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Katharine Kolcaba's Theory of Comfort In the early part of the 20th century, comfort was the central goal of nursing and medicine, and it remained the nurse's first consideration. A "good nurse" was expected to make patients comfortable. Textbooks from the early 1900s emphasized the role of healthcare providers in ensuring emotional and physical comfort and in adjusting the patient's environment. For instance, in 1926, Harmer advocated that nursing care should be focused on providing an atmosphere of comfort. In the 1980s, a modern inquiry into comfort began. Comfort activities were observed, and meanings of comfort were explored. Comfort was conceptualized as multidimensional, including emotional, physical, and spiritual aspects. Nurses provided comfort through environmental interventions. During this decade, Kolcaba began developing a theory of comfort while she was a graduate student at Case Western Reserve in Cleveland, Ohio. She currently holds the position of nursing professor at the University of Akron in Ohio. Kolcaba's (1992) theory is based on the work of earlier nurse theorists, including Orlando (1961), Benner, Henderson, Nightingale, and Watson (1979), as well as Henderson and Paterson. Additionally, Murray (1938) was a non-nursing influence on Kolcaba's work. The theory was developed using induction (from practice and experience), deduction (through logic), and retroactive concepts (concepts from other theories). The basis of Kolcaba's theory is a taxonomic structure or grid that consists of 12 cells (Kolcaba, 1991; Kolcaba & Fisher, 1996). The grid has three types of comfort listed at the top and four contexts in which comfort occurs listed down the side. The three types of comfort are relief, ease, and transcendence, while the four contexts are physical, psycho-spiritual, sociocultural, and environmental. Kolcaba does not believe that a focus on comfort is unique to nursing, and she believes that her theory can be interdisciplinary. She thinks that multiple professions can converge around her theory of comfort and provide holistic care to patients. Internal Evaluation: Major assumptions underlying Kolcaba's (1992) theory include: 1. Human beings have holistic responses to multiple and complex stimuli. 2. Comfort is a desirable outcome and is germane to nursing. 3. Human beings strive to meet their comfort needs, and it is a continuous process. 4. Having their comfort needs met strengthens patients and encourages them to engage in health-seeking behaviors of their own. 5. Patients who are empowered to engage in health-seeking behaviors have better perceptions of and about their healthcare. 6. When an institution's care is based on a value system that is focused on the patient or those who receive care, that institution is said to have integrity. Kolcaba defined the concepts of nursing's metaparadigm as follows:
As much as generous and honest Nick Carraway is, he still needs a few important improvements in himself. Nick went to Yale, fought in world war one and moved to East of New York to work in finance. After moving to New York, Nick faces tough dilemmas throughout the story such as revealing secrets, and witnessing betrayal. His innocence and malevolence toward others was beyond his control. He did not have the ability or knowledge to know what he should have done in the spots he was set in. He seemed lost and having no control of what went on- almost trapped- but indeed, he had more control than he could have ever known. Because of the situations he has experienced and the people he has met, such as Gatsby, Tom, Jordan and Daisy, his point of view on the world changed dramatically which is very depressing. Trusting the others and caring for them greatly has put him in a disheartening gloomy position.
Comfort care or palliative care is when a terminal patient is placed in a quiet room, where no medical interventions are done except morphine. The patients are not placed on any monitors, no vital signs or given prescription medications. Only the presence of families, periodic turning, swabs for dampening the lips, and perhaps restful music is around the patient. Comfort care is meant to allow a dying person a peaceful end, thus, morphine drip is added for pain relief. Stephens (2012), states that it’s the same medications used to control pain and discomfort, could be used to “help” the patient to stop breathing. The concept of terminal sedation assumes death as an outcome of the intervention.
Guilty or not guilty? This the key question during the murder trial of a young man accused of fatally stabbing his father. The play 12 Angry Men, by Reginald Rose, introduces to the audience twelve members of a jury made up of contrasting men from various backgrounds. One of the most critical elements of the play is how the personalities and experiences of these men influence their initial majority vote of guilty. Three of the most influential members include juror #3, juror #10, and juror #11. Their past experiences and personal bias determine their thoughts and opinions on the case. Therefore, how a person feels inside is reflected in his/her thoughts, opinions, and behavior.
