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The Comfort Theory and Care of Patients in the Perioperative Area: Theory Guiding Practice

The Comfort Theory and Care of Patients in the Perioperative Area: Theory Guiding Practice. Allison Kathleen Peters University of Central Florida. Background. Comfort Theory Model Designed by Katherine Kolcaba

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The Comfort Theory and Care of Patients in the Perioperative Area: Theory Guiding Practice

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  1. The Comfort Theory and Care of Patients in the Perioperative Area: Theory Guiding Practice Allison Kathleen Peters University of Central Florida

  2. Background • Comfort Theory Model Designed by Katherine Kolcaba • Looks at the whole person with emphasis on the manipulation of the environment such as sound, temperature, furniture • Comfort needs occur in the mental and physical contexts of the patient (Kolcaba, 2001)

  3. Patients that present to surgery are usually anxious • Anxiety produces a physiological rise in catecholamines (raising blood pressure) • Also increases cortisol which causes decreased immunity and healing • Anxiety caused by waiting for surgical procedure can cause feelings of abandonment, fear of anesthesia and of dying (McCance & Huether, 2006) (Gilmartin & Wright, 2008)

  4. Problem • Heightened anxiety can lead to poor surgical outcomes • Decreased healing • Nurses need to recognize anxiety and provide comfort measures

  5. Significance Feelings experienced: • Uncertainty • Relationship between danger or threat • Ambiguousness • Fear Intervention: • Communication • Control of environmental factors (light, noise, temperature) • Patient control (encouraging feedback, using pain scale, control of environment via RN) (Kagan & Bar-Tal, 2008) (Smith & Liehr, 2008)

  6. Specific Aims • Raise nurse awareness of comfort levels • Facilitation of comforting environment through: Physical Needs: Oxygenation, thermoregulation, pain relief Socio comfort: Cultural sensitivity, positive body language, caring Environmental: Orderly, quiet, safe (Kolcaba & DiMarco, 2005)

  7. Theory • A nursing art entailed by comforting actions performed by the nurse for enhanced patient comfort • Intervention needs to be immediate-time is the biggest threat • Focused in nursing • Can be duplicated in many different practices (Kolcaba, 2003) (Smith & Liehr, 2008)

  8. Application of the Theory to Clinical Problem • Information given to patient • Patient verbalizes understanding asks appropriate questions • Patient knows what to expect from three perioperative areas • Provision of small comfort measures such as warming • Not warming can lead to complications such as impaired wound healing, increased blood loss, cardiac arrest and increased wound infection (Burger & Fitzpatrick, 2009).

  9. Summary & Conclusion • Assisting patient through comfort measures at a very stressful juncture in life • No cost to implement comfort measures • Increase patient satisfaction scores equals increased revenues to hospital • Application of nurse’s knowledge & critical thinking skills • Promotes healing • Being connected with the patient (Buell, 2008)

  10. Reference • Burger, L., & Fitzpatrick, J. (2009). Prevention of inadvertent perioperative hypothermia. British Journal of Nursing (BJN), 18(18), 1114. Retrieved from CINAHL Plus with Full Text database. • Gilmartin, J., & Wright, K. (2008). Day surgery: patients' [sic] felt abandoned during the preoperative wait. Journal of Clinical Nursing, 17(18), 2418-2425. Retrieved from CINAHL Plus with Full Text database • . • Kagan, I., & Bar-Tal, Y. (2008). The effect of preoperative uncertainty and anxiety on short-term recovery after elective arthroplasty. Journal of Clinical Nursing, 17(5), 576-583. Retrieved from CINAHL Plus with Full Text database. • Kolcaba, K., & DiMarco, M. (2005). Comfort theory and its application to pediatric nursing. Pediatric Nursing, 31(3), 187-194. Retrieved from CINAHL Plus with Full Text database. • Kolcaba, K. (2003) Comfort theory and practice. New York, NY: Springer Publishers • Kolcaba, K. (2001). Evolution of the mid range theory of comfort for outcomes research. Nursing Outlook, 49(2), 86-92. Retrieved from CINAHL Plus with Full Text database. • McCance, K.L. & Huether, S.E. (2006) Pathophysiology: The biologic basis for disease in adults and children. (5th ed.) St. Louis, MO: Elsevier Mosby. • Smith, M. J. & Liehr, P.R. (2008) Middle range theory for nursing (2nd ed.) New York, NY: Springer. • Wagner, D., Byrne, M., & Kolcaba, K. (2006). Effects of comfort warming on preoperative patients. AORN Journal, 84(3), 427. Retrieved from CINAHL Plus with Full Text database. • Walker, J. (2007). Patient information. What is the effect of preoperative information on patient satisfaction?. British Journal of Nursing (BJN), 16(1), 27-32. Retrieved from CINAHL Plus with Full Text database.

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