Professional Documents
Culture Documents
Introduction
Purpose: the purpose of this assignment is to reflect how Kolcabas
Objectives:
Describe strategies from Kolcabas theory to empower patients or
families at the
end-of-life (patient-centered care-Knowledge)
Reflect how to engage patients or designated surrogates in active
partnerships that promote health, safety and transcendence at the end-oflife (patient-centered care- Skill).
Value active partnership with patient or designated surrogates in
planning, implementation, and evaluation of care (patient-centered careAttitude) (Singleterry, 2014, p. 6).
2
Types of comfort
Relief
Ease
Transcendence
Physical
Psychospiritual
Environmental
Social
3
s
Eight Domains: Care of the dying patient
Structure and process of care
Spiritual, religious, and existential aspects of care
End of Life
Nurses Impact
which patients live until they die, the manner in which the
death occurs, and the enduring memories of that death for the
families (Smeltzer et al., 2010, p. 396).
Interdisciplinary collaboration
Partnership
consistent
Much of care is intuitive
Strengthen family and patient
Value
Patient-centered Care: Recognize the patient or designee as the source
References
American Association of Colleges of Nursing | Quality & Safety Education for Nurses
(QSEN). (2014). Retrieved from
http://www.aacn.nche.edu/faculty/qsen/competencies.pdf
Singleterry, L. (2014). NURS 451 Nursing Theory 4 [Syllabus]. p. 6.
Smeltzer, S., Bare, B., Hinkle, J., & Cheever, K. (2010).Textbook of Medical Surgical
Nursing. Philadelphia: Wolters Kluwer/ Lippincott Williams & Wilkins.
Vendlinski, S., & Kolcaba, K. Y. (1997). Comfort care: a framework for hospice nursing. The
American journal of hospice & palliative care, 14(6), 271276. (you can find it on
PubMed: PMID: 9392722)
Reflection
L: Theory in practice
E: I felt disappointed in the healthcare team involved in the death of a family
member while researching this topic. The roles of the nurse were not met in my
situation. I dont remember seeing a nurse beyond quick vital signs throughout
the entire process. Knowing the responsibilities of the nurse I can now benefit
from this research when delivering care. I have gone through the death of a
loved one and grieving without support and feel as a nurse I can improve the
process for others. I felt confident in my project as much of the research was
straight forward. This assignment was challenging due to the amount of reading
and objectives to meet. I dont understand how this assignment could be
completed through a poster presentation based on the amount of content
involved. I was surprised to not see research from Kolcabas comfort theory
within the Smeltzer book.
A: I feel nervous when I think about end of life care. Each person grieves
differently and there are a lot of questions from the patient and family directed
to the nurse. I need to be confident in my responses to those questions and not
take comments or actions personally while those involved complete the dying
process. The anger they may express toward me is natural and most likely not
meant to be directed toward me. I believe Kolcabas theory is useful in creating
care plans based on the wide range of needs assessed and met throughout. I
believe people work better when provided with a map and this theory provides a
Reflection cont.
A: The advantage of using the theory is the ability to have a tool to guide you into providing holistic care to all
involved in the situation. The disadvantage is that the map may be difficult to fill in without help from an
experienced member of the team initially. Three types of comfort are met in this theory but the family may
seek more then just relief, ease, and transcendence in their situation. The advantages in communicating it to
an interdisciplinary team are 100% positive all around if the team understands the theory beforehand, The
disadvantage occurs when the team is not familiar with theory or how you obtained your assessments and care
plans. Educating the team on the theory may not be timely enough for the plan and theory to be effective for
the whole team to use. I think nursing knowledge always benefits the communication between team members.
All members make up the team and they all have their own tasks, skills, and language. All need to participate
respectfully to provide quality comfort care, or any care for that matter. The nurse knows things no other
person on the team does based on the amount of time and assessing the nurse spends with the patient and
families- the nursing language can only be helpful to the team, if they are willing to hear it.
R: I think the theory could be improved based on the feelings of those involved. If there are other areas
patients and families need help in related to types of comfort (relief, ease, and transcendence) the theory can
be elaborated on. There is no better theory or approach I can think of that would be better but maybe a couple
that could help. Maslows hierarchy of needs can be used to assess their levels of motivation and Dorothy
Orems theory of self care can be used for the patient and family members to evaluate the need for care and
analyze improvement or decline in patient and family status.
N: The only way I know of how I can improve this process in the future would be to use it. Since I have not yet
used it on my own I cant possibly fully understand it or suggest changes due to my ignorance.