Kolcaba

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Kolcabas Theory of Comfort

• NURS 451
• Ferris State University
• Tracy Stark

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Description of Kolcabas TheoryComfort Care
Measures No Extraordinary Measures

• Kolcabas Theory describes comfort existing in
  three forms relief, ease, and transcendence.
• When specific comfort needs of a patient are met,
  the patient experiences comfort in the sense of
  relief.
• Ease addresses comfort in a state of contentment.
• Transcendence is described as a state of comfort
  in which patients are able to rise above their
  challenges.
• There are four aspects of life that can
  experience Kolcabas forms of comfort
• Physical SOB, fatigue, weakness, complaints r/t
  immobility
• Psychospiritual Fear of dying, anticipatory
  grief of spouse, belief in finality of death,
  i.e. no afterlife
• Environmental Homelike setting valued.
• Sociocultural Patient needs, family needs

(Nursing Theory, 2013 Vendlinski, Kolcaba,
1997)
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Strategies of Kolcabas TheoryEnd-of-Life/Palliat
ive Care

• Empowerment of patients or families at the
  end-of-life
• Active involvement that is facilitated by the
  healthcare team, strengthened by having comfort
  needs meet.
• Comfort needs are assessed subjectively (what
  patients and families say) and objectively (what
  the nurse observes).
• Nursing must account for all intervening
  variables
• Interdisciplinary Care Approach
• Utilizes nursing, physician, respiratory care,
  social work, case worker, hospice, child life,
  religious services.
• Use therapeutic communication, promote autonomy,
  reposition as needed, medicine administration for
  palliative care as needed/requested.
• Verbal and written communication, using the
  comfort grid as a framework for interdisciplinary
  discussion, can promote continuity, consistency
  and efficiency in the management of emerging
  comfort needs.
• Comfort is reassessed to determine effectiveness

(Kolcaba Fisher, 1996 Vendlinski Kolcaba,
1997)
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QSEN Competency ObjectivesPatient-Centered Care
KSAs

• Knowledge
• Active involvement of interdisciplinary team,
  patient and family.
• Evaluation and reevaluation accounting for all
  variables that affect comfort (i.e. physical,
  psychospiritual, environmental, and
  sociocultural.
• Skill
• As with the interdisciplinary team verbal and
  written communication can be utilized with
  patient and families, using the comfort grid as a
  framework for discussion. This can promote
  continuity, consistency and efficiency in the
  management of emerging comfort needs.
• Attitude
• Value opinion of all of those involved in care.
  Take time to explain and discuss aspects of care.
  
• Family at bedside at time of death peace of mind
  and less misapprehension.

(Vendlinski Kolcaba, 1997)
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References

• Kolcaba, K. Y., Fisher, E. M. (1996). A holistic
  perspective on comfort care as an advance
  directive. Aspen Publishers, Inc. 18(4) p.66-76
• Nursing Theory. (2013). Kolcaba's theory of
  comfort. Nursing Theory. Retrieved from
  http//www.nursing-theory.org/theories-and-models/
  kolcaba-theory-of-comfort.php
• Vendlinski, S., Kolcaba, K. Y. (1997). Comfort
  care A framework for hospice nursing. American
  Journal of Hospice and Palliative Medicine. 14
  (271). doi 10.1177/104990919701400602