Discuss The Concept of Comfort and Care in a Nursing Home and its importance
Sample Concept Analysis Nursing Essay Paper
The Concept of Comfort and Care in a Nursing Home
This paper analyzes the concept of comfort and care in the context of Imperial Healthcare Rehabilitation and Nursing Center. This analysis will be useful not only to stakeholders of the nursing center but also for other participants in such establishments elsewhere. The main purpose of analyzing the concept of comfort and care in nursing practice is to create a better insight into the main purpose of nursing for the better understanding of the importance of optimizing for the residents, significant others, care givers, and policy makers. Nursing practice aims at optimizing the comfort of all clients through competent and appropriate nursing care. After all, nursing care involves the systematic assessment of the needs of clients for comfort, the formulation of support strategies to address the needs, and the reevaluation of the level of comfort after nursing interventions to determine the level of achievement of the goals of care (Tomey & Alligood, 2006).
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Moreover, being a complex term that serves as one of the distinguishing entities of the goals of the nursing care, comfort has not been adequately conceptualized, researched and surveyed in clinical settings over the years. Thus, analyzing the concept of comfort and nursing care is an invaluable contribution to the field of nursing education, practice, and management. This will be achieved through review of literature on comfort and nursing care, followed by a description of the critical attributes of the concept and the surrogate and relevant uses of the concept. Moreover, the antecedents and consequences of the concept are elaborated to arrive at the theoretical and working definitions of the concept. Finally, the relevance of the analysis of the concept of comfort and care to student development and the application of the concept in a model case are discussed before the paper is concluded.
Literature Review: Comfort and Nursing Care
Katherine Kolcaba premiered the theory of comfort in nursing care in the 1990s when she conceptualized comfort as comprising of the three forms namely relief, ease and transcendence (Kolcaba, 2003). While the relief aspect of comfort occurs through assistance with accomplishing the activities of daily living, ease ensues through resolution of the issues that cause anxiety leading to a feeling of contentment. As transcendence, an individual achieves comfort when they manage to overcome their challenges. To clarify the meaning of comfort, Seiferi (2002) analyzed the concept systematically as it appeared in journals, books, professional organizations’ statements, and electronic sources. His conclusion was that in order to develop knowledge of nursing even further, clearer definition and meaning of comfort and the ability to apply the concept empirically in nursing care were necessary (Seiferi, 2002).
A look at the continuous evolution of the comfort concept in nursing care indicates that the adoption of theoretical concepts into patient care, as well as the tremendous educational advances in the entire healthcare industry, is significantly precipitated by the changing role of comfort with time (McLiveen & Morse, 1995). It is, however, sad to note that most nurses still feel inadequate in providing sufficient comfort especially when it comes to transcultural nursing. Curley (2007) emphasized this finding in his survey to assess the level of comfort provided by nursing students taking the baccalaureate program. The findings of this survey agree with those of previous researchers that nursing students are not equipped with the necessary experiences for the provision of transcultural nursing care and comfort to ethnically diverse clients (Curley, 2007). Sample concept analysis nursing essay paper.
With a view to develop the concept of holistic comfort in nursing care, Donna, Quinn & Schick (2004) observed that the actual model of the human press is like a framework relating comfort to those interventions that enhance the comfort state and eventually lead to the subsequent desired outcomes. To this effect, Kolcaba developed a taxonomic research tool to formulate the pretests of comfort for nurses to apply in assessing the possible comfort needs of patients in order to develop their post-tests and interventions, and eventually assess their effectiveness. To achieve this, she derived three technical senses of comfort from the archaic and current lexical entries, analyzed the use of the comfort concept in historical and contemporary nursing literature, and explored theoretical support found in ergonomics and nursing disciplines (Kolcaba, 2003).
Kolcaba & Steiner (2000) outline that holistic comfort is a goal of nursing encompassing the physical, environmental, social, and psycho-spiritual elements of nursing care. Empirical studies such as that one conducted by Kolcaba & Steiner (2000) reveal that while comfort is sensitive to time changes, the proportions of trait characteristics and state in comfort are equal. The same study showed that wholesome comfort is more significant than the sum of its components. Individuals showed linearly increasing differences in comfort when exposed to effective interventions as compared to a control group (Kolcaba & Steiner, 2000). Moreover, Curley (2007) recognized comfort as a nursing modality, characterized by individualized holistic care. As a matter of fact, holistic care for every individual makes the delivery of health care even more efficient.
