Philippine Women's University, Master of Arts in Nursing
Theoretical Framework for Nursing Practice – Module 4
A. Look for an example of middle-range theory. Evaluate it as to the following (Be sure to justify your answers):
1. Congruence with nursing standards.
2. Congruence with current nursing interventions or therapeutics.
3. Evidence of empirical setting, research support and validity.
4. Use by educators, nursing researches or nursing administrators.
5. Social relevance
6. Transcultural relevance
7. Contribution to nursing
8. Conclusions and recommendations.
The middle-range Theory of Comfort by Katharine Kolcaba described the concept of comfort as existing in three forms (relief, ease and transcendence) and its inter-relationship with four different contexts of experience (physical, psychospiritual, sociocultural and environmental). (Kolcaba, 2003)
In 2005, the Philippine Board of Nursing created the Committee on Core Competency Standards Development in collaboration with the Commission on Higher Education Technical Committee on Nursing Education with the primary goal to develop the competency standards for nursing practice in the country which will then serve as a unifying framework for nursing education, regulation and practice (http://bonphilippines.org, accessed March 30, 2012). Among the eleven key areas of responsibility for nursing practice, the domain of “quality and safe nursing care” includes promotion of safety and comfort where Kolcaba’s theory can be integrated. Comfort has always been included in nursing education, and Kathatine Kolcaba’s theory seems simple yet an effective one when caring for a patient. We all know the definition of comfort; what we do not know is the science and the concept behind it and it is good that one fellow nurse has developed a theory to guide us in giving comfort measures. Katharine Kolcaba has presented the different types and taxonomy of comfort and has correlated it with our unique function which involves the holistic approach.
The comfort theory was first used by Kolcaba in her study in the Guided Imagery (GI) audiotape for women with breast cancer going through conservative treatment (Radiation Therapy) and yielded positive results. Hogan-Miller (1995) also approached Kolcaba in using the comfort framework in her study on immobilization of post-angiography patients. Other settings in nursing practice where the comfort framework was used include the burn unit, gynecological examination, hospital ship, medical and surgical, midwifery, hospice, long-term care, infertility, acute care for elders, urinary incontinence, newborn nursery, emergency department, psychiatry and critical care. For each setting, the General Comfort Questionnaire, the primary tool for comfort measurement, was revised to address relevant concerns in other settings leading to the creation of more specific nursing comfort instruments. (Kolcalba, 2003 as cited in http://comfortcareinnursing.blogspot.com, accessed March 30, 2012)
The theory’s social and transcultural relevance is already imbedded/integrated within the taxonomic structure formulated by Kolcaba herself. It is considered expansively as two out of the four contexts of experience. Her views on holism have resulted in the need to cover these areas of concern, making the theory universally accepted and relevant.
The theory’s contribution to nursing couldn’t be ignored. The concept of comfort has always been present in this particular discipline since its inception more than a hundred years ago. However, due to Kolcaba’s efforts, the concept is now enjoying a much more defined and refined status – measurable, more operative and better understood. To put it in her husband’s own terms: “If your discipline is going to progress as a science, you must define your central terms precisely so you can understand...