering from pain. From a practical incidence, a patient suffering from pain expresses the pain from a facial expression. Accordingly, that calls for the nurses to take a step and ensure that one interacts with the victim to establish the source of the pain. It is not necessarily that one will be in a position to understand the cause of the pain. However, that is left to the practitioners to use the medical expertise to determine the cause of the pain (Kolcaba & Kolcaba, 1991). The theorists reflect on this approach as a suitable one considering that the ability to study one’s behavior or expressions from the facial expressions enables the practitioner to address issue causing pain. The theorist applies an approach where the aspect of intervention is necessary after realizing the facial and verbal expressions of a patient who is in pain. According to the theorist’s findings, it is clear that one may not determine the magnitude of pain that the patients may be experiencing. However, it is certain that mere intervention could resolve the cause of the pain. The intervention could include the taking time and conversing with the victim of pain (Nursing Theories, 2011). According to the theorist, it is concise that there are usually signs of getting relaxed, as well as, comfortable in the hospital bed after engaging in a thrilling conversation. That means that understanding others is very crucial in the context of determining a future approach or resolution to the psycho issues that the theorist addresses. Therefore, the expressions and arguments postulated by the theorist are applicable despite the fact that they are meant to explain the possibilities of the argument working out is such a health scenario.
From a summative platform, the personal knowledge depicts self-awareness, as well as, that of others considering that the two parties are engaging in an interaction process. The pattern is essential in the development of the theory. However, it considers a series of factors that could deter the success of the interaction process identify the patients who suffer pain amongst other aspects. The first aspect that is used to understand the other individual is culture. Culture depicts the most probable behavior by individuals as they express pain or happiness. Therefore, some cultures may not cry but will show it on their face that there is an issue that is affecting them from the inside (Kolcaba & Kolcaba, 1991). Different scholars used to support this argument shows that pain beliefs differ from one individual to the other depending on the culture of socialization. As such, the approach is essentially important in ensuring that one understands the role of the caregiver in interacting with the patients. That means that it becomes the sole responsibility of the caregiver to ensure that he shares experiences of pain with the patients to improve the attitude of the patients towards pain. Most importantly, that will influence them to take the pain affirmatively. Ultimately, the level of comfort is improved indefinitely.
The application of the critical theories of the development of the theory of comfort mainly considers the importance of interpersonal interaction, relationships and even the transactions between the nurses and the patient who is the client in this case. Therefore, the findings acquired from the approach depict that the therapeutic use of oneself to approach the client authenticates and actualizes the relationship between the two parties. Therefore, the theorist focused on this framework to ascertain and approve of the open system that helps in the growth, as well as, the fulfillment of the full human potential.
In the theory of comfort, the basis of ethics is to foster common morality the context of service delivery. Usually, the as caregivers attempt to change the psychological perspectives of pain amongst the patients in the hospitals; there are moral issues that are likely to emerge. The actions that the caregivers provide may be right or wrong. According to the theorist, some actions may be unintentionally unethical as the healthcare provider attempts to promote the health status of the patients (Young & Paterson, 2007). As such, these issues are likely to rise from the context where ambiguity or uncertainty exist. Therefore, the theorists approach on comfort goes hand in hand with the moral obligation of nurses in the context of dealing with patients on an interactive basis.
The theorists focus was to establish a reliable approach in which the concept of entrusted care can apply within the process of ensuring that the patients counter most pain issues with diligence. Ethics seem dire in situations where the need for health care exceeds the expected scenarios. For instance, there are scenarios where the patient may be dying and could still have some input. Such a scenario becomes very complex to address. However, it is certain that the nurse or an alternative health care provider has to ensure that the patient reduces the possible pain and attain a desirable level of comfort. As stipulated, it becomes essential to ensure that one applies an ethical approach in assisting the patient client to relax before any other step is taken to conduct medical tests (Young & Paterson, 2007). That means that there is the ethical obligation to keep the patient calm.
First, the theory in question here is that of comfort. Concurrently, the major concept here is the comfort too. The ultimate goal is ensuring that the patient clients are relieved of the painful experience and gain a calm mood in the context of receiving or awaiting treatments. Notably, the concept of comfort is essential in the context of the nursing profession (Parker & Smith, 2010). Particularly, the profession itself is related to an act of ensuring that the patients are in their state of comfortable regardless of the approach used provided that it is not unethical. Therefore, in a bid to establish a rational inference regarding the middle range theory and the goal associated with it, it is essential to demonstrate the magnitude in which the two concepts are expected to work for the betterment of the patient and the nurse (Lasiuk & Ferguson, 2005).