The first vote ended with eleven men voting guilty and one man not guilty. We soon learn that several of the men voted guilty since the boy had a rough background not because of the facts they were presented with. Although numerous jurors did make racist or prejudice comments, juror ten and juror three seemed to be especially judgmental of certain types of people. Juror three happened to be intolerant of young men and stereotyped them due to an incident that happened to his son. In addition, the third juror began to become somewhat emotional talking about his son, showing his past experience may cloud his judgment. Juror ten who considered all people from the slums “those people” was clearly prejudiced against people from a different social background. Also, Juror ten stated in the beginning of the play “You 're not going to tell us that we 're supposed to believe that kid, knowing what he is. Listen, I 've lived among 'em all my life. You can 't believe a word they say. I mean, they 're born liars.” Juror ten did not respect people from the slums and believed them to all act the same. As a result, Juror ten believed that listening to the facts of the case were pointless. For this reason, the tenth juror already knew how “those people” acted and knew for sure the boy was not innocent. Even juror four mentioned just how the slums are a “breeding ground
Twelve Angry Men is a depiction of twelve jurors who deliberate over the verdict of a young defendant accused of murder, highlighting many key communications concepts discussed throughout the semester. One of these concepts was the perspective of a true consensus, the complete satisfaction of a decision by all parties attributed. An array of inferences were illustrated in the movie (some spawning collective inferences) as well as defiance among the jurors. Each of these concepts play a role endorsing, or emphasizing the other. We can analyze the final verdict of the jurors and establish if there was a true consensus affecting their decision. In turn, we can analyze the inferences during the deliberation and directly link how they affect the consensus (or lack thereof). Defiance among the jurors was also directly
Every person’s needs must be recognized, respected, and filled if he or she must attain wholeness. The environment must attuned to that wholeness for healing to occur. Healing must be total or holistic if health must be restored or maintained. And a nurse-patient relationship is the very foundation of nursing (Conway et al 2011; Johnson, 2011). The Theory recognizes a person’s needs above all. It sets up the conducive environment to healing. It addresses and works on the restoration and maintenance of total health rather than only specific parts or aspect of the patient’s body or personality. And these are possible only through a positive healing relationship between the patient and the nurse (Conway et al, Johnson).
In the play “Twelve Angry men”, the story line presents a variety of perspectives and opinions between twelve very different men. Some are more likely to be pointed out as prejudice, and others are more focused on reaching fair justice. Clearly, it is quite difficult for different people to vote ‘guilty’ or ‘not guilty’ in unity when coming to a fair decision. In all of the twelve jurors, I have chosen Juror 3 and Juror 8 for contrast and comparison. I believe that Juror number 3 is a very opinionated man, with more differences than similarities comparing with Juror number 8.
Slaves and slave trade has been an important part of history for a very long time. In the years of the British thirteen colonies in North America, slaves and slave trade was a very important part of its development. It even carried on to almost 200 years of the United States history. The slave trade of the thirteen colonies was an important part of the colonies as well as Europe and Africa. In order to supply the thirteen colonies efficiently through trade, Europe developed the method of triangular trade. It is referred to as triangular trade because it consists of trade with Africa, the thirteen colonies, and England. These three areas are commonly called the trades “three legs.”
To “live as fully and comfortably as possible” is a key phrase in the care and treatment of a patient under hospice care. Hospice care focuses on the comfort and quality of life for a person with a terminal illness. The focus is not on a cure. A hospice care provider wants to help the patient be as pain free and comfortable as they can be, so that they can live the rest of their life as fully as possible. Unfortunately, more often than not, patients with terminal illnesses are viewed to be too frail to participate in occupations (Russell, M., & Bauh-Lampe, A., 20016). It is also true that people facing the end of their life feel helpless or depressed, lose their ability to participate in a lot of the daily activities they once enjoyed, and experience a loss of dignity. (Badger, S., Macleod, R., & Honey, A. 2016). However, with hospice care, many patients are able to find some degree of comfort, safety and control over their lives during their final days.
Nick Carraway is Jay Gatsby’s closest and only companion. Nick said, “I believe that on the first night I went to Gatsby’s house I was one of the few guests who had actually been invited. People were not invited—they went there” (Fitzgerald 45). Gatsby did not have friends that appreciated him enough to comprehend his inner being (Fitzgerald 45). When Gatsby grinned, Nick Carraway could instantly feel comforted and sympathized the way a real friend should feel. According to Gilbey, “But with the sound of Nick's description of that smile: ‘It seemed to understand and believe in you just as you wanted to be understood and believed in’” (Gilbey). Nick Carraway held several unspoken and interesting conversations with Gatsby (Vancheri). Jay Gatsby displayed his feelings and experiences from his past to Nick Carraway. Gatsby can trust Nick with his emotional memories towards Daisy. Jay Gatsby explained his real background to Nick wanting him to overlook all the rumors and lies people have babbled about (“Great”, Scott).
Nursing dates back centuries ago; though technology has changed the tasks, the beautiful act of
Nursing behaviors that improve patient comfort are as simple as positioning and repositioning, knowing patients special comfort habits, and advocating for family presence (Kolcaba & DiMarco, 2005). It is important to use a measurement tool to assess comfort and remember to reassess for a positive outcome or plan a new intervention. Comfort is associated with the pursuit of healthy behavior, increased patient satisfaction, and better cost-benefit ratios (Kolcaba & DiMarco, 2005). Although Watson’s caring model is a broad philosophy that applies to nursing practice in general, nurses utilizing this theory would find Kolcaba’s middle-range comfort theory aligns well within the framework those
We can see that the hospice concept is a bio-psychosocial approach to the dying process, concerned with biological, psychological, and social health. Because of its proponents, Hospice is considered a more humane and sensible approach to terminal illness, combining care, comfort, and support of family and friends as the individual faces death. Their concern for dignity and fo...
McEwen, M., & Wills, E. (2011). Theoretical Basis for Nursing (3 ed.). Philadelphia, PA: Lippincott, Williams & Wilkins.
Comfort is important to caring in nursing because it is the nurse 's job to try and help the patient feel at ease and be pain free.