Critical Attributes of the Concept
A concept is characterized by critical attributes, which are qualities that distinguish it from other different or related concepts. The critical attributes of comfort and care are described here based on Kolcaba’s comfort theory. Kolcaba’s conceptualization of comfort interventions, as stipulated in her book, Comfort theory and practice: A vision for holistic health care and research, directs the formulation of the critical attributes of the concept of comfort as described below:
Comfort is technical in those aspects of managing pain and maintaining homeostasis. These include such things as observation and monitoring of vital signs as well as laboratory tests results.
Technical comfort also includes the administration of medications for the patient’s restoration or maintenance of physical comfort, and for the prevention of complications.
Comfort through coaching comprises of interventions for relieving anxiety, providing information and assurance, instilling hope, listening and helping in making realistic plans for recovery, re-integration, or peaceful comfortable death in a manner that is culturally sensitive. Coaching needs proper timing in capturing the patient’s readiness to agree with the new ideas presented to them. Sample concept analysis nursing essay paper.
There also exists the need of caring for soul of the client. To achieve this, interventions entailing the basic old-fashioned nursing care that is not quite expected but welcome among people today are necessary.
These interventions of comfort, just like the food that people eat, strengthen patients in a tangible and personalized manner. Interventions of comfort food transcend through memorable connections as the nurse interacts with the client.
Suggestions for comfort food include such things as massage, music therapy, guided imagery, reminiscence, environmental adaptations enhancing tranquility and peace, and hand-holding. It is these interventions that strengthen the patient for demanding tasks.
Surrogate and Relevant Uses of the Concept
The concept of comfort applies in all the steps of the nursing process – assessment, diagnosis, planning, interventions, and evaluation. Assessment of the level of the health status of an individual shows clearly in their level of physical, psycho-spiritual, sociocultural, and environmental comfort as apparent at the time of assessment. Diagnosis involves assessing the level of comfort of the patient in accordance with the standard nursing diagnoses preferably based on Gordon’s eleven functional health patterns. The planning of nursing care aims at designing a schedule and methodology of are that will maximize the comfort of the client. Lastly, the care provided is evaluated against the expected standards of comfort. This helps to determine the level of comfort that is achieved.
Antecedents and Consequences of the Concept
In order to demonstrate those actions necessary for an individual’s level of comfort to be impaired (the Antecedents), and the outcomes of the interventions that implemented to enhance comfort (the Consequences), it is appropriate to utilize the tabular format below to elaborate these phenomena. The information contained in the table comes from Lawton’s conceptualization of the conditions for and outcomes of comfort in nursing care (Lawton, 2000).
Antecedents that Cause Loss of Comfort Consequences of Comforting Intervention
Disease processes
Physical incapacitations
Experiencing pain most of the time
Achieving pain relief through better management of pain
Self-Esteem
Having difficulty adjusting to changes
Being overly afraid
Feeling relaxed, having faith in God, and feeling relaxed
Positioning
Unsuitable chairs, benches and wheel chairs
Sitting for too long
Sliding down in the class
Unfavorable position in bed
Clients adjusted to the, sitting correctly
Individual adjustments and movement on a chair
Going to bed when advised
Attitudes and Approaches of Staff
Lack of and inaccessibility of understanding and caring staff
Fragmented nursing care
Understanding and caring nursing staff show empathy and intervene with care, thus strengthening the patients
Patients are encouraged to help themselves
Continuity of staff leads to continuity and effectiveness of nursing care
Hospital Life
Tolerating the new system takes time leading to boredom and idleness
Lack of adequate privacy inhibits comfort
The atmosphere during mealtimes is unfriendly
Patients eventually regard the health centers like their usual home
Social and family contacts are established
Occupational and physical delivery therapy
Theoretical Definition of the Concept
Borrowing from Kolcaba’s description of comfort, comfort is the desired experience in a patient of being empowered and strengthened by fulfillment of the needs for ease, relief, and transcendence in all the four spheres of life – the physical, environmental, sociocultural, and psycho-spiritual aspects of human life.
Working/Operational Definition of the Concept
The concept of care in an operational context refers to the design, implementation and evaluation of nursing care interventions done for residents in a health care facility such as Imperial Health Nursing Rehabilitation Center. These clients are cared for in consideration of all the needs in their lives; these are the physical, environmental, sociocultural and psycho-spiritual aspects of human needs. Sample concept analysis nursing essay paper.