First, the concept of comfort is the major concept since it is broad and reduces all elements of pain in the most effective manner. Secondly, the concept arrives at very easy and cheap approaches to determining the level of a patient’s comfort. That includes engaging in a communication process where the nurse seeks to know the state of the patient (Kolcaba, 1992). Alternatively, the nurse may assess the conduct and expressions of the patient and understand that there could be a possibility of pain and agony in the patient. The rationale for choosing this theory is the intensity and the magnitude in which it related to the nursing profession. Arguably, the definition of the nursing field in health care oscillates around creating a comfortable environment for the patients. Accordingly, there is a very stringent relationship between the comfort and nursing. The central focus of nursing is establishing comfort to the patients.
In a bid to understand the major and most effective approach that the concepts ought to be developed, it is imperative to consider the ideas postulated by recent scholars in the nursing field. A series of authors have attempted to define the concept and theory of comfort. Most argue out that it refers to the concept as one amongst the indispensable demands by patients. Secondly, the some argue that it is the major requirement, as well as, concern for those who are practicing the nursing profession (Parker & Smith, 2010). However, despite the fact that the definition of the concept is incorporated in each of these definitions, there is a need to recognize it as the central principle in the nursing profession. Thus, most amongst these scholars focus on creating emphasis on the need to comfort the patients in the process of providing health care.
Patients tend to suffer the agony of pain especially when the environment they are in does not influence them in an otherwise direction. The nurses are required to fix this situation. Accordingly, they are judged by the extent in which they enhance a comfortable environment for their patient clients. Most nursing associations, therefore, attempt to assist in maintaining the quality of life in a dignified manner and eventually comfort them until they succumb to a comfortable death.
Nursing, from a theoretical and practical perspective, is considered be crucial in the process of maintaining a comfortable environment for the patients. The theory of comfort, through a complementary analysis of the knowing patterns, provides a well-orchestrated layout of the benefits and challenges that a nurse ought to live within in the provision. According to the study, the concept of comfort is usually subjective. Thus, the patient is usually in a better position to explain the level of comfort that he or she is enjoying that the nurse can. The concept, from a virtue of controversy, could be considered as multidimensional. Different people understand it from different angles or perspectives. However, the most outstanding definition and argument regarding the essence of the concept is that of motivating the patients in a bid to improve their well-being, as well as, the entire quality of life.
The concepts associated with patients pain, agony and the role of the nurses in dealing with the issue are precise enough and do not need any form of narrowing. There are different perceptions that are associated with the concept and theory of comfort besides that which was provided by the theorist, Kolcaba (Kolcaba, 2003). However, all the arguments seem to rhyme especially regarding the ultimate objective of the concepts. As such, it is imperative to note that the nurses are mandated to focus on ensuring that they offer their services to the patients in a bid to improve the quality of their lives. The empirical, personal knowledge and ethical consideration in engaging in an activity that will influence comfort for patients in the central objective of the nursing professionals in all health care centers.
Kolcaba, K. (2003). Comfort theory and practice: a vision for holistic health care and research. Springer Publishing Company.
Young, L. E., & Paterson, B. L. (Eds.). (2007). Teaching nursing: Developing a student-centered learning environment. Lippincott Williams & Wilkins.
Parker, M. E., & Smith, M. C. (2010). Nursing theories & nursing practice. FA Davis.
Kolcaba, K. Y., & Kolcaba, R.J. (1991). An analysis of the concept of comfort. Journal of Advanced Nursing, 16(11), 1301-1310.
Kolcaba, K. Y. (1992). Holistic comfort: operationalizing the construct as a nurse-sensitive outcome. Advances in Nursing Science, 15(1), 1-10. Retrieved from http://www.thecomfortline.com
Lasiuk, G. C., & Ferguson, L. M. (2005). From practice to midrange theory and back again. Advances in Nursing Science, 28, (2), 127-136.
Nursing Theories. (2011). Comfort theory. Retrieved on January 26, 2013, from