Analyze and evaluate a middle-range theory** You will select a middle-range theory and identify the application of nursing theories into clinical practice.
Content Requirements:
1 Component of the theory
2 Discuss the major concepts of the theory
Philosophical basis or worldview change, advancing health
Structural aspects of the theory
3 Discuss the framework of the theory.
Identify an area of your practice where this theory could be applicable
4 What question does the theory help to answer?
5 Describe the area of interest in relation to the theory/theoretical model.
6 Is it appropriate for the practice setting and is it applicable?
7 Discuss the strength and weaknesses of the theory. If there is a weakness, discuss what makes it difficult to be used in practice.
8 Use of theory in clinical practice.
9 Performing a literature review is essential to completing this section. If there is no literature available about the application of this theory in practice, address the reason(s) why based on your findings.
10 Evaluation of theory
Is this theory used to understand and apply into practice?
11 What difficulties did you encounter or would anticipate encountering in using this theory?
12 What would make this theory more usable or applicable to practice?
Submission Instructions:
The paper is to be clear and concise and students will lose points for improper grammar, punctuation, and misspelling.
The paper should be formatted per current APA and references should be current (published within the last five years) scholarly journal articles or primary legal sources (statutes, court opinions.)
The paper is to be 4 pages in length, excluding the title, abstract, and references page.
Incorporate a minimum of 3 current (published within the last five years) scholarly journal articles or primary legal sources (statutes, court opinions) within your work. Journal articles and books should be referenced according to the current APA style.
Analysis and Evaluation of a Middle Range Theory
Introduction
Nursing theories assist in providing the meaning of nursing as a unique discipline that is separate from others. Nursing theories can be defined as an organized body of knowledge that dictates the meaning of nurses, what nurses do, and why they practice it (WGU, 2021). The first nursing theories were developed in the late 1800s when nursing education was gaining recognition. Nursing theories are classified as grand nursing theories, middle-range nursing theories, and practice-level nursing theories. Grand nursing theories are based on abstracts and provide a high-level framework for nursing ideas. Middle-range nursing theories provide more specific ideas (WGU, 2021). Practice-level nursing theory deal with very specific concepts that are narrow in scope. In that regard, the purpose of this paper is to discuss a middle-range nursing theory.
Kolcaba’s Theory of Comfort
Components of the Theory
The selected middle range theory is Kolcaba’s Theory of Comfort. The major concepts of the theory include healthcare needs, nursing interventions, intervening variables, health-seeking behavior, enhanced comfort, and institutional integrity. In terms of healthcare needs, the theory assumes that nurses should determine the comfort needs of patients, more so, those not met in existing settings (Awal, 2017). Nurses plan and coordinate nursing interventions to allow them to coordinate activities to accomplish unmet comfort. In addition, nurses should take into consideration intervening variables when planning an intervention. To achieve enhanced comfort, nurses implement proper interventions to certain outcomes. By attaining the state of enhanced comfort patients, family and nurses further unite their ties for health-seeking behavior, which cultivate more comfort (Awal, 2017). Institutional integrity includes best policies and practices to achieve enhanced comfort that then promotes health-seeking behavior.
The philosophical basis of the theory is that when a patient is sick, nursing interventions are implemented, taking into account intervening variables, and the outcome is enhanced comfort (Wu et al., 2022). Once the patient achieves enhanced comfort they develop health-seeking behaviors which can be internal (relief from pain), external (active participation), or peaceful death. The theory also presumes that improved health-seeking behavior indicates institutional integrity, which includes the implementation of best practices and policies (Petiprin, 2020). In addition, increased institutional integrity enhances the positive outcomes experienced by the patient.
Kolcaba’s Theory of Comfort was first developed in the 1990s. It is a middle-range theory for health, practice, education, and research (Petiprin, 2020). The components of this theory include its major concepts and three forms in which comfort exists. Katharine Kolcaba developed this theory after conducting a concept analysis of comfort by looking at literature from different disciplines such as nursing, psychology, medicine, ergonomics, and others (Petiprin, 2020). The concept of comfort is a holistic outcome because it denotes a multifaceted and dynamic state of a person.
Structural Aspects of Theory
Kolcaba’s Theory of Comfort describes three forms of comfort such as relief, ease, and transcendence. If the specific needs of the patient are accomplished, he experiences comfort is a sense of relief (Wu et al., 2022). However, when the patient is in a state of contentment, he experiences comfort in the sense of ease. In addition, transcendence is described as a state of comfort in which patients can rise above their challenges. Besides, the theory is based on six concepts as discussed above. The types of needs can be physical, psycho-spiritual, social, and environmental. Possible variables as identified by Kolcaba include age, experience, emotional state, attitude, and support, among others. Katherine Kolcaba also considered patients to be communities, families, and individuals in need of health care (Wu et al., 2022). The four contexts in which comfort happens include physical, psychospiritual, environmental, and sociocultural.
