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The Comfort Care Concept At End Of Life

1997 words - 8 pages

The Comfort Care Concept at End of Life

Introduction
End of life is a concept that is often ignored despite the fact that everyone will die some day. It is because death is a part of life that people are familiar with comfort care given at the end of life. Comfort care is offered when someone is dying, and when the end is predictable. Comfort care is an essential part of nursing care at the end of life. It is care that helps or soothes a person who is dying. The goal is to prevent or relieve suffering as much as possible while respecting the dying person’s wishes (NIH, 2012). The goal of comfort care in nursing is the immediate state of being strengthened by having the needs for ...view middle of the document...

According to Kolcaba (2003), comfort is defined as "the immediate state of being strengthened through having the human needs for relief, ease, and transcendence addressed" (2003, p. 251). The three types of comfort were derived through Kolcaba's research while developing her concept analysis of comfort. Relief is the state of having a discomfort mitigated or alleviated. Ease is the absence of specific discomforts. Lastly, transcendence is the ability to "rise above" discomforts when they cannot be eradicated or avoided. The three types of comfort can occur in four contexts of experience: physical, psychospiritual, sociocultural, and environmental. Later, Kolcaba continued her work on the comfort theory by developing a broader theory for comfort and a taxonomic structure. This structure was developed as a guide for assessment, measurement and evaluation of patient comfort. In this context, the physical are needs that pertain to bodily sensations; the psychospiritual is pertaining to internal awareness of self, including esteem, concept, sexuality, and meaning in one's life and one's relationship to a higher order or being; the sociocultural which pertaining to interpersonal, family, and social relationships; and lastly, the environmental is pertaining to the external surroundings, conditions, and influences; (Kolcaba, 2003). Indeed, the work of Katharine Kolcaba, RN, MSN continues to be of vital use till this day in nursing.
There are other nursing theories which discuss comfort care. For example, Sr Callista Roy built her theory of adaptation around the nurse who helps the patient adapt to four categories of needs physiological, self-concept, role-function, and interdependence (Roy & Roberts 1981). The nurse was to employ traditional comfort measures to achieve comfort in the physiological mode. If one of the basic physiological needs was compromised, the nurse assessed the problem and provided comfort, thereby relieving the discomforts of physiological compromise. Dr. Jean Watson developed a theory in which she stated that a patient's environment was critical for his or her mental and physical well-being. Therefore, the nurse provided comfort through environmental interventions. In her theory, Watson used the term "comfort measures" synonymously with "interventions" which were based on a moral, ethical, philosophical foundation of love and value (Watson, 1979). In Dr. Josephine Paterson's comfort theory, which has characteristics of Humanistic Nursing, Paterson called comfort a construct that communicated "the nature or experience of nursing". She believed that comfort was an "umbrella under which all the other terms such as growth, health, freedom, and openness could be sheltered" (Paterson & Zderad 1988). Paterson was a psychiatric nurse, therefore she defined comfort from a mental perspective rather than from a physical one. She believed that mental discomforts could often lead to physical discomforts. Paterson...

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