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The Nursing Theorist Comparison

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The Nursing Theorist Comparison

The Nursing Theorist Comparison

Nursing theories refers to organized knowledge bodies to define nursing concerning what it is, what it does, and why it is done. Nursing theories involve a framework of purposes and concepts meant to guide nursing practice at level that is more concrete and specific. Kolcaba’s comfort theory is a middle range theory, and it explains comfort as a need fundamental to all humans for ease, relief, or distinction arising from stressful healthcare situations. Sister Callista Roy’s adaptation model, on the other hand, explains nursing provision and sees the individual as a series of interrelated systems struggling to balance between different stimuli. Nursing and medicine are separate disciplines as the former uses its body knowledge to deliver care. This essay will distinguish two nursing theories, Kolcaba’s comfort theory and Sister Callista Roy’s adaptation model. (Thesis///).

Overview of Kolcaba’s Comfort Theory

The Kolcaba’s theory of comfort shades light on the importance and role of nurses in ensuring patients are comfortable and well cared for. Nurses identify their patient’s unmet needs, as well as those of their families, and modify them by mediating unchangeable variables (such as a diagnosis or poverty). Nurses are required to assess the comfort needs of patients through a nursing care plan that focuses on meeting those needs. The comfort of the patients can improve their outcomes as it ensures they feel better mentally and emotionally through health seeking behaviors (HSB). The goals of HSB are mutually agreed upon and can either be internal, external, or a peaceful death.

 

 

Overview of Sister Callista Roy’s adaptation model

Sister Callista Roy’s adaptation model is grand nursing theory that involves a conceptual framework focusing on the comprehensive and interconnected individuals and how they interact with the environment. In her theory, the human adaptive system pertains a whole with separate parts that uniformly function to perform some purpose. The theory perceives adaptation as the outcomes observed when reactions to environmental changes experienced positively. Roy’s adaptation model is based on the contention that one’s adaptive ability is a positive response for maturity and life development concerning their quality of life as well as physical needs.

Concepts of Kolcaba’s Comfort Theory

This middle-range nursing theory emphasizes three forms of comfort among patients; ease, transcendence, and relief. Relief comfort takes place in the form of pain management, and nurses can manage it through medications. Ease comfort, on the other hand, is concerned with the patient’s psychological and environmental state. Lastly, transcendence comfort is concerned with the patient’s ability to overcome challenges related to care and recovery. The comforts take place in four contexts: psycho-spiritual, physical, environment, social, and environmental. The physical state pertains to homeostatic mechanisms, bodily sensations, and immune functions, to mention a few. The environmental state pertains to the external background related to human experience, including sound, color, light, and temperature. The psycho-spiritual state is concerned with the patient’s internal awareness of self, such as sexuality, identity, and esteem. Finally, the sociocultural state pertains to family, interpersonal, and societal relationships.

 

 

Concepts of Sister Callista Roy’s adaptation model

Roy’s model is made up of four key concepts; the person, environment, health, and nursing. The person concept is perceived as a bio-psycho-social being that constantly interacts with a changing environment. The person uses acquired and innate mechanisms to adapt, and it includes individuals and groups (families, communities, and organizations). The health concept is represented by a health-illness sequence which make it an inevitable dimension in one’s life. Roy also perceives health as a process and state of being whole. The environment concept is further divided into three components; focal, contextual, and residual. The focal component pertains internal or external factors that confronts the person immediately. The contextual component refers to all stimuli that is in the current situation and contributes to the impacts of the focal stimuli. The residual component, on the other hand, refers to the unclear effects in the current situation. Nursing is represented both as an art and as a science. Nursing includes clinical and basic nursing science as it aims to understand why and how. As an art, the theory represents nursing by expressing and understanding the realities of life.

Background of Kolcaba’s Comfort Theory

            The theory was developed by Katherine Kolcaba in the 1990s and it aims at placing comfort as the center of patient care. Katherine Kolcaba developed the theory after conducting concept analysis of comfort based on literature from disciplines like medicine, nursing, ergonomics, psychology, and English. A taxonomic structure was developed to guide the measurement, assessment, and evaluation of patient’s comfort based on the three comfort forms and four states of comprehensive human experience. Kolcaba also defines key elements of her theory, including health care needs, which is defined as the needs that patients or families identify in a certain setting of nursing practice. Another key element defined are health seeking behaviors (HSB), which are the patient’s behaviors in their quest to find health.

