Analysis of a Middle Range Nursing Theory Student Name ......Kolcaba’s nursing model falls under...

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.


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


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


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


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


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


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


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


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.


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.


Smith, M. J., & Liehr, P. R. (Eds.). (2018). Middle range theory for nursing. Springer Publishing

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