Running head: KOLCABA'S THEORY OF COMFORT 1

Kolcaba's Theory of Comfort in Practice

Audra Brooks
Ferris State University




KOLCABA'S THEORY OF COMFORT 2

Abstract
Kolcabas Theory of comfort can be used to provide patient centered care with a holistic outlook
for patients and their families who are facing end of life or are in need of palliative care. This
reflection provides an overview of how Kolcabas theory of comfort can be used to empower
patients and their families to become partners with the interdisciplinary team members. It is
designed to look at attitudes of patients and their families to discover ways to promote health and
educate about the end of life process.
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Kolcaba's Theory of Comfort in Practice
This is a reflection of how Kolcabas theory of comfort can be used in the care of patients
who are approaching end of life or in need of palliative care. A brief description of the theory
will be provided, along with how to empower patients and their families. Explanations of how to
engage patients and their families while promoting health and safety for end of life care, all the
while encouraging an active partnership will be provided.
Knowledge
Kolcabas Theory of comfort nursing was based on the premise of the holistic art of
nursing, meaning it represents the connection to those around you. Kolcaba states that there are
three forms of comfort; i.e. relief, ease and transcendence (Kolcaba, K., Stoner, M., & Durr, K.
(2010). Relief means that a specific comfort need is met. The use of ease is where there is a
state of calmness or contentment. Lastly, transcendence is where one can rise above their
problems or pain. There are four therapeutic contexts in which patient comfort can be met which
include physical, psychospiritual, environmental and sociocultural. Using all of these specific
areas, a taxonomic structure of comfort was then created (Kolcaba, K., Stoner, M., & Durr, K.,
2010).
The multidisplinary health care team members use these strategies to assess the patients
and families comfort needs by developing and implementing the necessary interventions to meet
those needs and ultimately evaluating those interventions. There are many different areas that
can cause stress for patients and families facing end of life or palliative care needs. These can be
for the patient specifically, the families, or a combination of the two. For examples, the patient
could be experiencing an issue of controlling their pain, the worry of having a loved one care for
them, and the financial stress. Other issues that may affect the family include the impending loss
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of a loved one, financial issues, and the physical and mental exhaustion of caring for the one they
love. As you can see, the patient and their families have similar concerns. Acknowledging that
patients and families are facing the same issues and struggles, healthcare providers can then use a
chart called Taxonomic Structure of Comfort to guide them in providing the necessary care and
comfort for patients and their families. This will allow for better communication, comfort, and
care for the patient, and also allow family members to feel that they are providing the patient
with the necessary care for dignified death.
Skills/Attitudes
Often, when patients and families are facing the impending death, there are feelings of
uncertainty and confusion of what to do, say, or how to act. By using the strategies from
Kolcabas theory, healthcare providers can make certain that the patient and the familys needs
are met. As a healthcare provider, it will be important to keep in mind the physical, psychosocial,
environmental, and sociocultural aspects of care for patients and families. This can be achieved
by including ways of relief, ease, and transcendence.
There are several ways that these needs can be met by therapeutic communication and
education. These both play big roles in this process. By using therapeutic communication
healthcare providers are able to help patients work through difficult issues and topics. The first
step is to build trust between the healthcare providers, families, and patient. Education plays a
very important role when being involved in the care of someone dying. It is important to teach
about the dying process, what to expect, the emotions that may be felt, and that not everyone will
experience the same things or emotions. The dying process depends on each persons attitude
and personality. Nurses are required teach families how to administer physical care, administer
oxygen if needed, and also educate about safety. This can be done by education about
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medications the patient is taking or how to transfer and the patient from the bed to a wheelchair.
By educating families about patient centered care, patients needs are met and allow nurses to
take into account what level they are at in the dying process.
Ones attitude about death, dying, and care are important concepts to discuss not only
with the patient but also with family member. This process is not just focused on the patient but
difference of opinions and ideas of what type of care or how decisions are made. One way to
examine this is by asking and discussing ideas of care and expectations and then making a plan
and setting some goals. The last step would be to implement the goals that have been decided
upon.
Reflection
As I look back and reflect on this assignment, I felt confident in this subject. After
completing this assignment I have been able to learn important aspects of dying and the care that
is required. Completing this assignment was not too difficult; however, I do feel that that the
information from this theory could have been used in previous semesters. I found that theory was
able combine the physical, psychospiritual, environmental and sociocultural aspects of care all
the while making sure to provide comfort with relief, ease and transcendence. I really like the
taxonomic structure that was developed to make it easier to not forget about a specific area.
This assignment has inspired me to analyze the ways that I feel about the subject of death
and dying. I have come to realize that each person has different views and ideas of what the
process is and what their beliefs are. My beliefs are similar to those of my families and my faith,
remembering that each member of my family will have a slightly different view than mine. Each
and every person will have a different view bases upon their upbringing, faith, personality and
their own personal attitudes on the subject. This is an important lesson to learn not only for
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patients who are going through dying process but also when caring for all patients and their
families during and after the death. As I stated before, I feel that this theory can be used in many
different aspects of healthcare and will facilitate the needs of the patients to all interdisciplinary
team members. For example, Kolcabas theory is based on the premise of comfort, ease, and
transcendence. One could use these three specific concepts in the acute care setting and by the
different interdisciplinary team members, which could include the physician, nurse, pharmacist,
physical therapist and social workers. Most patient who a admitted to an acute care setting are in
pain, they could benefit from a calm environment and can all be encouraged to rise above their
problems.
After learning about this theory, I am looking forward to using it with my patients and
their families. While in the clinical setting, as a student nurse it seems as if you really do not
think about the different theories we have been taught. This week while in the clinical setting I
will use the premise of this theory with my patient and their families. I will attempt to keep in all
steps and level from the taxonomic structure making sure to meet all individuals need not just
the patient.
Conclusion
Kolcabas Theory of Comfort can be used to promote health and safety of patients and
their families. This will allow for patient centered care with a holistic outlook for end of life and
palliative care. This theory can also be used with diverse population and across and ones
lifespan. As members of the interdisciplinary team, it is important to be aware of the difference
of attitudes with the goal when implementing and planning care.


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Reference
Kolcaba, K., Stoner, M., & Durr, K. (2010). The comfort line. Retrieved June 11, 2014, from
http://www.thecomfortline.com/
Taylor, C., Lillis, C., LeMone, P., & Lynn, P. (2011). Fundamentals of nursing (7th ed.).
Philadelphia, PA: Lippincott Williams & Wilikins.