Background of Sister Callista Roy’s adaptation model

            Roy’s adaptation model of nursing was developed in 1976, in collaboration with Dorothy E. Johnson, hence convincing her of the essence of describing the nature of nursing mainly as a service to others. Roy began organizing her nursing theory after developing the course curriculum for students at Mount St. Mary’s College. Her ideas were introduced as based on the integrated nursing curriculum, and was influenced by factors like religious background, education, family, and clinical experience. Roy proposes that humans are stimulated by changing environments that nurses have the role to promote adaptation in health and illness situations and to promote the interaction with the environment. Roy also proposes that human being are adaptive systems that are growing and developing constantly with the environment.

Philosophical Underpinnings of Kolcaba’s Comfort Theory

            Kolcaba’s comfort theory is based on three core levels; relief, stress, and transcendence. Patients are considered to be individuals, families, or communities that need health care. Nurses are required to identify and meet the needs of the patients which are yet to be met, and modify them by intervening variable factors and formulating a comfort care plan. Kolcaba suggests that when the comfort of patients is enhanced, they can fully engage in health seeking behaviors either consciously or subconsciously. The theory assumes that when the patient does better, the healthcare institution also does better through improved measures of patient satisfaction.

Philosophical Underpinnings of Sister Callista Roy’s adaptation model

            Roy’s adaptation model is grounded on two main beliefs, veritivity and humanism. Veritivity refers to the state of being true, while humanism is a philosophical poise emphasizing the value of humans both individually and collectively. Both ideas help define the adaptation model more precisely with a theocentric focus and anthropological values related to veritivity. According to the theory, Roy perceives humans as people in a community with a loving God and with others as well. Roy discusses freedom, moral ends, and truth in terms of contemporary values and veritivity. Roy adaptation model also incorporated several concepts from the adaptation-level theory of perception from Harry Helson, and American psychologist. The adaptation philosophy is significant in Roy’s framework as it involves the relationship between people, families, organizations, and societies. Nurses are required to play their role healthcare by supporting patients in their adaptive process.

Assumptions of Kolcaba’s Comfort Theory

            The major assumptions of Kolcaba’s comfort theory is that human beings have comprehensive responses to complex and multiple stimuli. The theory also assumes that patients with the power to take part in their own health-seeking behaviors have better perspectives concerning their health. Moreover, Kolcaba believes that humans strive to achieve comfort needs, and the process is continuous. Another assumption of the theory is that meeting comfort needs of a patient can strengthen their desire to engage in their own health-seeking behaviors. Lastly, the theory assumes that an institution has integrity when its care is based on a set of values centered on the patients.

Assumptions of Sister Callista Roy’s adaptation model

            Roy’s adaptation model makes several explicit assumptions. One of the explicit assumptions is that the person component constantly interacts with a changing environment and that the person is a bio-psycho-social being. The person uses both acquired and innate coping mechanisms (of psychosocial, biological, and social origin) to cope with the changing world. Roy believes that one’s adaptation is a function of the stimulus they are exposed to as well as their level of adaptation. The theory also assumes that the person has four adaptation modes: self-concept, role function, psychological needs, and interdependence. Implicit assumptions made by Roy’s theory is that a person can be for the purposes of study and care, a person can be reduced to parts. Another implicit assumption is that the opinions and values of a patient should be respected and considered.

Relationships of the Two Theories

            A therapeutic relationship is portrayed by both theories concerning their ideas and assumptions. Both theories emphasize the need for patient centered care to improve the patient’s outcome and quality of care. Both theories also involve the concept of environment and its effect on the patient’s well-being. Consequently, the approaches used in implementing both theories need to consider environmental impacts to the care and recovery. The family component is also emphasized in both theories as being essential to the adaptation and health of individuals. As such, nurses should be in the frontline to involve the family in the patient’s care, based on evidence-based practices, to improve the well-being of the patient.