Application of the Concept in a Model Case and the Value of Concept Analysis to Student Development
To clarify the relevance of this concept, the importance of comfort and care is illustrated here in a model case at the Imperial Health Nursing and Rehabilitation Center. The model case is that of Ann who is a resident of this hospice. The primary nurse assigned to care for Ann has been a valuable partner in care. The nurse involves herself with commitment and dedication to optimizing Ann’s comfort and happiness. The nurse assists the client to participate in all aspects of her care while ensuring that she is comfortable at all times. The nurse achieves maximum comfort for Ann by discussing and planning the care with her in order to involve her fully and gain her trust and respect. Thus, this model demonstrates maximization of the comfort of a client through participatory nursing care that emphasizes collaborative assessment, planning of care, formulation of expected outcomes, implementation of the care plans, as well as evaluation of the outcomes of care.
From the analysis of the concept of comfort and nursing care in this work, it is evident that the main purpose of setting up and running a nursing center is optimizing the comfort of residents. This is in line with the goal of therapeutic nursing, which is to provide care and optimize comfort in clients. The clients in nursing homes have myriad comfort needs in their physical, environmental, sociocultural and psycho-spiritual spheres of life. The model of comfort and nursing care is, therefore, the most relevant in the settings of nursing homes and rehabilitation centers given that the nurses are the health care professionals who interact with clients in the closest manner and spend the longest time with them (Maria & Paula, 2007). From this, students are able to conceptualize the entire aspect of comfort in its wholeness. They also learn the necessity of presence and individual attention in providing care and comfort to patients.
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Conclusion
The content of this paper demonstrates the importance of focusing the care of residents in nursing homes and rehabilitation centers on their overall comfort. By recognizing the vital and universal need for comfort among all humans, stakeholders of nursing homes and other health care facilities can now prioritize the services provided in their institutions to optimization of the residents’ comfort. Maximization of comfort is achieved through collaborative management by the health care team of professionals. Each member of this team has his/her roles in caring for the clients well stipulated (Hardin & Hussey, 2003).
It is also beneficial to involve the client’s significant others in their care during their stay in the nursing center. This is because involving relatives and friends also contributes to the well-being and comfort of the client especially in the area of sociocultural comfort. It is indispensable that comfort strengthens the patient and enhances the process of recovery from their ill conditions. Thus, it is critical to note that care should be provided in an empathetic and caring way. Therefore, this work also serves to inform policy-makers and financiers of the health industry to give the deserved attention to maximization of comfort of clients. Another valuable implication of the concept in this paper is the discovery that nursing interventions without understanding and comforting service are not likely to enhance the comfort of clients at any moment. In essence, provision of care and comfort is a process and an outcome, as well as a science and an art.
References
Bilger, M. (2009). America’s guide to the nursing home experience. New York, NY: Xlibris Corporation.
Curley, M. (2007). Synergy : The unique relationship between nurses and patients. Indianapolis: American Association of Critical-Care Nurses. Sample concept analysis nursing essay paper.
DeFazio, M., Quinn, D. & Schick, L. (2004). Perianesthesia nursing core curriculum: Preoperative, phase I and phase II PACU nursing. Philadelphia, PA: Elsevier Health Sciences.
Hardin, S. & Hussey, L. (2003). The AACN synergy model for patient care. Columbia: InnoVision Group.
Imperial Health Care. (2011). NJ Rehabilitation Center and Nursing Centre. Retrieved on June 14, 2011, from http://imperialhealthcarenj.com/index.htm
Kolcaba, K. & Steiner, R. (2000). Empirical evidence for the nature of holistic comfort. Journal of Holistic Nursing, 18(1), 46-62.
Kolcaba, K. (2003). Comfort theory and practice: A vision for holistic health care and research. New York, NY: Springer Publishing Company. Sample concept analysis nursing essay paper.
Lawton, L. (2000). Annual review of gerontology and geriatrics, Volume 20, 2000. New York, NY: Springer Publishing Company.
Maria, M. & Paula, D. (2007). The comfort of home: A complete guide for caregivers. Sudbury, MA: Care Trust Publishers.
McLiveen, K. H. & Morse, J. M. (1995). The role of comfort in nursing care. Clinical Nursing Research 4, 121-148.
Seiferi, S. D. (2002). Partners in caring and community: A team approach to service learning in nursing education. San Francisco, CA: Community-Campus Partnerships for Health.
Tomey, A. M. & Alligood, M. R. (2006). Nursing theorists and their work. Philadelphia, PA: Elsevier Health Sciences.
Sample concept analysis nursing essay paper.