Comfort PPT

The Comfort Theory and
Care of Patients in the
Perioperative Area: Theory
Guiding Practice
Allison Kathleen Peters
University of Central Florida
 Comfort Theory Model Designed by Katherine
 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)
 Patients that present to surgery are usually
 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
(McCance & Huether, 2006)
(Gilmartin & Wright, 2008)
 Heightened anxiety can lead to poor surgical
 Decreased healing
 Nurses need to recognize anxiety and provide
comfort measures
Feelings experienced:
 Uncertainty
 Relationship between danger or threat
 Ambiguousness
 Fear
 Communication
 Control of environmental factors (light, noise,
 Patient control (encouraging feedback, using
pain scale, control of environment via RN)
(Kagan & Bar-Tal, 2008)
(Smith & Liehr, 2008)
Specific Aims
 Raise nurse awareness of comfort levels
 Facilitation of comforting environment
Physical Needs: Oxygenation,
thermoregulation, pain relief
Socio comfort: Cultural sensitivity, positive
body language, caring
Environmental: Orderly, quiet, safe
(Kolcaba & DiMarco, 2005)
• A nursing art entailed by comforting actions
performed by the nurse for enhanced patient
• 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)
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
 Not warming can lead to complications such as
impaired wound healing, increased blood loss,
cardiac arrest and increased wound infection
(Burger & Fitzpatrick, 2009).
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)
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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