Applications of Kolcaba’s Comfort Theory in Clinical Setting

Kolcaba’s theory of comfort can be applied in the clinical setting on various situations. In the first place, the theory can be applied in pain reduction to enhance physical comfort. Control of pain can be done by prescribing and administering medication in the clinical setting. Healthcare professions can change the patient’s position to release pressure caused by bony prominence. Muscle spasms can also be minimized by placing a light sand bag on the patient’s residual limb, thus improving their physical comfort. Psycho-social comfort can also be increased among patients by encouraging them to disclose their interpersonal and social conflicts, and gradually exposing them to strategic body changes.

Applications of Sister Callista Roy’s adaptation model in Clinical Setting

The theory can be applied when assessing the behaviors of the patient and the stimuli affecting them. Nurses can then make a diagnosis of the patient’s adaptive state and set goals to promote them. After the setting achievable goals, nurses can develop interventions to manage the stimuli and enhance adaptation. The process of promoting the patient’s health based on the theory is more likely to be fruitful since the nurse manipulates the stimuli instead of the patient. Roy’s adaptation model can also be applied in the cardiac care unit (CCU) by identifying, assessing, and reinforcing the patient’s positive behavior to speed up their recovery.

Comparison of the Theories in Nursing Practice

            Roy’s adaptation model and Kolcaba’s theory of comfort are useful in improving nursing practice and the health of the patient. Moreover, they encourage nurses to include the patient’s family in healthcare to improve their outcomes. The focus of both theories, however, are not in line. Kolcaba’s comfort theory emphasizes more on the need for healthcare professionals to provide patient’s comfort to improve their outcome and improve the institution’s satisfaction rating. Healthcare professionals are, therefore, required to provide patient-centered care to all, with their comfort as a priority. On the contrary, Roy’s adaptation model focuses more on one’s adaptation, which is a function of the stimulus they are exposed to as well as their adaptation levels. Healthcare professionals are required to employ critical thinking while making assessments of behavior and stimuli and make a proper diagnosis based on the patient’s adaptive behaviors. Healthcare professionals are also required to make interventions that promote positive adaptive behavior of the patient.

Parsimony

            Roy’s adaptation model can be appropriate in nursing practice, thanks to its use of well-defined and logical concepts that guide nursing practice. The theory, however, requires a thorough definition of nursing diagnoses and categorization of the interventions for it to be more applicable in nursing practice. Roy’s adaptation model is based on four main concepts; nursing, person, health, and environment. Other sub-concepts include cognator and regulator, and four other modes, including self-concept, physiological, interdependence, and role factor. The main concepts of the theory can be understood but the use of other several sub-concepts makes the model difficult to grasp at first thus reducing the parsimony. The recognition of a supreme being also reduces its parsimony since not all people in the world believes in the existence of a supreme being.

Kolcaba’s theory of comfort is also vital in nursing practice as it emphasizes the importance of comfort as key to improving the patient’s outcome. The theory, however, has limited research on the concept of comfort and its meaning. The concept of comfort might need more elaboration and teaching, especially to individuals who do not come by the skill of giving comfort naturally. Moreover, the increasing patient-nurse ratios makes nurses to be uncomfortable in their work environments.

Conclusion

Both theories are significant in nursing practice and can positively impact the outcome of patients when appropriately applied. The comfort and adaptation theories have several similarities, including the emphasis on patient-centered care as well as the need to include the patient’s family and community in their healthcare. The comfort theory can improve nursing practice and nurses are required to assess the comfort needs of patients through a nursing care plan that focuses on meeting those needs. The adaptation theory, on the other hand, can be applied by nurses as they make a diagnosis of the patient’s adaptive state and set goals to promote them by developing interventions to manage the stimuli and enhance adaptation. Both models are vital in nursing practice and all nurses should apply it in their practice. Healthcare institutions should also play their role in providing a reliable patient-nurse ration to facilitate the comfort of more patients to improve their outcomes and the institution’s satisfaction ration.

 

 

 

 

 

 

 

 

 

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