TFN FINALS

1. HEALTH CARE NEEDS

 Needs for comfort arising from stressful health
care situations that cannot be met by recipients’
THE THEORY OF COMFORT traditional support systems.
2. INTERVENING VARIABLES
“Comfort is an antidote to the stressors inherent in health  Interacting forces that influence recipients’
care situations today, and when comfort is enhanced, perceptions of total comfort.
patients and families are strengthened for the task ahead.In 3. COMFORT INTERVENTIONS
addition, nurses feel more satisfied with the care they are  Nursing actions designed to address specific
giving.” comfort needs of the recipient.
—Katharine Kolcaba (March 7, 2008)
4. COMFORT
KATHARINE KOLKABA -Interacting forces that influence recipients’
perceptions of total comfort interventions.
❖Born and educated in Cleveland, Ohio 5. HEALTH SEEKING BEHAVIORS
❖In 1965, received her diploma in nursing and - A broad category of outcomes related to the
pursuit of health as defined by recipient in
practiced part time for many years in medical
consultation with the nurse Health-Seeking
surgical nursing, long-term care and home care
Behaviors (HSBs) was synthesized by Schlotfeldt
before returning to school.
(1975) and proposed to be internal, external or a
❖Graduated in MSN with specialty to gerontology peaceful death.
6. BEST PRACTICES
❖ She represents her own company, the COMFORT - Use healthcare interventions based on evidence
LINE, to assist health agencies implement Comfort Theory to produce best possible patient and family
on an ins titutional-wide basis. outcome.
❖ This is what you can see in her page. She is also the 7. INSTITUTIONAL INTEGRITY
founder and coordinator of local parish nurse program - Corporations, communities, schools, hospitals,
and a member of ANA and Sigma Theta Tau regions, states and countries that possess qualities
International. of being complete, whole, sound, upright,
appealing, ethical and sincere.
THEORY OF COMFORT 8. BEST POLICIES
- Institutional or regional policies ranging from
 RELIEF - The state of the patient who has had a
protocols for procedures and medical conditions to
specific need met
access and delivery of health care.
 EASE - The state of calm or contentment
 TRANSCENDENCE - The state in which one rises
FOUR (4) MAJOR THEORETICAL PROPOSITIONS
above one’s problems or pain.
❖ Comfort is generally state specific.
❖ The outcome of comfort is sensitive to changes
over time .
CONTEXT IN WHICH COMFORT OCCURS
❖ Any consistently applied holistic nursing
 PHYSICAL - Pertaining to bodily sensations. intervention with an established history for
 SOCIAL - Pertaining to interpersonal, family and effectiveness enhances comfort over time.
societal relationship. ❖ Total comfort is greater than the sum of its
 PSYCHOSPIRITUAL - Pertaining to internal parts.
awareness of self.
 ENVIRONMENTAL- Pertaining to the external
surroundings, conditions and influences.

SWEET ZHEL NARRETO?

MAJOR CONCEPTS and DEFINITIONS

 METAPARADIGM CONCEPTS Comfort into their Clinical Practice Guidelines for
management of patient comfort.
NURSING
The intentional assessment of comfort needs, the  EDUCATION
● The theory proved to be easy for faculty to
design of comfort interventions to address those
understand and apply and provided an effective
needs, and reassessment of comfort levels after
method to role-model a supportive learning
implementation compared with a baseline.
partnership with the students
PATIENT
● The theory is appropriate for students to use in any
Recipients of care may be individuals, families, clinical setting, and its application can be facilitated
institutions or communities in need of health care. by use of Comfort Care Plans available on Kolcaba’s
ENVIRONMENT website.
Environment is any aspect of patient, family or ● The taxonomic structure and conceptual
institutional setting that can be manipulated by nurse, framework guided ways of being a comforting
love ones or the institution to enhance comfort faculty member.
HEALTH ● The theory provided ways for students to
Optimal functioning of a patient, family, health care obtain relief from their heavy course work by
provider or community as defined by the patient or facilitating questions to their clinical problems,
group. maintaining ease with their curriculum through
trusting their faculty members, and
ASSUMPTIONS achieving transcendence from their stressors with
use of self-comforting techniques.
MAJOR ASSUMPTIONS  RESEARCH
 Human beings have holistic responses to ● Nurses can provide evidence to influence decision
complex stimuli. making at institutional, community, and legislative
levels through studies that demonstrate the
 Comfort is a desirable holistic outcome that is
effectiveness of comforting care.
germane to Enhanced comfort strengthens ● Using the taxonomic structure of comfort as a
patients to engage in health-seeking behaviors. guide, Kolcaba developed the General Comfort
 Enhanced comfort strengthens patients to Questionnaire to measure holistic comfort in a
engage in health-seeking behaviors. sample of hospital and community participants.
 Patients who are empowered to actively engage ● Researchers are welcome to generate comfort
in health-seeking behaviors are satisfied with questionnaires specific to their areas of research. The
their health care. verbal rating scales and other traditionally formatted
 Institutional integrity is based on value system questionnaires may be downloaded from Kolcaba’s
oriented to the recipients of care. Of equal website, where she also responds to inquiries in an
importance is an orientation to a health effort to enhance the use of her theory.
promoting, holistic setting for families and
providers of care.
 Comfort is a basic human need which persons
strive to meet or have met. It is an active
endeavor.