Areas of Practice Where the Theory Can be Applied
This theory tries to answer questions related to the enhancement of patient comfort. Questions related to the context where comfort can occur, variables that affect comfort, requirements for achieving patients’ comfort, how organizational integrity affects patients’ outcomes, and drivers of health-seeking behaviors (Wu et al., 2022). All these questions and many others are addressed by the theory. The area of interest in the theoretical model is health-seeking behavior. It is a major challenge experienced by many people. Preventive care has not been maximized due to people’s inability to seek and pursue health care as needed. However, the theory of comfort has a perception that institutional integrity has an impact on health-seeking behavior (Wu et al., 2022). Therefore, it is high time the healthcare stakeholders can revise and establish the best policies and practices that can enhance health-seeking behavior.
Kolcaba’s theory of Comfort is highly applicable in practice because the concepts are more practical. The theory is also appropriate in almost all healthcare settings. This theory is applicable in pain reduction to obtain physical comfort. Prescribed medications and other non-pharmacological interventions are administered to control pain (Wu et al., 2022). This theory supports consideration of the patient’s history when developing interventions. Here, the care providers examine intervening variables, which may include age, past experience, support system, and others. Therefore, the theory of comfort is applicable in practice. The strength of the theory is that it is easily applicable in practice (Petiprin, 2020). Besides practicality, it is relevant to almost all healthcare settings. The theory encourages nurses to focus on interventions that bring comfort. Its weakness is that the theory does not essentially bring anything new to the understanding of care (Petiprin, 2020). Many actions that may be proposed by the theory in a given case can be as well proposed by one of many other nursing theories that address patient comfort.
The Use of Theory in Clinical Practice
Based on the available literature, the theory of comfort can be utilized in clinical practice in various ways. Khaleghi et al. (2022) carried out a study aimed at investigating the effect of the Comfort Theory on pain, distress, and hemodynamic parameters in infants following heart surgery. The results of this study indicated that the comfort theory model is effective in improving pain and distress in children. Khaleghi et al. (2022) recommended that nurses in pediatric care should utilize the theory after cardiac surgery to reduce pain and distress. Wu et al. (2022) also stated that comfort theory could be implemented in neurology and general surgery departments. Nurses can utilize the theory by providing patients with appropriate psychological and psychosocial counseling in a timely manner. Comfort is also provided in preoperative, intraoperative, and postoperative periods. Awal (2017) states that pain reduction and managing anxiety are examples of comfort theory in clinical practice.
Evaluation of the Theory
Kolcaba’s Theory of Comfort is widely applicable in practice because making a patient comfortable is one of the major goals of nursing. Pain reduction is a very common aspect of the theory that is widely practiced and prioritized in all healthcare facilities (Petiprin, 2020). Patients will experience the three types of comfort based on the intervention provided. One challenge is that the nurse has to develop their own method of care to achieve the patients’ comfort. The theory does not provide a standard of operation for achieving comfort. However, this is not very challenging because healthcare professionals are skilled and care standards are already available (Petiprin, 2020). This theory would be made more usable by doing further research to learn more about its applicability in clinical practice.
Conclusion
Nursing theories provide a unique meaning to the discipline. There are several nursing theories categorized as grand nursing theories, middle-range nursing theories, and practice-level nursing theories. Kolcaba’s Theory of Comfort is a middle-range theory. The major concepts of the theory include healthcare needs, nursing interventions, intervening variables, health-seeking behavior, enhanced comfort, and institutional integrity. This theory has been discussed per the questions needed for the completion of this assignment.
References
Awal, A. A. (2017). Application of Katharine Kolcaba comfort theory to nursing care of patient. Int J Sci Res Publ [Internet], 7(3), 104-7. https://www.ijsrp.org/research-paper-0317/ijsrp-p6314.pdf
Khaleghi, M., Fomani, F. K., & Hoseini, A. S. S. (2022). The effect of the comfort care model on distress, pain, and hemodynamic parameters in infants after congenital heart defect surgery. Journal of Neonatal Nursing. https://doi.org/10.1016/j.jnn.2022.03.004
Petiprin, A. (2020). Kolcaba’s Theory of Comfort. https://nursing-theory.org/theories-and-models/kolcaba-theory-of-comfort.php
Wu, L., Chen, Y., Zhang, J., & Yu, H. (2022). Review on Comfort Nursing Interventions for Patients Undergoing Neurosurgery and General Surgery. Evidence-Based Complementary and Alternative Medicine, 2022. https://doi.org/10.1155/2022/6735054
WGU. (2021). Understanding Nursing Theories. https://www.wgu.edu/blog/understanding-nursing-theories2109.html