Analysis of a Middle Range Nursing Theory Student Name ......Kolcaba’s nursing model falls under...
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Running head: ANALYSIS OF A MIDDLE RANGE NURSING THEORY 1
Analysis of a Middle Range Nursing Theory
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ANALYSIS OF A MIDDLE RANGE NURSING THEORY 2
Analysis of a Middle Range Nursing Theory
Comfort theory is one of the nursing concepts, which has numerous applications to
nursing practice. It was developed in 1944 by Katherine Kolcaba. The theorist specialized in
various aspects of nursing, including comfort care, nursing research, end-life intercessions, and
nursing theory. This allowed her to come up with the middle-range nursing theory (Smith &
Liehr, 2018). The model prioritizes comfort in healthcare. Thus, it supports comfort is one of the
needs that nurses need to focus on creating health-seeking behavior in individuals. This essay
aims at evaluating the Kolcaba’s nursing model and discussing its relevance to nursing standards
and its contributions to the discipline of nursing.
Structural Components
The Purpose of the Theory
The aim of the comfort theory is to illustrate, predict, and give an explanation about
various foundations of nursing practice. This model describes that the role of nursing is to
evaluate the patient’s comfort needs, design, and execute effective nursing interventions, and
examining them to ensure positive patient outcomes (Puchi, Paravic-Klijn & Salazar, 2018).
Thus, as a nurse, one needs to determine the kind of health issue the patient is experiencing, offer
effective treatment, and find out whether the need is fully satisfied to ensure the patient is
comfortable. Also, the model considers health as the situation whereby the patient is functioning
optimally. In this case, the patient is regarded as the individual or family, which consists of
various healthcare needs. It also defines the environment as the factors surrounding the patient,
family, or institution (Puchi, Paravic-Klijn & Salazar, 2018). In that regard, an environment can
be modified by a healthcare provider to enhance comfort.
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The Scope of the Model
Kolcaba’s nursing model falls under the middle-range theories. This group of nursing
concepts has a limited range. This can be revealed some of their key features. For instance,
middle-range theories are concerned about particular phenomena (Smith & Liehr, 2018).
Similarly, Kolcaba’s nursing model revolves around an individual’s comfort needs. For example,
the approach provides various contexts under which comfort needs occur. They include physical,
environmental, sociocultural, and psychospiritual contexts (Nuraini et al., 2018). Besides, the
author support that patient comfort can be achieved by achieving calmness, meeting a specific
need, or by empowering the patient to rise above the healthcare need. Also, the middle-range
theory is more applicable directly to practice. Similarly, the concept of self-transcendence can be
applied directly to nursing practice. This concept is applied in nursing to help the patient
overcome their challenges through the use of the spiritual idea (Nuraini et al., 2018). This can be
expressed in the form of prayers.
Concepts and Propositions
Besides, the nursing model comprises of various concepts and themes. The theorist
identifies the three forms in which patient comfort can be achieved. One of them includes relief.
This can occur in a situation whereby a nurse helps a patient to overcome pain by administering
prescribed medication. In this case, one experiences comfort in the relief sense. Secondly, in
nursing practice, patient comfort can be achieved by easing the burden of a health condition on a
patient. One way through which satisfaction can be achieved through the easing sense is by
addressing the various factors contributing to depression in an individual. Lastly, the theory
introduces the transcendence concept as a way of reinstating comfort in an individual. This is a
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situation whereby an individual gets in a comfortable state after overcoming his/her challenges.
The three approaches of comfort can be realized in the environmental, physical, spiritual, or
sociocultural settings.
Nursing is one of the concepts of Kolcaba’s model. The author defines nurses play a
significant role in examining the patient’s comfort needs, addressing the needs through effective
comfort measures, and ensuring patients are comfortable after the enactment of the nursing
interventions. In this model, a patient refers to the person, family, or the population who have
various healthcare demands. The environment is used to represent external factors such as
policies, residential areas, and work settings. These factors can be transformed to enhance
comfort. The other concept includes health. This refers to a situation whereby the patient can
function normally. Additionally, it suggests that nurses are responsible for determining the
comfort needs of individuals seeking medical care. They also develop measures that help meet
the diagnosed needs. To enhance comfort needs, nurses ensure the interventions embraced are
effective. The other proposition is that comfort can be enhanced by promoting satisfaction
among family members and patients.
Assumptions
The model comprises of various significant assumptions. The theorist support that
comfort is the positive outcome that is achieved by providers in patients after the effective
implementation of appropriate nursing interventions. Secondly, the nursing model support that
nurses have the potential to recognize the comfort needs of various patients, develop effective
measures to help achieve the demands, and evaluate the outcome to ensure they promote
comfort. Thirdly, holistic comfort can be strengthened by satisfying the healthcare needs
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experienced by a patient through ease, relief, and transcendence strategies. Lastly, individuals
struggle to meet their basic comfort needs.
Functional Components of the Theory
Theoretical and Operation Definitions
Additionally, this nursing model uses theoretical and operation definitions that help to
explain what the model means and its components. For instance, the theorist considers comfort
as the direct outcome expected after providing nursing care. Secondly, according to the model,
the demands presented in a particular practice setting by an individual or family, are called
healthcare needs (Pinto, Caldeira, Martins, & Rodgers, 2017). Thirdly, the theorist proposes that
intervening variables include the factors which the healthcare providers are less likely to modify
during practice. One of them is the extent of social support (Pinto, Caldeira, Martins, & Rodgers,
2017). Lastly, according to the comfort model, nursing is a process of examining an individual’s
comfort needs, design, and enact effective nursing interventions, and also assess them to
determine their impacts.