ACCEPTANCE BY THE NURSING COMMUNITY

 PRACTICE

Students and nurse researchers have frequently selected TECHNOLOGICAL COMPETENCY AS CARING
this theory as a guiding framework for their studies in IN NURSING
areas such as nurse midwifery, hospice care,
perioperative nursing, long-term care, stressed college
students, dementia patients, and palliative care. When Rozzano Locsin
nurses ask patients or family members to rate their
comfort from 0 to 10 before and after an intervention or  Born in 1954.
at regular intervals, they produce documented evidence  A native of Dumaguete City, Philippines who
that significant comfort work is being done. resides and practices his nursing profession at
Perianesthesia nurses have incorporated the Theory of
 Tokushima University, Tokushima, Japan as human being such as in replacement
Professor Nursing. parts, both mechanical (prostheses)
 He is Professor emeritus of Florida Atlantic or organic (transplantation of
University in Boca Raton, Florida, USA. organs.)
 Earned his Doctor of Philosophy in Nursing
degree from the University of the Philippines in ▪ Technology as machine
1988,
technologies, e.g. computers and
 and his Master of Arts in Nursing and Bachelor
gadgets enhancing nursing activities
of Science in Nursing from Silliman University
in 1978 and 1976 respectively in the to provide quality patient care.
Philippines.
▪ Technologies that mimic human
Technological Competency as Caring in beings and human activities to meet
Nursing the demands of nursing care
practices, e.g. cyborgs (cybernetic
 Technological Competency as Caring in organisms) or anthropomorphic
Nursing machines and robots such as
– is a middle range theory grounded in ‘nursebots’.
Nursing as Caring.
- It is illustrated in the practice of nursing
grounded in the harmonious coexistence
between technology and caring in nursing. Technological Competency as
The assumptions of the theory Caring in Nursing
are:

▪ Persons are caring by virtue of

a) Technological competency as
caring in nursing is the harmonious
their humanness. coexistence between technologies
and caring in nursing.
▪ Persons are whole or complete in
the moment. b) The harmonization of these
concepts places the practice of
▪ Knowing persons is a process of nursing within the context of
nursing that allows for continuous modern healthcare and
appreciation of persons moment to acknowledges that these concepts
moment. can co-exist.

▪ Technology is used to know c) Technology brings the patient

closer to the nurse. Conversely,
wholeness of persons moment to
technology can also increase the gap
moment.
between the nurse and nursed. d)
▪ Nursing is a discipline and a When technology is used to know
persons continuously in the moment,
professional practice.
the process of nursing is lived.
Dimensions of Technological Value
The Process of Nursing
in the Theory

▪ Technology as completing human A. Knowing:

-The process of knowing person is
beings to re-formulate the ideal
guided by technological knowing in
which persons are appreciated as
participants in their care rather than
as objects of care.
-The nurse enters the world of the
other. In this process, technology is
used to magnify the aspect of the
person that requires revealing
- a representation of the real person.
-The person’s state change moment
to moment
- person is dynamic, living, and can
not be predicted.

B. Designing:
- Both the nurse and the one nursed
(patient) plan a mutual care process
from which the nurse can organize a
rewarding nursing practice that is
responsive to the patient’s desire for
care.

C. Participation in appreciation:
-The simultaneous practice of
conjoined activities which are
crucial to knowing persons
. -In this stage of the process is the
alternating rhythm of
implementation and evaluation.
-The evidence of continuous SISTER LETTY G. KUAN
knowing, implementation and
“Retirement and Role Discontinuities Theory”
participation is reflective of the
Sister - Letty Kuan
cyclical process of knowing persons.
 Born on November 19, 1936 in Katipunan –
D. Verifying knowledge: Dipolog , Zamboanga Del Norte
-The continuous, circular process  Master Degree in Nursing and Guidance
demonstrates the ever and counseling.
-changing, dynamic nature of  She also holds a Doctoral Degree in
knowing in nursing. Education.
-Knowledge about the person that is  Have a vast contribution to the University
derived from knowing, designing, of the Philippines College of nursing faculty
and implementing further informs and academic achievements.
the nurse and the one nursed.
 She is now a professor EMERITUS, a tittle
awarded in only to a few who met the strict
criteria.

Retirement and Role Discontinuitues

Theory
 • This theory states that retirement is • Retiree is an individual who has left the
another phase in a person’s life that would position occupied for the past years of
require some adjustments. According to the productive life because he/she has reached
theory, there are some roles that the person the prescribed retirement age of has
has already learned to play for many years. completed the required years of service.

• Now that the role has to be discontinued, • Role Discontinuity is the interruption in
there is a period of adjustment for this too the line of status enjoyed or role performed.
so that the person can adjust to yet again, The interruption may be brought about by
another new role in his/her life. There are an accident, emergency, and change of
different things that can make the role position or retirement.
discontinuity and retirement become
positive in people’s lives. • Coping Approaches refer to the
interventions or measures applied to solve a
problematic situation or state in order to
restore or maintain equilibrium and normal
functioning.
Determinants of positive perceptions in
retirement and positive reactions toward role
discontinuities.

Health Status – refer to physiological and mental

Basic Assumptions and Concepts:
state of the respondents, classified as either sickly or
healthy.
• Role refers to the set of shared
expectations focused upon a particular Income – (economic level) refers to the financial
position. These may include beliefs about affluence of the respondent which can be classified
what goals or values the position incumbent as poor, moderate or
is to pursue and the norms that will govern
Work status - status of the individual according to
his behavior.
his/her work.
– It is also the set of shared expectations
from the retiree’s socialization experiences Family Constellation – means family composition
and the values internalized while preparing described either close knit or extended family where
for the position as well as the adaptations to three more generations of family members live
the expectations socially defined for the under one roof; or distanced family, whose member
position itself. For every social role, there is live in separate dwelling units; or nuclear type of
complementary set of roles in the social family where only husband, wife and children live
structure among which interaction together.
constantly occurs.
Self-Preparation - it is preparing of self to the
• Change of Life is the period between near possible outcome in life.
retirement and post retirement years.
In medico-physiologic terms, this
equates with the climacteric period of
adjustment and readjustment to another
tempo of life.