Transcript Comfort PPT
The Comfort Theory and
Care of Patients in the
Perioperative Area: Theory
Guiding Practice
Allison Kathleen Peters
University of Central Florida
Background
Comfort Theory Model Designed by Katherine
Kolcaba
Looks at the whole person with emphasis on
the manipulation of the environment such as
sound, temperature, furniture
Comfort needs occur in the mental and
physical contexts of the patient
(Kolcaba, 2001)
Patients that present to surgery are usually
anxious
Anxiety produces a physiological rise in
catecholamines (raising blood pressure)
Also increases cortisol which causes
decreased immunity and healing
Anxiety caused by waiting for surgical
procedure can cause feelings of
abandonment, fear of anesthesia and of
dying
(McCance & Huether, 2006)
(Gilmartin & Wright, 2008)
Problem
Heightened anxiety can lead to poor surgical
outcomes
Decreased healing
Nurses need to recognize anxiety and provide
comfort measures
Significance
Feelings experienced:
Uncertainty
Relationship between danger or threat
Ambiguousness
Fear
Intervention:
Communication
Control of environmental factors (light, noise,
temperature)
Patient control (encouraging feedback, using
pain scale, control of environment via RN)
(Kagan & Bar-Tal, 2008)
(Smith & Liehr, 2008)
Specific Aims
Raise nurse awareness of comfort levels
Facilitation of comforting environment
through:
Physical Needs: Oxygenation,
thermoregulation, pain relief
Socio comfort: Cultural sensitivity, positive
body language, caring
Environmental: Orderly, quiet, safe
(Kolcaba & DiMarco, 2005)
Theory
• A nursing art entailed by comforting actions
performed by the nurse for enhanced patient
comfort
• Intervention needs to be immediate-time is
the biggest threat
• Focused in nursing
• Can be duplicated in many different practices
(Kolcaba, 2003)
(Smith & Liehr, 2008)
Application of the Theory to
Clinical Problem
Information given to patient
Patient verbalizes understanding asks
appropriate questions
Patient knows what to expect from three
perioperative areas
Provision of small comfort measures such as
warming
Not warming can lead to complications such as
impaired wound healing, increased blood loss,
cardiac arrest and increased wound infection
(Burger & Fitzpatrick, 2009).
Summary & Conclusion
• Assisting patient through comfort measures at
a very stressful juncture in life
• No cost to implement comfort measures
• Increase patient satisfaction scores equals
increased revenues to hospital
• Application of nurse’s knowledge & critical
thinking skills
• Promotes healing
• Being connected with the patient
(Buell, 2008)
Reference
•
Burger, L., & Fitzpatrick, J. (2009). Prevention of inadvertent perioperative hypothermia. British Journal of Nursing (BJN), 18(18),
1114. Retrieved from CINAHL Plus with Full Text database.
•
Gilmartin, J., & Wright, K. (2008). Day surgery: patients' [sic] felt abandoned during the preoperative wait. Journal of Clinical
Nursing, 17(18), 2418-2425. Retrieved from CINAHL Plus with Full Text database
.
Kagan, I., & Bar-Tal, Y. (2008). The effect of preoperative uncertainty and anxiety on short-term recovery after elective
arthroplasty. Journal of Clinical Nursing, 17(5), 576-583. Retrieved from CINAHL Plus with Full Text database.
•
•
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Kolcaba, K., & DiMarco, M. (2005). Comfort theory and its application to pediatric nursing. Pediatric Nursing, 31(3), 187-194.
Retrieved from CINAHL Plus with Full Text database.
•
Kolcaba, K. (2003) Comfort theory and practice. New York, NY: Springer Publishers
•
Kolcaba, K. (2001). Evolution of the mid range theory of comfort for outcomes research. Nursing Outlook, 49(2), 86-92. Retrieved
from CINAHL Plus with Full Text database.
•
McCance, K.L. & Huether, S.E. (2006) Pathophysiology: The biologic basis for disease in adults and children. (5th ed.) St. Louis,
MO: Elsevier Mosby.
•
Smith, M. J. & Liehr, P.R. (2008) Middle range theory for nursing (2nd ed.) New York, NY: Springer.
•
Wagner, D., Byrne, M., & Kolcaba, K. (2006). Effects of comfort warming on preoperative patients. AORN Journal, 84(3), 427.
Retrieved from CINAHL Plus with Full Text database.
•
Walker, J. (2007). Patient information. What is the effect of preoperative information on patient satisfaction?. British Journal of
Nursing (BJN), 16(1), 27-32. Retrieved from CINAHL Plus with Full Text database.