Logical Organization of the Theory
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The content and context of comfort are well organized and related to each other. Also,
both components are centered on holistic comfort. The nursing model comprises various
propositions that are clearly stated and are consistent throughout the theory. Lastly, the nursing
model comprises different parts that are dependent on the other. Thus, this implies that the theory
is logically organized.
Stated Outcome or Consequences
The nursing model proposes that the expected outcome of nursing practice is to promote
comfort among patients and families. In this model, comfort is considered a crucial measure of
nursing care. The author support that when patients and families are more comfortable, they are
more likely to embrace health-seeking habits. These include external and internal behaviors.
Additionally, engagement in health-seeking practices has various consequences. For instance, it
is associated with positive outcomes such as increased patient satisfaction, reduced cost of care,
and reduced length of stay (Lafond et al., 2019).
Evaluation Components of the Comfort Model
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Congruence with Nursing Standards
The nursing model is applicable to nursing practice in various contemporary healthcare
settings. The comfort model affects the patient, family, and the community. Some of the aspects
of nursing practice affected by Kolcaba’s nursing model. They include patient satisfaction,
enhanced access to healthcare, improved health-related outcomes, and reduced readmissions. For
instance, through the embracement of effective nursing interventions, nurses can be able to
achieve positive patient outcomes and also improve patient satisfaction, ensure positive patient
outcomes, and improve patient safety (Nuraini et al., 2018).
Additionally, the comfort model components are focused on achieving comfort. In this
case, comfort is thus one of the measures that can be used to ascertain the efficacy of the diverse
nursing interventions embraced in a given situation to achieve positive and desirable outcomes
among their patients. Also, at the end of life care, some of the responsibilities of nurses include
pain management and supporting patients and their families during the dying process (Lafond et
al., 2019). The purpose of end of life nursing practices is to ensure patients experience a peaceful
death. Similarly, theoretically, nurses are responsible for embracing various interventions such as
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the provision of empathic and compassionate care to the patient and family to ease pain and
facilitate a peaceful death.
Validity and Relevance of the Theory
Comfort Theory (CT) is a harmonizing with nursing values and standards such as care,
healing environment, symptom management, identification of needs, and holism. The nursing
model has the potential to provide a reliable framework that can guide the decisions or actions of
healthcare professionals (nurses) to ensure they satisfy the healthcare demands of patients,
families, and the community (Puchi, Paravic-Klijn & Salazar, 2018). For instance, the comfort
model supports that nurses are responsible for identifying the needs of the patients. Also, they
develop measures that help in ensuring the patients are comfortable. Similarly, in various
healthcare settings nurses, are responsible for diagnosing patients, families, and communities to
identify their healthcare needs.
Implications for Nursing in Association with the Implementation of the Nursing
Model
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According to the nursing theory, nurses are responsible for determining the factors
affecting the comfort of patients, families, and institutions. Then, it guides that nurses are
supposed to come up with various effective interventions to help the affected individuals and
families achieve their comfort. Thus, this model has provided a framework through which nurses
in multiple settings address the healthcare needs presented by individuals, families, and
institutions (Puchi, Paravic-Klijn & Salazar, 2018). In such a context, nurses assess the physical,
psychological, spiritual, environmental, and sociocultural needs of their patients. They then help
them to embrace health seek behavior to achieve enhanced comfort. Thus, optimal comfort is
achieved by ensuring patients embrace positive and effective health-seeking behavior. Secondly,
the implementation of comfort theory affects organizational institutions in various ways. For
instance, the use of the model in nursing helps a nurse to ensure positive target patient outcomes.
This is linked to better patient satisfaction, cost-effective care, and decreased hospital stay
(Puchi, Paravic-Klijn & Salazar, 2018). These factors are related to institutional integrity.
Contributions of the Theory to the Discipline of Nursing
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The model provides a framework that guides nursing practice. According to this model,
nurses identify comfort needs that have not been identified or addressed by other support
facilities. Then they are required to develop interventions that will help to achieve the unmet
healthcare demands among patients, families, and the community (Puchi, Paravic-Klijn &
Salazar, 2018). Additionally, they assess the intercessions to establish their efficacy in attaining
comfort. By achieving comfort, nurses ensure patients are encouraged to prosecute in wellness
seeking behaviors. Secondly, the concept of perceived benefits associated with this model plays
a significant role in the success of various nursing intercessions (Simes et al., 2018). For
instance, by providing education before discharge increases the quality of life and prevent
rehospitalization.
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References
Lafond, D. A., Bowling, S., Fortkiewicz, J. M., Reggio, C., & Hinds, P. S. (2019). Integrating the
Comfort Theory™ Into Pediatric Primary Palliative Care to Improve Access to Care.
Journal of Hospice & Palliative Nursing, 21(5), 382-389.
Nuraini, T., Andrijono, A., Irawaty, D., Umar, J., & Gayatri, D. (2018). Spirituality-focused
palliative care to improve indonesian breast cancer patient comfort. Indian journal of
palliative care, 24(2), 196.
Pinto, S., Caldeira, S., Martins, J. C., & Rodgers, B. (2017). Evolutionary analysis of the concept
of comfort. Holistic nursing practice, 31(4), 243-252.
Puchi, C., Paravic-Klijn, T., & Salazar, A. (2018). The comfort theory as a theoretical framework
applied to a clinical case of hospital at home. Holistic nursing practice, 32(5), 228-239.
Simes, T., Roy, S., O'Neill, B., Ryan, C., Lapkin, S., & Curtis, E. (2018). Moving nurse
educators towards transcendence in simulation comfort. Nurse education in practice, 28,
218-223.